epirubicin 🐶 Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
antineoplastics, daunorubicin derivatives	1030	56420-45-2

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: epirubicin epiadriamycin epidoxorubicin epirarubicin farmarubicin farmarubicine pharmarubicin epirubicin hydrochloride epirubicin HCl	An anthracycline which is the 4'-epi-isomer of doxorubicin. The compound exerts its antitumor effects by interference with the synthesis and function of DNA. Molecular weight: 543.53 Formula: C27H29NO11 CLOGP: 0.26 LIPINSKI: 3 HAC: 12 HDO: 6 TPSA: 206.07 ALOGS: -2.67 ROTB: 5 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Molecule

Description

Molfile Inchi Smiles

Synonyms:

epirubicin
epiadriamycin
epidoxorubicin
epirarubicin
farmarubicin
farmarubicine
pharmarubicin
epirubicin hydrochloride
epirubicin HCl

An anthracycline which is the 4'-epi-isomer of doxorubicin. The compound exerts its antitumor effects by interference with the synthesis and function of DNA.

Molecular weight: 543.53
Formula: C27H29NO11
CLOGP: 0.26
LIPINSKI: 3
HAC: 12
HDO: 6
TPSA: 206.07
ALOGS: -2.67
ROTB: 5

Status: OFP

Legend:
OFP - off patent
OFM - off market
ONP - on patent

Drug dosage:

None

ADMET properties:

Property	Value	Reference
BDDCS (Biopharmaceutical Drug Disposition Classification System)	1	Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine)	9.50 %	Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose)	5.75 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
Vd (Volume of distribution)	45 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	20 mL/min/kg	Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma)	0.25 %	Lombardo F, Berellini G, Obach RS
t_half (Half-life)	36 hours	Lombardo F, Berellini G, Obach RS

Approvals:

