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Daunorubicin, doxorubicin, idarubicin and epirubicin

Daunorubicin, doxorubicin, idarubicin and epirubicin are chemotherapy medicines used to treat certain types of cancer and leukaemia.

How are daunorubicin, doxorubicin, idarubicin and epirubicin given?

Each drug is given as an infusion through a cannula (intravenously or IV), into a vein, central venous catheter, implantable port or PICC line.

What are the side effects?

Nausea and vomiting

Anti-sickness drugs can be given to reduce or prevent these symptoms. Please tell your doctor or nurse if your child’s sickness is not controlled or persists.

Discoloured urine

These drugs may make your child’s urine turn an orange or red colour for a day or two after the drug is given. This is due to the colour of the drug. This is temporary and has no lasting effects.

Hair loss

Your child may lose some or all of his or her hair, including eyebrows and eyelashes. This is temporary and the hair will grow back once the treatment has finished.

Bone marrow suppression

There will be a temporary reduction in how well your child’s bone marrow works. This means he or she may become anaemic, bruise or bleed more easily than usual, and have a higher risk of infection. Your child’s blood counts will be checked regularly to see how the bone marrow is working. Please tell your doctor if your child seems unusually tired, has bruising, bleeding or any signs of infection, especially a high temperature.

Mouth sores and ulcers

You will be given advice about appropriate mouthcare including a copy of the mouthcare leaflet. If your child complains of having a sore mouth, please tell your doctor or nurse.

Changes in heart function

In some cases, these drugs may affect the muscle of your child’s heart and how well it works. Before having any of these drugs, your child will have a test called an echocardiogram (ECHO). This test will also be used to monitor the heart during the course of treatment and at long-term follow up clinics. The total amount of these drugs will be carefully calculated to minimise the risk of heart damage.

Flush/ache along vein

If these drugs are given into a vein, using a cannula, a red flush may appear along the path of the vein. This is temporary and will fade over time.

Changes in nails

Your child’s nails may become darker. Your child’s nail growth will return to normal in the future.

Inflammatory skin reaction

Sometimes these drugs may cause your child’s skin to become red and sore in the areas that have already been treated with radiotherapy.

Interactions with other medicines

Some medicines can react with daunorubicin, doxorubicin, idarubicin and epirubicin, altering how well they work. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines.

Important information you should know about daunorubicin, doxorubicin, idarubicin and epirubicin:

  • If these drugs leak into the tissues underneath your child’s skin, they can damage the tissue in this area.
  • If any of these drugs are given through a cannula, and your child complains of stinging and burning around the cannula, please tell your doctor or nurse immediately.
  • If any other these drugs are given through a central venous catheter or implantable port and your child complains of pain around their chest or neck, please tell your doctor or nurse immediately.

More information

  • Great Ormond Street Hospital (GOSH) switchboard: 020 7405 9200

  • Pharmacy department: 020 7829 8680

  • Pharmacy medicines information: 020 7829 8608

Last reviewed by Great Ormond Street Hospital: June 2013

Ref: 2013F0739 June 2013

Compiled by the Pharmacy department in collaboration with the Child and Family Information Group

Please read this information in conjunction with any patient information leaflet provided by the manufacturer. However, please note that this information explains about the use of medicines in children and young people so may differ from the manufacturer’s information.

Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned. This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.