Idarubicin (Intravenous)

Overview

Classified as a disorder of the myeloid line of blood cells, acute myeloid leukemia (AML) can progress very quickly and may be fatal if it is left untreated. When acute myeloid leukemia occurs, the abnormal and increased growth of the myeloid line of blood cells causes them to accumulate within the patient's blood and bone marrow. As a result, the functioning of normal cells is impaired and the cancer cells are able to replicate and spread further.

When patients are affected by this condition, they can experience a number of symptoms. In most cases, patients bruise or bleed easily when suffering from acute myeloid leukemia and they can also suffer from shortness of breath and extreme fatigue, as well as having an increased risk of contracting an infection.

In order to treat acute myeloid leukemia, Idarubicin is administered intravenously. As an anthracycline and antileukemic drug, Idarubicin is an anti-cancer medication. When administered to the patient, Idarubicin inserts itself into the DNA of cells. By interfering with the topoisomerase II enzyme, Idarubicin prevents the cell from replicating and allows the body to attack and kill the cell. As well as preventing the cancer cells from increasing and spreading, Idarubicin can enable the body to kill the cells and, therefore, help to rid the patient's body of the cancer.

Although Idarubicin can be effective in treating cancer cells, it also has an effect on normal, healthy cells. Due to this, patients can experience serious side effects while being treated with Idarubicin and these adverse effects may continue for months or years after treatment has been completed. In some cases, patients can experience permanent side effects as a result of being treated with Idarubicin and similar antineoplastic drugs.

However, acute myeloid leukemia is a life-threatening condition so the benefits of using Idarubicin to treat the condition normally outweigh the risks of leaving the patient untreated. While Idarubicin can be used in isolation, it is often used in conjunction with other anti-cancer drugs, in order to increase the efficacy of the patient's treatment.

Conditions Treated

Type Of Medicine

  • Antineoplastic
  • Anthracycline
  • Antileukemic

Side Effects

Although side effects can occur when patients take any type of medicine, it's extremely common for patients to experience adverse effects when being treated with anti-cancer medications. While some side effects require immediate medical attention, others can be receptive to self-treatment. Before receiving Idarubicin, patients should discuss the possibility of side effects with their physician. Often, doctors are able to provide advice and information regarding how these side effects can be reduced.

If patients experience the following side effects when being treated with Idarubicin, they may not require immediate medical attention:

  • Stomach or abdominal cramps
  • Tingling or numbness of the face, toes or fingers
  • Diarrhea
  • Nausea or vomiting
  • Headache
  • Redness or darkening of the skin (after x-ray treatment)

Although the above side effects may not require medical intervention if they are fairly mild, patients should seek medical help if their side effects are severe or prolonged.

Patients will also need to obtain immediate medical attention if they experience any of the following side effects after being treated with Idarubicin:

  • Tarry, black stools
  • Chills
  • Bleeding gums
  • Fever
  • Pain at the injection site
  • Joint pain
  • Blood in the stools or urine
  • Increased vaginal bleeding or menstrual flow
  • Dizziness
  • Coughing up blood
  • Hoarseness or cough
  • Difficulty with swallowing or breathing
  • Pain in lower back or side
  • Difficult or painful urination
  • Rash on the skin
  • Nosebleeds
  • Hives
  • Dark brown or red urine
  • Severe stomach pain
  • Paralysis
  • Red, pinpoint spots on the skin
  • Unusual bruising or bleeding
  • Prolonged bleeding from cuts
  • Sores on the lips or in the mouth
  • Red, tarry or black stools
  • Irregular or fast heartbeat
  • Swelling of the lower legs or feet

If patients experience any other side effects when being treated with Idarubicin, they should also obtain medical help.

Patients should be aware that the side effects associated with Idarubicin can continue for some time after their treatment has finished. If patients experience any of the above side effects following their treatment, they should still seek medical attention.

Dosage

When adult patients are treated with Idarubicin, they are usually given 12mg per meter of body surface area. Although Idarubicin is delivered intravenously, it should be administered fairly slowly over ten to fifteen minutes and medication should be given over a period of three days. In most instances, patients will also be given Cytarabine when they are being treated with Idarubicin.

Although this is an example of the standard treatment regime with Idarubicin, every patient will be assessed individually. Their dose or treatment may differ, depending on their medical history, current condition, age, weight and existing medications they are using.

As Idarubicin is delivered intravenously, patients will be given this medicine in a clinical setting, such as at a treatment center or hospital. Patients will not, therefore, have to calculate their own dose of Idarubicin or administer the medication.

However, Idarubicin does need to be administered on a fixed schedule and should be given over a period of three days. If patients believe they are going to miss a treatment appointment, they should contact their physician immediately.

While patients are being treated with Idarubicin, they may experience nausea, vomiting or other side effects. Although it's important that treatment is continued, patients should notify their healthcare practitioner if they are feeling unwell during or following the treatment.

Physicians may advise patients drink additional fluids while they are being treated with this medicine. Drinking extra water will increase urination and help to keep the patient's kidneys in good working order while they are being treated.

As patients may be taking other medicines while being treated with Idarubicin, they should ask their physician to assist them in creating a treatment schedule. Other medicines may have to be taken at specific times, depending on when Idarubicin has been administered, so it's essential that patients are aware of how and when to take their medication.