Date	Agency	Company	Orphan
Sept. 15, 1999	FDA	PFIZER INC

FDA Adverse Event Reporting System (Female)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Agranulocytosis	1158.92	18.75	436	28933	24698	63434955
Febrile neutropenia	800.83	18.75	560	28809	117889	63341764
Myelosuppression	735.13	18.75	309	29060	23394	63436259
Disease recurrence	619.24	18.75	288	29081	27742	63431911
White blood cell count decreased	568.12	18.75	488	28881	138616	63321037
Neutropenia	529.56	18.75	519	28850	174486	63285167
Bone marrow failure	499.14	18.75	252	29117	29038	63430615
Metastases to bone	415.11	18.75	200	29169	20819	63438834
Leukopenia	400.96	18.75	312	29057	76978	63382675
Ejection fraction decreased	330.99	18.75	175	29194	22157	63437496
Cardiotoxicity	309.00	18.75	124	29245	8314	63451339
Metastases to liver	286.02	18.75	162	29207	23477	63436176
Acute myeloid leukaemia	284.60	18.75	145	29224	17002	63442651
Cardiac failure	268.24	18.75	264	29105	88878	63370775
Malignant neoplasm progression	267.40	18.75	254	29115	81867	63377786
Cardiac dysfunction	266.26	18.75	80	29289	2235	63457418
Palmar-plantar erythrodysaesthesia syndrome	231.63	18.75	140	29229	22875	63436778
Second primary malignancy	214.44	18.75	94	29275	7859	63451794
Neutrophil count decreased	211.78	18.75	189	29180	56217	63403436
Congestive cardiomyopathy	209.69	18.75	86	29283	6096	63453557
Metastases to lung	206.29	18.75	106	29263	12644	63447009
Alopecia	201.33	18.75	466	28903	337070	63122583
Neoplasm progression	182.07	18.75	144	29225	36284	63423369
Death	168.92	18.75	465	28904	373916	63085737
Metastases to lymph nodes	165.14	18.75	79	29290	8079	63451574
Hepatic function abnormal	154.55	18.75	132	29237	37010	63422643
Breast cancer recurrent	149.30	18.75	61	29308	4280	63455373
Cardiomyopathy	144.30	18.75	94	29275	17490	63442163
Disease progression	137.93	18.75	222	29147	122536	63337117
Breast cancer metastatic	136.32	18.75	79	29290	11939	63447714
Pyrexia	124.95	18.75	488	28881	469990	62989663
Febrile bone marrow aplasia	118.77	18.75	61	29308	7264	63452389
Mucosal inflammation	117.48	18.75	126	29243	46802	63412851
Neuropathy peripheral	114.82	18.75	196	29173	113471	63346182
Drug ineffective	108.22	18.75	200	29169	1044565	62415088
Interstitial lung disease	107.85	18.75	138	29231	61770	63397883
Metastasis	107.23	18.75	51	29318	5146	63454507
Rheumatoid arthritis	96.85	18.75	5	29364	253814	63205839
Product dose omission issue	94.82	18.75	3	29366	234310	63225343
Polyneuropathy	93.60	18.75	67	29302	14522	63445131
Colony stimulating factor therapy	92.72	18.75	23	29346	304	63459349
Left ventricular dysfunction	90.87	18.75	61	29308	11927	63447726
Metastases to skin	88.08	18.75	32	29337	1631	63458022
Vomiting	87.68	18.75	498	28871	559119	62900534
Pain	87.41	18.75	130	29239	740498	62719155
Joint swelling	85.49	18.75	23	29346	327643	63132010
Device related thrombosis	82.23	18.75	31	29338	1754	63457899
Diffuse large B-cell lymphoma recurrent	81.14	18.75	33	29336	2287	63457366
Systemic lupus erythematosus	80.05	18.75	4	29365	208914	63250739
Vasogenic cerebral oedema	77.92	18.75	25	29344	871	63458782
Nail disorder	77.19	18.75	57	29312	12958	63446695
Abdominal discomfort	75.67	18.75	27	29342	320858	63138795
Fall	74.05	18.75	45	29324	392289	63067364
Synovitis	73.50	18.75	3	29366	186915	63272738
Administration site extravasation	72.09	18.75	24	29345	941	63458712
Neurotoxicity	71.91	18.75	61	29308	16929	63442724
Neutropenic sepsis	71.59	18.75	60	29309	16378	63443275
Therapeutic product effect decreased	70.07	18.75	5	29364	193182	63266471
Aortitis	69.29	18.75	24	29345	1063	63458590
Asthenia	67.07	18.75	352	29017	383252	63076401
Swelling	66.94	18.75	22	29347	275356	63184297
Lymphangiosis carcinomatosa	66.22	18.75	25	29344	1420	63458233
Troponin I increased	65.38	18.75	28	29341	2210	63457443
Hormone receptor positive breast cancer	63.42	18.75	19	29350	525	63459128
Metastases to chest wall	61.80	18.75	19	29350	574	63459079
Pruritus	60.80	18.75	47	29322	361406	63098247
Anaemia	60.30	18.75	282	29087	293148	63166505
Arthropathy	60.23	18.75	17	29352	234775	63224878
Haematotoxicity	60.00	18.75	43	29326	9333	63450320
Pancytopenia	59.88	18.75	136	29233	96797	63362856
Weight increased	59.68	18.75	23	29346	260769	63198884
Product use issue	58.38	18.75	15	29354	220505	63239148
Treatment failure	57.82	18.75	11	29358	199032	63260621
Extravasation	57.41	18.75	26	29343	2346	63457307
Contusion	57.06	18.75	3	29366	150041	63309612
Contraindicated product administered	55.37	18.75	16	29353	217632	63242021
Thrombocytopenia	54.74	18.75	174	29195	150983	63308670
Pneumocystis jirovecii pneumonia	54.35	18.75	52	29317	16862	63442791
Paraesthesia	53.51	18.75	177	29192	156789	63302864
Skin toxicity	53.48	18.75	31	29338	4683	63454970
Metastases to central nervous system	53.31	18.75	46	29323	13059	63446594
Granulocytopenia	53.19	18.75	33	29336	5639	63454014
Therapy partial responder	52.93	18.75	42	29327	10616	63449037
Nausea	51.19	18.75	611	28758	853860	62605793
Chemotherapy	50.27	18.75	21	29348	1558	63458095
Acute leukaemia	49.73	18.75	19	29350	1115	63458538
Wound	49.64	18.75	8	29361	163255	63296398
Glossodynia	49.64	18.75	11	29358	178865	63280788
Pleural effusion	49.16	18.75	123	29246	93087	63366566
Blood creatine increased	48.55	18.75	31	29338	5570	63454083
Drug hypersensitivity	47.81	18.75	44	29325	310643	63149010
Systolic dysfunction	46.69	18.75	20	29349	1579	63458074
Hydrothorax	45.92	18.75	17	29352	914	63458739
Granulocyte count decreased	44.61	18.75	18	29351	1222	63458431
Miller Fisher syndrome	44.22	18.75	10	29359	86	63459567
Hypertransaminasaemia	43.88	18.75	31	29338	6578	63453075
Menopausal disorder	43.68	18.75	9	29360	47	63459606
Subclavian vein thrombosis	43.48	18.75	20	29349	1870	63457783
Arthralgia	43.42	18.75	128	29241	569582	62890071
Acute interstitial pneumonitis	42.78	18.75	15	29354	689	63458964
Leukaemia cutis	42.77	18.75	10	29359	101	63459552
Somnolence	42.14	18.75	15	29354	178670	63280983
Gastrointestinal necrosis	41.63	18.75	22	29347	2776	63456877
Urinary tract infection	40.10	18.75	38	29331	264646	63195007
Left ventricular dilatation	39.59	18.75	13	29356	488	63459165
Neutropenic colitis	39.55	18.75	22	29347	3073	63456580
Xerophthalmia	38.96	18.75	13	29356	513	63459140
Sinusitis	38.67	18.75	29	29340	226624	63233029
White blood cell count abnormal	38.51	18.75	28	29341	6214	63453439
Acute lymphocytic leukaemia	38.05	18.75	20	29349	2496	63457157
Nasopharyngitis	37.94	18.75	37	29332	254220	63205433
Musculoskeletal stiffness	37.92	18.75	19	29350	184599	63275054
Malignant pleural effusion	37.39	18.75	20	29349	2586	63457067
Metastases to pleura	37.18	18.75	17	29352	1568	63458085
Hypertension	36.86	18.75	45	29324	279258	63180395
Mobility decreased	36.68	18.75	6	29363	121153	63338500
Hyperpyrexia	36.28	18.75	22	29347	3610	63456043
Metastases to the mediastinum	35.91	18.75	12	29357	476	63459177
Rash	35.87	18.75	136	29233	560735	62898918
Urticaria	35.68	18.75	16	29353	165786	63293867
Acute promyelocytic leukaemia	35.23	18.75	14	29355	913	63458740
Tumour marker increased	34.84	18.75	24	29345	4891	63454762
Hypersensitivity	33.75	18.75	52	29317	292633	63167020
Merycism	33.56	18.75	10	29359	271	63459382
Osteonecrosis of jaw	33.37	18.75	59	29310	35064	63424589
Diarrhoea	33.30	18.75	489	28880	714877	62744776
Metastases to soft tissue	32.80	18.75	9	29360	180	63459473
Neurological symptom	31.34	18.75	24	29345	5759	63453894
Deafness	31.20	18.75	40	29329	17917	63441736
Menopause	30.52	18.75	18	29351	2807	63456846
Metastases to thorax	30.45	18.75	9	29360	237	63459416
Confusional state	30.22	18.75	39	29330	236341	63223312
Weight decreased	30.20	18.75	51	29318	276747	63182906
Septic shock	30.09	18.75	83	29286	66546	63393107
Cardiac failure acute	30.07	18.75	29	29340	9494	63450159
Migraine	29.38	18.75	6	29363	103340	63356313
Acute kidney injury	29.23	18.75	48	29321	263367	63196286
Metastases to meninges	29.22	18.75	17	29352	2585	63457068
Loss of personal independence in daily activities	29.05	18.75	5	29364	97285	63362368
Condition aggravated	28.72	18.75	93	29276	402124	63057529
Skin exfoliation	28.31	18.75	62	29307	43040	63416613
Overdose	28.27	18.75	9	29360	115069	63344584
Osteoarthritis	28.25	18.75	5	29364	95338	63364315
Catheter site bruise	28.08	18.75	10	29359	481	63459172
Pericardial effusion	27.92	18.75	50	29319	30008	63429645
Platelet count decreased	27.86	18.75	117	29252	116005	63343648
Tympanic membrane disorder	27.81	18.75	8	29361	191	63459462
Recurrent cancer	27.81	18.75	15	29354	1972	63457681
Lymphopenia	27.50	18.75	38	29331	18289	63441364
Brachydactyly	27.40	18.75	7	29362	105	63459548
Myeloproliferative neoplasm	27.13	18.75	10	29359	531	63459122
PIK3CA-activated mutation	26.87	18.75	12	29357	1047	63458606
Feeling abnormal	26.59	18.75	18	29351	148374	63311279
Injection site phlebitis	26.52	18.75	7	29362	120	63459533
Pericarditis	26.33	18.75	14	29355	131565	63328088
Acute pulmonary oedema	26.05	18.75	25	29344	8133	63451520
Paraneoplastic syndrome	25.76	18.75	10	29359	613	63459040
Anxiety	25.69	18.75	38	29331	217503	63242150
Therapeutic product effect incomplete	25.48	18.75	13	29356	125043	63334610
Hepatic enzyme increased	24.23	18.75	35	29334	202293	63257360
Gait apraxia	23.97	18.75	5	29364	28	63459625
Myocardial fibrosis	23.68	18.75	10	29359	762	63458891
Administration site oedema	23.68	18.75	5	29364	30	63459623
Invasive ductal breast carcinoma	23.51	18.75	22	29347	6936	63452717
Post embolisation syndrome	23.48	18.75	4	29365	5	63459648
Gastrointestinal toxicity	23.37	18.75	23	29346	7718	63451935
SAPHO syndrome	23.30	18.75	6	29363	93	63459560
Neutrophilia	23.25	18.75	18	29351	4388	63455265
Discomfort	23.10	18.75	26	29343	167348	63292305
Anal erythema	22.98	18.75	7	29362	205	63459448
Dandy-Walker syndrome	22.84	18.75	6	29363	101	63459552
Psoriasis	22.83	18.75	6	29363	86951	63372702
Wheezing	22.57	18.75	8	29361	95587	63364066
Blood pressure increased	22.56	18.75	25	29344	162037	63297616
Hot flush	22.38	18.75	63	29306	51096	63408557
Radiotherapy	22.34	18.75	8	29361	391	63459262
Human herpesvirus 6 infection	22.29	18.75	15	29354	2942	63456711
Arachnoid cyst	22.24	18.75	7	29362	229	63459424
Oxygen saturation decreased	21.63	18.75	7	29362	88578	63371075
Depression	21.60	18.75	36	29333	196456	63263197
Ischaemic enteritis	21.52	18.75	5	29364	49	63459604
Endocardial fibrosis	21.44	18.75	4	29365	11	63459642
Drug interaction	20.83	18.75	47	29322	229084	63230569
Acute respiratory distress syndrome	20.40	18.75	38	29331	23496	63436157
Blister	20.39	18.75	18	29351	129796	63329857
Pulmonary embolism	20.24	18.75	107	29262	116577	63343076
Skin hypopigmentation	20.19	18.75	9	29360	782	63458871
Bronchitis	20.02	18.75	17	29352	124918	63334735
Peripheral swelling	20.01	18.75	60	29309	265882	63193771
Infusion site vesicles	19.97	18.75	8	29361	533	63459120
Amnestic disorder	19.95	18.75	7	29362	322	63459331
Polydipsia	19.77	18.75	15	29354	3549	63456104
Lymphatic obstruction	19.56	18.75	4	29365	20	63459633
Infusion related reaction	19.49	18.75	54	29315	245467	63214186
Inappropriate schedule of product administration	19.46	18.75	12	29357	103953	63355700
Acute myelomonocytic leukaemia	19.34	18.75	6	29363	187	63459466
Cardiac perfusion defect	19.09	18.75	4	29365	23	63459630
Wrong technique in product usage process	19.06	18.75	3	29366	62337	63397316
Dysgeusia	18.96	18.75	56	29313	46654	63412999
Heart rate increased	18.89	18.75	10	29359	94228	63365425
Hepatitis B	18.88	18.75	15	29354	3797	63455856
Gastrointestinal haemorrhage	18.81	18.75	7	29362	81169	63378484

