Valrubicin (Intravesical)

Used to treat bladder cancer, Valrubicin is a chemotherapy drug and is routinely administered via a catheter. Prescribed at regular intervals, Valrubicin is often prescribed on a weekly basis.

Overview

Commonly used as a form of chemotherapy, Valrubicin is prescribed to patients who have been diagnosed with cancer of the bladder. Administered via intravesical installation, the medication reaches the bladder directly, via the use of a urinary catheter.

Once the appropriate dose of Valrubicin has been delivered, the patient is normally advised to move around and change positions. This enables the medication to reach all areas of the bladder and, as a result, should increase the efficacy of the treatment.

Considered to be an anti-tumor antibiotic, Valrubicin works by halting cell division. When the RNA or DNA of the cell is damaged, it cannot divide and the cell will then die. By using Valrubicin in the bladder, cells can be prevented from dividing which should cause the cancerous tumor to shrink.

Often used as an alternative to surgical procedures, a course of Valrubicin can also be given prior to surgery, if doctors deem it appropriate.

Given in weekly cycles, patients are generally required to retain Valrubicin in the bladder for a period of two hours. This time period is optimal as it allows the medication to fully take effect. Following this, the patient can empty their bladder naturally and the medication will be voided from the body.

Conditions Treated

  • Bladder Cancer

Type of Medicine

  • Chemotherapy drug; Anthracyclines

Side Effects

Over 30% of patients who receive Valrubicin experience some mild side effects. These may include:

  • Bladder spasm
  • Frequent urination
  • Urgent urination
  • Painful urination
  • Bladder irritation

In most cases, these side effectives do not cause significant pain or discomfort and they often resolve themselves at a fairly rapid rate. If the patient struggles to cope with the side-effects of the medication, however, there are various treatments which can help to reduce the presentation of side-effects.

Although doctors will provide specific advice tailored to each individual, patients are generally advised to stay well-hydrated whilst receiving Valrubicin treatment. In addition to this, patients should rest as much as possible and maintain adequate nutrition.

If nausea is preventing a patient from eating, anti-nausea medications may be prescribed and self-help remedies, such as eating small meals, sipping water and sucking lozenges, may be advised.

In some cases, patients may experience tiredness, dizziness or visual disturbances while they are receiving treatment. Patients affected by these side-effects should refrain from driving, using machinery or performing tasks which require them to remain alert.

Patients are often advised to avoid sun exposure whilst receiving chemotherapy drug treatment. Using sun block and wearing protective clothing can help to protect your skin whilst you're undergoing a course of Valrubicin.

It should be noted that Valrubicin does tend to cause urine to develop a red-tinge. Normally, this is only present for 24 hours after the medication has been administered. Normally, this does not indicate a problem with the treatment but patients should be warned of this side-effect. If the colour change persists for over 24 hours, patients should contact their physician and inform them.

Less common side-effects of Valrubicin treatment do occur and they may include:

  • Bladder pain
  • Urinary incontinence
  • Bladder infection
  • Increased urination at night
  • Local burning sensation
  • Urinary Tract infection
  • Blood in the urine

When an infection occurs following treatment with Valrubicin, doctors will normally need to provide additional medication. Left untreated, the infection could worsen and cause serious illness. As chemotherapy can affect a patient's immunity, it's important that infections are dealt with quickly and effectively.

If patients experience a high fever, breathing problems, chills, tremors, a bad cough, swelling, chest tightness or seizures, they should obtain urgent medical assistance. These symptoms could indicate an allergic reaction to the medication and/or the presence of an infection and may constitute a life-threatening emergency.

Whilst the following side-effects do not normally indicate an emergency situation, you should notify your doctor if you experience:

  • Diarrhea
  • Nausea and/or vomiting
  • Inability to urinate
  • Signs of dehydration or inability to eat

Serious side-effects of Valrubicin are rare and most patients tolerate the treatment extremely well. Whilst some patients may experience some mild or moderate side-effects, many people do not experience any side-effects at all.

Dosage

Normally administered once a week over a six week period, Valrubicin must be given by a doctor or an alternative healthcare practitioner. When treating bladder cancer in adults, a standard dose of Valrubicin is 800mg (75 milliliters). A patient's dosage can depend on a number of factors, however.