Potential Drug Interactions

As some medicines interact with others, patients may need to modify existing medication schedules when they are being treated with this medicine. Idarubicin is not normally used in conjunction with the following medicines, for example:

Furthermore, taking the following medicines alongside Idarubicin is not normally advised:

  • Adenovirus vaccine
  • Yellow fever vaccine
  • Live bacillus of Calmette and Guerin vaccine
  • Live poliovirus vaccine
  • Trastuzumab
  • Live cholera vaccine
  • Live influenza virus vaccine
  • Typhoid vaccine
  • Smallpox vaccine

Before being given Idarubicin, patients should tell their doctor if they are using any other medicines, supplements or vitamins. In addition to this, patients will need to obtain medical advice before using any medicines, vitamins or supplements once they have begun treatment with Idarubicin.

Warnings

If patients have other medical conditions in addition to acute myeloid leukemia, their treatment with Idarubicin may be affected. Due to this, patients should discuss their medical history and current conditions with their physician before they are treated with this medicine. The following conditions, in particular, may be relevant to treatment with Idarubicin:

The safety of Idarubicin for pediatric patients has yet to be confirmed so, due to this, infants and children are not usually treated with this medicine.

Although geriatric patients can be given Idarubicin, they may have age-related conditions that could affect treated. In addition to this, older patients are more likely to have congestive heart failure and arrhythmia, which may affect their treatment with Idarubicin.

When patients are being treated with Idarubicin, they will need to have regular check-ups with their physician. Urine and blood tests will also need to be carried out on a regular basis to assess whether the medication is working as intended.

For one or two days after Idarubicin has been administered, the drug may turn the patient's urine red. Normally, this is not a cause for concern, but patients should obtain medical advice if this side effect persists or if they are concerned about it.

Although Idarubicin can be effective in treating acute myeloid leukemia, it may lower the patient's white blood cell count or the level of platelets in their blood. Due to this, patients may be more likely to bleed or bruise while being treated with Idarubicin and they may be more prone to infections and illnesses.

Patients should, therefore, try and avoid mixing with people they know are unwell and should obtain immediate medical assistance if they begin to feel unwell themselves. In addition to this, patients should take extra care to avoid suffering an injury, cut or bruise. Patients may adopt a new oral hygiene routine to help prevent bleeding gums, for example, or avoid crowds so that they do not risk being hurt by other people.

When Idarubicin is administered, it should go straight into the patient's vein. If any of the medicine leaks out onto the surrounding tissue or skin, it may cause damage or scarring. If patients notice that the medication is leaking or isn't flowing directly into the vein during their treatment, they should notify a healthcare practitioner immediately. Similarly, patients should notify their physician if they experience swelling, redness or pain at the site of the injection.

When patients are being treated with Idarubicin, they should not have any vaccinations or immunizations unless their doctor has expressly authorized it. As patients are more prone to infections when being treated with Idarubicin, they may contract the disease that the vaccination is intended to prevent, if live vaccines are used.

Furthermore, people living in the patient's household should not take the oral polio vaccine, as there is a risk they could pass the virus on to the patient. If this is unavoidable, the patient should avoid contact with them and use a face mask to reduce the risk of contracting the virus.

If patients experience any of the following symptoms after being treated with Idarubicin, they should notify their doctor immediately:

  • Troubled breathing
  • Irregular or fast heartbeat
  • Chest discomfort or pain
  • Swelling of the lower legs or feet

If patients are due to undergo any medical tests, procedures or dental work, they must notify the relevant healthcare practitioner of their treatment with Idarubicin.

If pregnant patients are treated with Idarubicin, it may cause serious harm to the unborn fetus and may result in a miscarriage occurring. However, if patients are suffering with life-threatening acute myeloid leukemia, the benefits of beginning treatment may outweigh the risks. If patients become pregnant while being treated with Idarubicin or soon after, they should contact their physician immediately.

Both male and female patients should use effective birth control while they are being treated with Idarubicin and for some time after treatment has finished. Patients should seek medical advice before trying to conceive once they have been treated with Idarubicin, even if their treatment occurred some time ago. As Idarubicin may affect fertility, patients should discuss whether they hope to have children with their physician before their treatment begins.

If patients breastfeed while taking medication, there is a chance that it could be passed on to the infant and may cause them harm. Due to this, patients are usually advised not to breastfeed while they are being treated with Idarubicin. Patients should obtain medical advice before breastfeeding, even if they were treated Idarubicin in the past.

Before patients begin treatment, they should tell their doctor if they have any known allergies. In rare cases, patients may develop an allergic reaction when they are being treated with Idarubicin. If so, they will require emergency medical treatment. An allergic reaction may include the following symptoms:

  • Wheezing
  • Difficulty breathing
  • Hives
  • Rash on the skin
  • Itching
  • Hoarseness
  • Difficulty swallowing
  • Welts
  • Swelling of the hands, face, lips, tongue, throat or mouth

Storage

The manufacturer's instructions should be followed when storing Idarubicin. This medicine can normally be kept at a controlled room temperature, but will need to be protected from the light.

As Idarubicin is only administered in a clinical setting, patients will not be required to handle or store this medication.

Summary

When patients are diagnosed with acute myeloid leukemia, it's important that treatment is commenced as quickly as possible. As acute myeloid leukemia can be a particularly aggressive type of cancer, patients have the best chance of survival if a diagnosis is made early and treatment is started immediately.

Although treatment with Idarubicin and other anti-cancer drugs does carry some risks, it can be effective in treating the patient's condition. While physicians will monitor the patient thoroughly to try and prevent any harmful effects occurring, it is likely that patients will experience some side effects during treatment.

However, acute myeloid leukemia is life-threatening and, without treatment, it may be fatal. Due to this, the benefits of treatment with Idarubicin generally outweigh the risks. With careful monitoring and regular testing, physicians can try to minimize the risk of the patient suffering long-term side effects as a result of the treatment and can use Idarubicin to successfully treat the patient's condition.