FDA Adverse Event Reporting System (Male)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Myelosuppression	447.82	26.84	147	4673	19118	34932993
Bone marrow failure	268.88	26.84	113	4707	29140	34922971
Anastomotic leak	122.35	26.84	26	4794	605	34951506
Neutropenia	66.33	26.84	94	4726	156684	34795427
Delayed puberty	65.43	26.84	13	4807	214	34951897
Hepatic artery stenosis	64.08	26.84	12	4808	142	34951969
Body height below normal	58.67	26.84	12	4808	230	34951881
Neutropenic sepsis	57.57	26.84	31	4789	13736	34938375
Disease progression	51.96	26.84	69	4751	108008	34844103
Carbohydrate antigen 15-3 increased	51.59	26.84	9	4811	69	34952042
Intestinal atresia	50.30	26.84	9	4811	81	34952030
Oligohydramnios	48.23	26.84	11	4809	357	34951754
Mucosal inflammation	46.11	26.84	40	4780	38582	34913529
Hyperammonaemic encephalopathy	43.03	26.84	15	4805	2309	34949802
Ameloblastoma	42.61	26.84	8	4812	96	34952015
Extravasation	42.05	26.84	14	4806	1876	34950235
Off label use	41.40	26.84	139	4681	419385	34532726
Malignant neoplasm progression	38.92	26.84	54	4766	87992	34864119
Foetal growth abnormality	37.11	26.84	6	4814	27	34952084
Vascular pseudoaneurysm	36.36	26.84	13	4807	2154	34949957
Basal cell naevus syndrome	36.11	26.84	6	4814	33	34952078
Liver abscess	35.50	26.84	15	4805	3880	34948231
Bladder perforation	34.01	26.84	8	4812	298	34951813
Idiosyncratic drug reaction	30.50	26.84	8	4812	468	34951643
Renal hypoplasia	30.47	26.84	6	4814	94	34952017
Malassezia infection	29.06	26.84	5	4815	35	34952076
White blood cell count decreased	28.71	26.84	49	4771	95396	34856715
Tumour perforation	28.32	26.84	7	4813	322	34951789
Duodenal obstruction	27.02	26.84	6	4814	172	34951939

