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Generic Name: epirubicin (EP i ROO bi sin)
Brand Names: Ellence
Ellence is a cancer medication that interferes with the growth of cancer cells and is used to treat breast cancer. Learn about side effects, interactions and indications.
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Drug Information:
Ellence (epirubicin) is a cancer medication that interferes with the growth and spread of cancer cells in the body. Ellence is used to treat breast cancer. Ellence may also be used for purposes not listed in this medication guide. You should not use this medication if you have an untreated or uncontrolled infection, severe liver disease, severe heart problems, or if you have recently had a heart attack. Ellence may cause dangerous effects on your heart. Call your doctor at once if you have chest pain, shortness of breath (even with mild exertion), swelling, or rapid weight gain. Learn more

Ellence Side Effects

Ellence Side Effects

Note: This document contains side effect information about epirubicin. Some of the dosage forms listed on this page may not apply to the brand name Ellence.

For the Consumer

Applies to epirubicin: intravenous solution


Intravenous route (Solution)

If extravasation occurs during administration, severe local tissue necrosis will occur; avoid administering via IM or subQ routes. Cardiac toxicity, including fatal congestive heart failure (CHF), may occur during therapy or months to years after therapy ends. Risk of CHF is increased with increasing cumulative dose, especially with total cumulative doses in excess of 900 mg/m(2); use extreme caution when exceeding this dose. Active or dormant cardiovascular disease, prior or concomitant radiotherapy to the mediastinal/pericardial area, previous therapy with other anthracyclines or anthracenediones, or concomitant use of other cardiotoxic drugs may increase the risk of cardiac toxicity. Secondary acute myelogenous leukemia has been reported in patients with breast cancer treated with anthracyclines, with an increased risk of refractory cases in patients with concomitant DNA-damaging antineoplastic agent use, heavy pretreatment with cytotoxic drugs, or escalated anthracycline dose. Severe myelosuppression may occur.

Along with its needed effects, epirubicin (the active ingredient contained in Ellence) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor or nurse immediately if any of the following side effects occur while taking epirubicin:

More common

  • Black, tarry stools
  • bleeding, redness, or ulcers in the mouth or throat
  • chest pain
  • cough or hoarseness
  • fever or chills
  • lower back or side pain
  • pain or burning in the mouth or throat
  • painful or difficult urination
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • swollen glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Less common

  • Blood in the urine or stools
  • pinpoint red spots on the skin
  • red streaks along the injected vein


  • Darkening or redness of the skin at place of irradiation
  • difficulty with breathing
  • fast or irregular heartbeat
  • joint pain
  • pain, redness, or warmth at the injection site
  • skin rash or itching
  • swelling of the abdomen or stomach, lower legs, and feet
  • swelling or tenderness of the lymph nodes, abdomen, side or lower back
  • wheezing

Get emergency help immediately if any of the following symptoms of overdose occur while taking epirubicin:

Symptoms of overdose

  • Abdominal or stomach swelling or tenderness
  • high fever
  • stomach pain
  • swelling of the lining of the mouth, nose, or throat
  • vomiting

Some side effects of epirubicin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Absent, missed, or irregular menstrual periods
  • burning, dry, or itching eyes
  • diarrhea
  • discharge or excessive tearing
  • feeling of warmth
  • hair loss or thinning of the hair
  • nausea
  • redness of the face, neck, arms, and occasionally, upper chest
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • stopping of menstrual bleeding
  • sudden sweating
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Less common

  • Changes in the skin
  • loss of appetite
  • weight loss


  • Darkening of the soles, palms, or nails

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

  • Fast or irregular heartbeat
  • shortness of breath
  • swelling of the abdomen or stomach, feet, and lower legs

For Healthcare Professionals

Applies to epirubicin: intravenous powder for injection, intravenous solution


Very common (10% or more): Leukopenia (80%), neutropenia (80%), anemia (72%), thrombocytopenia (49%)

Frequency not reported: Myelosuppression, febrile neutropenia, pancytopenia


Very common (10% or more): Nausea/vomiting (92%), mucositis (59%), diarrhea (25%), stomatitis

Common (1% to 10%): GI pain, GI erosion, GI ulcer

Uncommon (0.1% to 1%): GI hemorrhage

Frequency not reported: Abdominal discomfort, esophagitis

Postmarketing reports: Ulceration, pain or burning sensation, bleeding, hyperpigmentation of the oral mucosa


Very common (10% or more): Infection (22%)

Frequency not reported: Secondary infection

Postmarketing reports: Sepsis, pneumonia


Very common (10% or more): Conjunctivitis/keratitis (15%)


Very common (10% or more): Alopecia (96%), skin toxicity

Common (1% to 10%): Rash, itching, skin changes, pruritus, nail pigmentation, skin disorder, skin/nail hyperpigmentation

Uncommon (0.1% to 1%): Erythema, urticaria

Frequency not reported: Tissue hypoxia

Postmarketing reports: Flushes, photosensitivity reaction, hypersensitivity to irradiated skin (radiation-recall reaction)


Very common (10% or more): Hot flashes (39%)

Common (1% to 10%): Asymptomatic drops in left ventricular ejection fraction (LVEF), cardiac heart failure (CHF), ventricular tachycardia, atrioventricular block, bundle branch block, bradycardia, congestive heart failure

Frequency not reported: Transient ECG changes (including low QRS voltage), arrhythmia, T wave flattening, ST depression, T inversion, cardiomyopathy, venous sclerosis

Postmarketing reports: Shock, hemorrhage, embolism arterial, thrombophlebitis, phlebitis


Postmarketing reports: Pulmonary embolism


Postmarketing reports: Anaphylaxis


Postmarketing reports: Dehydration, hyperuricemia


Very common (10% or more): Amenorrhea (72%), chromaturia (red coloration of urine for 1 to 2 days after administration)

Frequency not reported: Azoospermia

Postmarketing reports: Chemical cystitis (following intravesical administration)


Very common (10% or more): Local toxicity (20%)

Frequency not reported: Erythematous streaking along the infused vein


Frequency not reported: Confusion, depression


Very common (10% or more): Transaminases abnormal


Uncommon (0.1% to 1%): Acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL)


Very common (10% or more): Lethargy (46%), malaise, pyrexia

Common (1% to 10%): Fever

Frequency not reported: Weakness

Postmarketing reports: Chills

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Ellence