idarubicin

Contraindicated in:

Lactation: Lactation.

Use Cautiously in:

Active infection;
↓bone marrow reserve;
Other chronic debilitating illnesses;
Hepatic impairment (dose ↓ may be required; avoid if bilirubin ≥5 mg/dL);
Renal impairment;
Pre-existing cardiac disease;
Previous daunorubicin or doxorubicin therapy;
OB: Another anthracycline is preferred for induction treatment in AML; use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Rep: Women of reproductive potential and men with female partners of reproductive potential;
Pedi: Safety and effectiveness not established in children;
Geri: ↑incidence of adverse reactions in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

CV: ARRHYTHMIAS, HF

Derm: alopecia, photosensitivity, rash

Endo: gonadal suppression

GI: abdominal cramps, diarrhea, mucositis, nausea, vomiting

Hemat: anemia, leukopenia, thrombocytopenia, BLEEDING

Local: phlebitis at IV site

Metab: hyperuricemia

Neuro: headache, mental status changes, peripheral neuropathy

Resp: pulmonary toxicity, pulmonary allergic reactions

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

↑myelosuppression with other antineoplastics or radiation therapy.
Concurrent use with paclitaxel, trastuzumab, or cyclophosphamide) may ↑ risk of cardiotoxicity; avoid use of idarubicin for up to 7 mo after discontinuing trastuzumab.
May ↓ antibody response to and increase risk of adverse reactions from live-virus vaccines.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 1 mg/mL

Route/Dosage ⬆ ⬇

IV (Adults ): 12 mg/m² once daily for 3 days.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits nucleic acid synthesis.

Therapeutic effects:

Death of rapidly replicating cells, particularly malignant ones.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: anthracyclines

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Rapidly distributed with extensive tissue binding. High degree of cellular uptake.

Metabolism/Excretion: Extensive hepatic and extrahepatic metabolism. One metabolite is active (idarubicinol). Primarily eliminated via biliary excretion.

Half-Life: 22 hr (range 4–46 hr).

Time/Action Profile ⬆ ⬇

(effects on blood counts)

ROUTE	ONSET	PEAK	DURATION
IV	Unknown	10–14 days	21 days

Patient/Family Teaching ⬆ ⬇

Instruct patient to notify health care professional promptly if fever; sore throat; signs of infection; bleeding gums; bruising; petechiae; blood in stools, urine, or emesis; increased fatigue; dyspnea; or orthostatic hypotension occurs. Caution patient to avoid crowds and persons with known infections. Instruct patient to use soft toothbrush and electric razor and to avoid falls. Caution patient not to drink alcoholic beverages or take medication containing aspirin or NSAIDs, as these may precipitate gastric bleeding.
Instruct patient to report pain at injection site immediately.
Instruct patient to inspect oral mucosa for erythema and ulceration. If ulceration occurs, advise patient to use sponge brush, rinse mouth with water after eating and drinking, and confer with health care professional if mouth pain interferes with eating. Further courses of idarubicin should be withheld until recovery from mucositis, and subsequent doses should be decreased by 25%. Stomatitis pain may require treatment with opioid analgesics.
Instruct patient to notify health care professional immediately if irregular heartbeat, shortness of breath, or swelling of lower extremities occurs.
Advise patient to wear sunscreen and protective clothing to prevent photosensitivity reactions.
Discuss with patient the possibility of hair loss. Explore methods of coping.
Instruct patient not to receive any vaccinations without advice of health care professional.
Inform patient that urine may turn a reddish color.
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception during and for at least 6.5 mo after last dose and to avoid breastfeeding during and for 14 days after last dose of therapy. Advise males with female partners of reproductive potential to use effective contraception during and for 3.5 mo after last dose. May impair fertility; advise both men and women to seek advice for fertility preservation before therapy and/or seek genetic counseling after treatment.
Emphasize the need for periodic lab tests to monitor for side effects.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0013- Pharmacia and Upjohn Company LLC
- 0013-2576- Idamycin PFS
  - 0013-2576-91- 1 VIAL in 1 CARTON (0013-2576-91) > 5 mL in 1 VIAL

0013- Pharmacia and Upjohn Company LLC
- 0013-2586- Idamycin PFS
  - 0013-2586-91- 1 VIAL in 1 CARTON (0013-2586-91) > 10 mL in 1 VIAL

0013- Pharmacia and Upjohn Company LLC
- 0013-2596- Idamycin PFS
  - 0013-2596-91- 1 VIAL in 1 CARTON (0013-2596-91) > 20 mL in 1 VIAL

0143- West-Ward Pharmaceuticals Corp
- 0143-9217- Idarubicin Hydrochloride
  - 0143-9217-01- 1 VIAL, GLASS in 1 BOX (0143-9217-01) > 5 mL in 1 VIAL, GLASS

0143- West-Ward Pharmaceuticals Corp
- 0143-9218- Idarubicin Hydrochloride
  - 0143-9218-01- 1 VIAL, GLASS in 1 BOX (0143-9218-01) > 10 mL in 1 VIAL, GLASS

0143- West-Ward Pharmaceuticals Corp
- 0143-9219- Idarubicin Hydrochloride
  - 0143-9219-01- 1 VIAL, GLASS in 1 BOX (0143-9219-01) > 20 mL in 1 VIAL, GLASS

0143- West-Ward Pharmaceuticals Corp
- 0143-9306- Idarubicin Hydrochloride
  - 0143-9306-01- 1 VIAL, GLASS in 1 BOX (0143-9306-01) > 5 mL in 1 VIAL, GLASS

0143- West-Ward Pharmaceuticals Corp
- 0143-9307- Idarubicin Hydrochloride
  - 0143-9307-01- 1 VIAL, GLASS in 1 BOX (0143-9307-01) > 10 mL in 1 VIAL, GLASS

0143- West-Ward Pharmaceuticals Corp
- 0143-9308- Idarubicin Hydrochloride
  - 0143-9308-01- 1 VIAL, GLASS in 1 BOX (0143-9308-01) > 20 mL in 1 VIAL, GLASS

0703- Teva Parenteral Medicines, Inc.
- 0703-4154- Idarubicin Hydrochloride
  - 0703-4154-11- 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-4154-11) > 5 mL in 1 VIAL, SINGLE-DOSE

0703- Teva Parenteral Medicines, Inc.
- 0703-4155- Idarubicin Hydrochloride
  - 0703-4155-11- 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-4155-11) > 10 mL in 1 VIAL, SINGLE-DOSE

0703- Teva Parenteral Medicines, Inc.
- 0703-4156- Idarubicin Hydrochloride
  - 0703-4156-11- 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-4156-11) > 20 mL in 1 VIAL, SINGLE-DOSE

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Indications ⬇

Contraind./Precautions ⬆ ⬇