FDA Adverse Event Reporting System (Geriatric)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Agranulocytosis	1055.66	17.53	451	29108	44579	79670250
Myelosuppression	1039.41	17.53	432	29127	39864	79674965
Bone marrow failure	679.88	17.53	346	29213	50761	79664068
White blood cell count decreased	587.47	17.53	515	29044	187773	79527056
Febrile neutropenia	447.92	17.53	487	29072	230512	79484317
Neutropenia	403.85	17.53	514	29045	287196	79427633
Leukopenia	351.37	17.53	313	29246	116200	79598629
Metastases to bone	326.32	17.53	166	29393	24261	79690568
Cardiac dysfunction	242.21	17.53	81	29478	4043	79710786
Neoplasm progression	222.87	17.53	171	29388	51511	79663318
Metastases to liver	210.42	17.53	131	29428	28183	79686646
Ejection fraction decreased	200.66	17.53	137	29422	34440	79680389
Acute myeloid leukaemia	192.70	17.53	128	29431	30757	79684072
Metastases to lung	184.85	17.53	103	29456	18060	79696769
Congestive cardiomyopathy	183.79	17.53	89	29470	11691	79703138
Neutrophil count decreased	177.90	17.53	196	29363	93763	79621066
Palmar-plantar erythrodysaesthesia syndrome	172.89	17.53	123	29436	33011	79681818
Malignant neoplasm progression	171.61	17.53	231	29328	135759	79579070
Metastases to lymph nodes	166.59	17.53	80	29479	10317	79704512
Second primary malignancy	161.56	17.53	87	29472	14263	79700566
Cardiotoxicity	148.50	17.53	78	29481	12161	79702668
Cardiac failure	137.52	17.53	223	29336	154619	79560210
Hepatic function abnormal	135.75	17.53	151	29408	72956	79641873
Pyrexia	134.09	17.53	551	29008	678158	79036671
Mucosal inflammation	123.28	17.53	146	29413	75434	79639395
Vomiting	110.37	17.53	513	29046	665315	79049514
Neutropenic sepsis	102.51	17.53	83	29476	26981	79687848
Febrile bone marrow aplasia	101.17	17.53	62	29497	12958	79701871
Breast cancer recurrent	101.17	17.53	39	29520	2938	79711891
Cardiomyopathy	100.12	17.53	84	29475	28690	79686139
Neuropathy peripheral	94.86	17.53	180	29379	141125	79573704
Breast cancer metastatic	93.61	17.53	51	29508	8551	79706278
Nausea	90.76	17.53	635	28924	956561	78758268
Extravasation	89.13	17.53	38	29521	3712	79711117
Disease progression	87.76	17.53	204	29355	184158	79530671
Metastases to skin	85.87	17.53	30	29529	1709	79713120
Anastomotic leak	83.28	17.53	26	29533	1039	79713790
Product dose omission issue	78.63	17.53	3	29556	247534	79467295
Colony stimulating factor therapy	77.55	17.53	21	29538	503	79714326
Administration site extravasation	77.36	17.53	26	29533	1317	79713512
Metastases to chest wall	76.73	17.53	21	29538	524	79714305
Device related thrombosis	76.63	17.53	31	29528	2652	79712177
Fall	74.90	17.53	44	29515	487585	79227244
Interstitial lung disease	73.78	17.53	142	29417	112458	79602371
Nail disorder	71.20	17.53	48	29511	11804	79703025
Vasogenic cerebral oedema	70.83	17.53	25	29534	1468	79713361
Granulocyte count decreased	69.80	17.53	26	29533	1782	79713047
Paraesthesia	67.94	17.53	180	29379	176143	79538686
Polyneuropathy	66.99	17.53	62	29497	24089	79690740
Asthenia	63.47	17.53	364	29195	511325	79203504
Aortitis	63.08	17.53	23	29536	1484	79713345
Haematotoxicity	61.75	17.53	49	29510	15470	79699359
Hepatic artery stenosis	59.45	17.53	14	29545	186	79714643
Rheumatoid arthritis	58.67	17.53	5	29554	208465	79506364
Lymphangiosis carcinomatosa	58.48	17.53	24	29535	2130	79712699
Pruritus	53.32	17.53	41	29518	394607	79320222
Diffuse large B-cell lymphoma recurrent	51.56	17.53	27	29532	4180	79710649
Drug interaction	51.34	17.53	47	29512	415136	79299693
Alopecia	51.15	17.53	195	29364	231160	79483669
Therapy partial responder	50.86	17.53	46	29513	17351	79697478
Joint swelling	50.32	17.53	22	29537	288624	79426205
Chemotherapy	49.15	17.53	20	29539	1737	79713092
Hydrothorax	49.06	17.53	19	29540	1449	79713380
White blood cell count abnormal	48.87	17.53	29	29530	5716	79709113
Acute promyelocytic leukaemia	48.77	17.53	19	29540	1472	79713357
Menopausal disorder	47.24	17.53	9	29550	38	79714791
Somnolence	47.04	17.53	15	29544	238966	79475863
Neutropenic colitis	46.45	17.53	28	29531	5679	79709150
Troponin I increased	45.83	17.53	26	29533	4712	79710117
Acute kidney injury	45.19	17.53	77	29482	519327	79195502