The number of doses given, the timing between doses and the length of the course of treatment will all affect how much Valrubicin solution is administered.

As Valrubicin is administered via a urinary catheter, patients must receive the treatment in a hospital or clinical setting. Treatment can normally be given as an outpatient, however, and patients are generally able to return home in between treatments.

Tests, such as urine cytology and cystoscopies, can be carried out during treatment to determine the efficacy of Valrubicin on the patient. Based on these results, doctors may decide to alter the patient's dose or to supplement the medication with additional treatment. In some cases, surgery may be used as an alternative to Valrubicin or following a course of Valrubicin treatment.

Interactions

Like all medications, Valrubicin is known to interact with some other types of pharmaceutical drugs. In some cases, doctors will proceed with Valrubicin treatment, even if you're currently taking a drug which may interact with the medication. In most cases, physicians will determine whether the benefits of the medication outweigh the potential side-effects and proceed with caution.

If you are taking either Tasonermin or Trastuzumab, however, doctors may decide not to proceed with Valrubicin treatment. Alternatively, dosages can be lowered or existing medications altered to reduce the risk of interactions occurring.

As well as interacting with other medications, Valrubicin may affect existing medical conditions. If the patient is suffering from a bladder or urinary tract infection when the Valrubicin treatment is due, it's essential that the relevant physicians are informed. Similarly, patients should notify their doctor if they experience bladder irritation on a regular basis or if they have a small bladder. Patients with a small bladder may struggle to retain the Valrubicin solution for a period of two hours and treatment times may, therefore, need to be modified or altered.

Warnings

Before commencing Valrubicin treatment, patients should inform their doctor if they have experienced an allergic reaction to medications in the past. Allergies to Daunorubicin, Doxorubicin, Epirubicin and Idarubicin are particularly relevant.

Many doctors maintain that Valrubicin should not be used if you are pregnant, planning to become pregnant or are planning to father a child, however. Similarly, Valrubicin should not be given to breastfeeding or nursing patients as it could cause harm to their child. If patients discover they are pregnant or are due to become a father whilst undergoing Valrubicin treatment, they are advised to contact their physician immediately.

Patients should not take aspirin whilst receiving Valrubicin treatment, unless this has been discussed with their physician in advance.

Whilst undergoing Valrubicin treatment, patients should not receive any immunizations or vaccinations, unless they have been approved by the prescribing doctor.

Storage

Normally supplied in single-use vials, Valrubicin can be stored at a refrigerated temperature of 2°-8°C (36°-46°F) until the use-by date stated on the packaging. Vials of Valrubicin should not, however, be frozen or heated.

As treatment is administered in a clinical setting, patients will not be required to store the medication at home. Instead, Valrubicin will be stored, prepared and administered in a clinical environment.

Summary

Valrubicin can be an extremely effective treatment for bladder cancer but is may not be suitable for all patients diagnosed with this condition. Following initial tests, surgery may be performed instead of administering Valrubicin. Alternatively, Valrubicin treatment can be administered prior to surgery or as an alternative, if surgery isn't a viable option for the patient.

Although drugs, such as Valrubicin, are effective because they prevent cancer cells from dividing and replicating, they are unable to differentiate between cancer cells and healthy cells. As a result, healthy cells may be affected by the treatment and some side-effects may occur. In time however, healthy cells will be replaced and side-effects should lessen.

Administering Valrubicin treatments in weekly cycles, rather than on a daily basis, enables healthy cells to regenerate and may help to minimize unpleasant side-effects associated with chemotherapy drug treatment.

Due to its effectiveness, Valrubicin is a popular treatment for bladder cancer. Suitable for use on both male and female patients, Valrubicin enables people to receive appropriate treatment on an outpatient basis, thus negating the need for lengthy stays in hospital.

When used in isolation or in conjunction with additional treatments and surgical interventions, Valrubicin can successfully treat cancer of the bladder and enable the patient to enter a period of remission.

Resources
Last Reviewed:
December 25, 2017
Last Updated:
April 05, 2018
Content Source: