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Overview	Photos	How To Use	Side Effects	Precautions	Missed Dose	Drug Interactions

ellence Uses Epirubicin is used to treat breast cancer. It works by eliminating or stopping the growth of cancer cells. Storage Store vials at refrigerator temperature between 36 and 46 degrees F (2 and 8 degrees C) away from light and moisture. Do not freeze. Discard unused portion. Overdose If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include black stool, coffee ground-like vomit, trouble breathing, change in amount of urine. How To Use Inject Ellence into a vein (IV) through other IV fluids (e.g., saline, dextrose), usually over three to five minutes; or as directed by your doctor. Follow all instructions for proper mixing and dilution with the correct IV fluids. Ask your pharmacist if you have questions regarding the use of Ellence. To minimize serious side effects, you may be given other medications (e.g., antiemetics, antibiotics) in addition to Ellence. Follow all directions for the proper use of other medications. Consult your doctor or pharmacist if you have questions regarding the use of additional medications. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard needles and medical supplies safely. Consult your pharmacist. Side Effects Nausea, hair loss, diarrhea, or stomach pain may occur. If any of these effects persist or worsen, contact your doctor or pharmacist promptly. Ellence may cause your urine to turn red in color. This is a normal effect of Ellence. It is temporary and should disappear in one to two days. Notify your doctor if this effect persists longer than two days. Tell your doctor immediately if any of these serious side effects occur: pain or redness at the injection site, easy bruising or bleeding, persistent sore throat or fever, unusual tiredness, flushing, changes in menstrual period, eye problems, sores in the mouth or throat. Tell your doctor immediately if any of these unlikely but serious side effects occur: fast/slow/irregular heartbeat, unexplained weight gain, bloating, loss of appetite, joint pain, sun sensitivity, changes in the appearance of the skin. An allergic reaction to Ellence is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist. Precautions Tell your doctor your medical history, especially of: previous chemotherapy or radiation treatments, kidney problems, allergies (especially to anthracyclines such as daunorubicin or doxorubicin, or anthracenediones such as mitoxantrone). Ellence is not recommended for use if you have any of the following medical conditions: bone marrow suppression (e.g., leukopenia, neutropenia), heart problems (e.g., congestive heart failure, myocardial infarction), liver problems. Ellence may make you more sensitive to the sun. Avoid prolonged sun exposure, use a sunscreen, and wear protective clothing when outdoors. Caution is advised when using Ellence in the elderly because they may be more sensitive to the effects of Ellence. Caution is advised when using Ellence in children because they may be more sensitive to the effects of Ellence. Because Ellence may effect the production of sperm, it is recommended that men undergoing treatment with Ellence use effective contraceptive methods (e.g., condoms). Consult your doctor or pharmacist for details. Ellence can interfere with the menstrual cycle and cause premature menopause (change of life). Consult your doctor or pharmacist for details. Ellence is not recommended for use during pregnancy. Consult your doctor for more details. Based on information of related drugs, Ellence may pass into breast milk. Therefore, breast-feeding while using Ellence is not recommended. Consult your doctor before breast- feeding. Missed Dose If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. If the dose is interrupted, contact your doctor or pharmacist immediately to establish new dosing. Drug Interactions Tell your doctor or pharmacist of all prescription and nonprescription drugs you may use, especially of: other cancer chemotherapy (e.g., daunorubicin, doxorubicin), calcium channel blockers (e.g., diltiazem, nifedipine, verapamil), beta-blockers (e.g., atenolol, metoprolol), cimetidine. Do not start or stop any medicine without doctor or pharmacist approval.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.