Idarubicin (Intravenous route)
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Administer slowly into a freely flowing intravenous infusion. If extravasation occurs during administration, severe local tissue necrosis will occur; never administer via IM or subQ routes. Administer only under the supervision of a physician who is experienced in leukemia chemotherapy and in facilities that can monitor for drug tolerance and toxicity. The physician and institution must be able to respond to severe hemorrhagic conditions or overwhelming infection. Like other anthracyclines, idarubicin hydrochloride injection can cause myocardial toxicity leading to congestive heart failure. Cardiac toxicity is more common in patients who have received prior anthracyclines or who have preexisting cardiac disease. Severe myelosuppression will occur with idarubicin hydrochloride when used at therapeutic doses and dose reductions are required for patients with impaired hepatic or renal function
Uses of This Medicine:
Idarubicin injection is used in combination with other medicines to treat acute myeloid leukemia (AML) in adults.
Idarubicin belongs to the group of medicines known as antineoplastics. It seems to interfere with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by idarubicin, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.
Before you begin treatment with idarubicin, you and your doctor should talk about the benefit as the risks of using this medicine.
Idarubicin is to be given only by or under the direct supervision of your doctor.
Before Using This Medicine:
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of idarubicin injection in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of idarubicin injection in the elderly. However, elderly patients are more likely to have congestive heart failure, arrhythmias, chest pain, or heart attack which may require caution in patients receiving this medicine.
|All Trimesters||D||Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.|
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Influenza Virus Vaccine, Live
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine
- Yellow Fever Vaccine
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems—
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Anemia or
- Arrhythmia (heart rhythm problem) or
- Bone marrow depression or
- Congestive heart failure or
- Heart or blood vessel disease (eg, cardiomyopathy, pericarditis, myocarditis)—Use with caution. May increase risk for heart problems caused by idarubicin.
- Bone marrow suppression caused by other medicines or radiation—Should not be used in patients with this condition, unless your doctor says it is okay.
- Gout or
- Kidney stones—Idarubicin may increase levels of uric acid in the body, which can cause gout or kidney stones.
- Infection—May decrease your body's ability to fight infections.
- Kidney disease or
- Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Proper Use of This Medicine:
A nurse or other trained health professional will give you this medicine in a hospital or cancer treatment center. This medicine is given through a needle placed in one of your veins. The medicine must be injected slowly, so your IV tube will need to stay in place for 10 to 15 minutes every day for 3 days.
Idarubicin is sometimes given together with certain other medicines. If you are receiving a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your doctor to help you plan a way to take them at the right times.
While you are receiving this medicine, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.
Idarubicin often causes nausea and vomiting. However, it is very important that you continue to receive it, even if you begin to feel ill. Ask your doctor for ways to lessen these effects.
This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.
Precautions While Using This Medicine:
It is very important that your doctor check you closely to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
Check with your doctor right away if you have chest pain or discomfort, fast or irregular heartbeat, swelling of the feet and lower legs, or troubled breathing after receiving this medicine.
Idarubicin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
- Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
- Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injury could occur.
If idarubicin accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell your right away if you notice redness, pain, or swelling at the injection site.
While you are being treated with idarubicin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Idarubicin may lower your body's resistance, and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Side Effects of This Medicine:
- More common
- Black, tarry stools
- bleeding gums
- blood in the urine or stools
- coughing up blood
- cough or hoarseness
- difficulty with breathing or swallowing
- fever or chills
- increased menstrual flow or vaginal bleeding
- lower back or side pain
- painful or difficult urination
- pinpoint red spots on the skin
- prolonged bleeding from cuts
- red or dark brown urine
- red or black, tarry stools
- sores in the mouth and on the lips
- unusual bleeding or bruising
- Less common
- Fast or irregular heartbeat
- joint pain
- pain at the injection site
- swelling of the feet and lower legs
- Skin rash or hives
- stomach pain (severe)
- More common
- Abdominal or stomach cramps
- nausea and vomiting
- Less common
- Darkening or redness of the skin (after x-ray treatment)
- numbness or tingling of the fingers, toes, or face
- Fast or irregular heartbeat
- shortness of breath
- swelling of the feet and lower legs
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Last Updated: 9/4/2017