Epirubicin: Effects, Uses & Risks

Epirubicin is a widely used organic substance that is primarily used as a hydrochloride in the course of chemotherapy to treat cancer. Preparations containing epirubicin are fundamentally toxic and are therefore referred to as cytostatic drugs. The main uses of epirubicin include treatment of breast cancer, stomach cancer, and advanced cancers of the skin, tendons, muscles, or ligaments.

What is epirubicin?

The pharmacological agent epirubicin is used in human medicine to treat various cancers. The substance forms an essential part of the chemotherapy to be administered for breast cancer, stomach cancer, and advanced cancers of the muscles, tendons, ligaments, or skin. Epirubicin is usually administered in the hydrochloride form and forms the component of many cytostatic drugs. A cytostatic is a fundamentally toxic substance that is used as a drug to treat cancer because of its potent effects. Epirubicin has the chemical molecular formula C 27 – H 29 – N – O 11. However, the hydrochloride form used in preparations for therapy is described by the molecular formula C 27 – H 29 – N – O 11 – H – Cl. Epirubicin inhibits cell division as well as the formation of genetic material of cancer cells. It also prevents the formation of nucleic acids. Since epirubicin is administered to perform chemotherapy, it is given intravenously as an infusion solution. The purpose of treatment may be curative (to cure) or merely palliative (to relieve symptoms), depending on the severity of the cancer.

Pharmacologic action

Epirubicin is one of the cytostatic drugs. Thus, the substance itself is highly toxic. The hydrochloride form used in therapy inhibits RNA and DNA polymerase by binding non-covalently to DNA. Due to this non-covalent binding, complete failure of DNA and RNA synthesis occurs, eventually causing apoptosis of the cancer cells. Apoptosis is understood to be controlled cell death that is driven by gene expression and does not cause an inflammatory response. Epirubicin thus kills cancer cells and prevents them from proliferating or spreading the cancer. Medical studies have shown that the drug rapidly penetrates cancer cells and concentrates around the nucleus. Therefore, epirubicin is effective against many different forms of cancer. These include stomach and breast cancers, as well as cancers of the skin, muscles, ligaments, tendons and bronchi. Epirubicin can also be given to fight bladder cancer.

Medical use and application

Because of its highly toxic effect on cells, epirubicin forms the main effective component of many cytostatic drugs. Preparations containing the substance are therefore administered to effectively combat various forms of cancer. This is achieved through comprehensive chemotherapy, which can be guided by curative or palliative considerations. Here, epirubicin is administered intravenously as an infectious solution under constant medical supervision to specifically kill cancer cells. For the treatment of bladder cancer, the active ingredient can also be administered directly into the urinary bladder to enable precisely controlled therapy. Because of its toxic effects and its intended use as chemotherapy, epirubicin is administered only by healthcare professionals. Patients cannot purchase and use the substance themselves at pharmacies.

Risks and side effects

Because of its fundamentally toxic effect on cells, therapy with epirubicin causes severe side effects. This is typical of cytostatic drugs, as they can affect other cells in addition to the targeted cancer cells, resulting in a massive weakening of the [[immune system]]. The most common side effects include severe hair loss and gastrointestinal complaints. These usually manifest as nausea, vomiting, diarrhea, stomach cramps, persistent loss of appetite, and abdominal pain. Skin reactions such as itching, redness or rashes of various degrees are also not uncommon. Patients treated with cytostatic drugs such as epirubicin also report a strong feeling of fatigue as well as general listlessness and weakness.In addition, the treatment can also trigger disease of the heart muscle (myocardium), which is

responsible for the mechanical and electrophysiological functional control of the heart. Experts then refer to this as cardiomyopathy. Common side effects of epirubicin also include the development of anemia, as well as bone marrow depression and the development of neutropenia or thrombocytopenia.