Thrombocytopenia	44.88	17.53	206	29353	265053	79449776
Diarrhoea	44.60	17.53	510	29049	879979	78834850
Synovitis	44.15	17.53	3	29556	150731	79564098
Contusion	43.46	17.53	3	29556	148773	79566056
Metastases to central nervous system	43.41	17.53	41	29518	16334	79698495
Arthropathy	43.04	17.53	7	29552	177104	79537725
Weight increased	42.57	17.53	25	29534	277361	79437468
Drug ineffective	41.29	17.53	234	29325	1080679	78634150
Anaemia	41.14	17.53	294	29265	444721	79270108
Overdose	41.10	17.53	9	29550	184197	79530632
Swelling	40.23	17.53	15	29544	216696	79498133
Blood creatine increased	40.09	17.53	31	29528	9424	79705405
Metastases to the mediastinum	39.90	17.53	13	29546	597	79714232
Metastasis	39.27	17.53	27	29532	6853	79707976
Granulocytopenia	38.99	17.53	33	29526	11398	79703431
Leukaemia cutis	38.92	17.53	10	29549	194	79714635
Therapeutic product effect decreased	38.66	17.53	7	29552	163856	79550973
Pancytopenia	38.52	17.53	142	29417	165603	79549226
Xerophthalmia	38.50	17.53	13	29546	668	79714161
Acute interstitial pneumonitis	37.95	17.53	15	29544	1208	79713621
Intestinal atresia	37.65	17.53	8	29551	64	79714765
Left ventricular dysfunction	37.65	17.53	41	29518	19320	79695509
Influenza	36.76	17.53	3	29556	129603	79585226
Merycism	36.37	17.53	10	29549	254	79714575
Bladder irritation	36.07	17.53	10	29549	262	79714567
Miller Fisher syndrome	36	17.53	10	29549	264	79714565
Brachydactyly	35.78	17.53	7	29552	35	79714794
Abdominal discomfort	35.19	17.53	25	29534	250702	79464127
Hyperpyrexia	34.99	17.53	24	29535	6068	79708761
Carbohydrate antigen 15-3 increased	34.98	17.53	14	29545	1165	79713664
Ameloblastoma	34.72	17.53	8	29551	96	79714733
Delayed puberty	34.63	17.53	9	29550	183	79714646
Systemic lupus erythematosus	33.82	17.53	3	29556	121146	79593683
Hypertransaminasaemia	33.82	17.53	31	29528	11893	79702936
Recurrent cancer	32.20	17.53	17	29542	2676	79712153
Gastrointestinal necrosis	32.14	17.53	22	29537	5543	79709286
Arthralgia	32.00	17.53	107	29452	571696	79143133
Pain	31.54	17.53	144	29415	703658	79011171
Catheter site bruise	30.93	17.53	10	29549	448	79714381
Myocardial infarction	30.57	17.53	15	29544	184114	79530715
Post embolisation syndrome	30.54	17.53	7	29552	82	79714747
Hepatitis B	30.38	17.53	25	29534	8307	79706522
Basal cell naevus syndrome	30.19	17.53	6	29553	33	79714796
Tympanic membrane disorder	29.89	17.53	8	29551	183	79714646
Confusional state	29.63	17.53	45	29514	317952	79396877
Urticaria	29.39	17.53	16	29543	185185	79529644
Gastrointestinal toxicity	28.87	17.53	24	29535	8085	79706744
Toxicity to various agents	28.59	17.53	72	29487	421468	79293361
Pleural effusion	28.50	17.53	118	29441	145144	79569685
Breast mass	28.32	17.53	22	29537	6732	79708097
Hypertension	27.90	17.53	50	29509	330942	79383887
Neurological symptom	27.21	17.53	24	29535	8759	79706070
Mobility decreased	27.19	17.53	6	29553	122169	79592660
Musculoskeletal stiffness	26.51	17.53	16	29543	174992	79539837
Osteonecrosis of jaw	26.45	17.53	53	29506	43173	79671656
Feeling abnormal	26.38	17.53	13	29546	159186	79555643
Pneumocystis jirovecii pneumonia	26.36	17.53	45	29514	32463	79682366
Blood pressure increased	26.00	17.53	24	29535	211336	79503493
Injection site phlebitis	25.88	17.53	7	29552	167	79714662
Pneumonia	25.62	17.53	142	29417	660104	79054725
Urinary tract infection	25.42	17.53	39	29520	274473	79440356
Drug hypersensitivity	25.33	17.53	45	29514	298871	79415958
Neurotoxicity	25.04	17.53	44	29515	32474	79682355
Administration site oedema	24.93	17.53	5	29554	29	79714800
Cardiac perfusion defect	24.79	17.53	5	29554	30	79714799
Bladder perforation	24.73	17.53	8	29551	359	79714470
Hormone receptor positive breast cancer	24.73	17.53	8	29551	359	79714470
Gait apraxia	24.51	17.53	5	29554	32	79714797
Metastases to soft tissue	24.40	17.53	9	29550	600	79714229
Lymphopenia	24.38	17.53	42	29517	30515	79684314
Platelet count decreased	24.37	17.53	139	29420	194525	79520304
Anxiety	24.29	17.53	34	29525	248478	79466351
Bradycardia	24.13	17.53	10	29549	135547	79579282
Malassezia infection	24.00	17.53	5	29554	36	79714793
Hepatic lesion	23.55	17.53	20	29539	6939	79707890
Malignant pleural effusion	23.50	17.53	15	29544	3365	79711464
Pseudocirrhosis	23.43	17.53	9	29550	671	79714158
Loss of personal independence in daily activities	22.90	17.53	5	29554	102575	79612254
Dandy-Walker syndrome	22.72	17.53	5	29554	48	79714781
Treatment failure	22.62	17.53	18	29541	170468	79544361
Nasopharyngitis	22.62	17.53	37	29522	253844	79460985
Skin toxicity	22.39	17.53	21	29538	8293	79706536
Acute pulmonary oedema	22.37	17.53	27	29532	14203	79700626
Ischaemic enteritis	22.31	17.53	6	29553	140	79714689
Hospitalisation	22.28	17.53	4	29555	94232	79620597
Rash	22.09	17.53	125	29434	578233	79136596
Metastases to pleura	22.02	17.53	11	29548	1543	79713286
Inappropriate schedule of product administration	22.01	17.53	11	29548	133617	79581212
Infusion site vesicles	21.97	17.53	8	29551	514	79714315
Wheezing	21.77	17.53	8	29551	116656	79598173
Wound	21.62	17.53	8	29551	116171	79598658
Neutrophilia	21.25	17.53	20	29539	7931	79706898
Disease recurrence	21.15	17.53	49	29510	44060	79670769
Arachnoid cyst	21.01	17.53	7	29552	345	79714484
Liver injury	20.96	17.53	57	29502	56557	79658272
Radiotherapy	20.81	17.53	8	29551	598	79714231
Septic shock	20.46	17.53	95	29464	122706	79592123
Contraindicated product administered	20.45	17.53	17	29542	157521	79557308
Acute lymphocytic leukaemia	20.43	17.53	16	29543	4953	79709876
Metastases to meninges	20.24	17.53	14	29545	3587	79711242
Myeloproliferative neoplasm	20.17	17.53	9	29550	980	79713849
Osteoarthritis	20.01	17.53	4	29555	87305	79627524
Sinusitis	19.85	17.53	26	29533	195475	79519354
Ovarian necrosis	19.83	17.53	4	29555	24	79714805
Heart rate increased	19.79	17.53	10	29549	120714	79594115
Liver abscess	19.67	17.53	17	29542	6037	79708792
Systolic dysfunction	19.58	17.53	14	29545	3781	79711048
Hyperkalaemia	19.47	17.53	9	29550	114389	79600440
Left ventricular dilatation	19.25	17.53	9	29550	1092	79713737
Product use issue	19.24	17.53	30	29529	209792	79505037
Cardiac failure acute	19.18	17.53	29	29530	18900	79695929
Breast cancer	18.99	17.53	40	29519	33741	79681088
Arterial thrombosis	18.92	17.53	12	29547	2662	79712167
Menopause	18.90	17.53	11	29548	2091	79712738
Decreased appetite	18.89	17.53	202	29357	342216	79372613
Weight decreased	18.80	17.53	68	29491	355130	79359699
Mitral valve incompetence	18.66	17.53	36	29523	28529	79686300
Nasal congestion	18.65	17.53	3	29556	76549	79638280
Sarcoidosis	18.61	17.53	19	29540	8316	79706513
Blood creatinine increased	18.60	17.53	18	29541	155039	79559790
Gas gangrene	18.47	17.53	6	29553	273	79714556
Atypical pneumonia	18.33	17.53	17	29542	6619	79708210
Vulvovaginal dryness	18.33	17.53	11	29548	2213	79712616
Oral pain	18.28	17.53	38	29521	31760	79683069
Vascular pseudoaneurysm	18.23	17.53	13	29546	3497	79711332
Tumour marker increased	18.10	17.53	14	29545	4258	79710571
Vena cava thrombosis	18.05	17.53	12	29547	2883	79711946
Depression	18.03	17.53	33	29526	216757	79498072
Gastrointestinal anastomotic leak	17.96	17.53	7	29552	543	79714286
Oxygen saturation decreased	17.92	17.53	13	29546	129034	79585795
Dysgeusia	17.72	17.53	54	29505	57123	79657706
Acute myelomonocytic leukaemia	17.59	17.53	6	29553	318	79714511
Hepatitis B reactivation	17.55	17.53	16	29543	6092	79708737

FDA Adverse Event Reporting System (Pediatric)

None

Pharmacologic Action:

Source	Code	Description
ATC	L01DB03	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS ANTINEOPLASTIC AGENTS CYTOTOXIC ANTIBIOTICS AND RELATED SUBSTANCES Anthracyclines and related substances
FDA CS	M0028312	Anthracyclines
FDA MoA	N0000000176	Topoisomerase Inhibitors
FDA EPC	N0000175414	Anthracycline Topoisomerase Inhibitor
CHEBI has role	CHEBI:33281	antibiotics
CHEBI has role	CHEBI:35610	antineoplastic agents
CHEBI has role	CHEBI:50750	inhibitors of type II topoisomerase
MeSH PA	D000903	Antibiotics, Antineoplastic
MeSH PA	D000970	Antineoplastic Agents
MeSH PA	D004791	Enzyme Inhibitors
MeSH PA	D059005	Topoisomerase II Inhibitors
MeSH PA	D059003	Topoisomerase Inhibitors

Drug Use | Suggest Off label Use Form| |View source of the data|

Disease	Relation	SNOMED_ID	DOID
Carcinoma of breast	indication	254838004	DOID:3459
Diffuse non-Hodgkin's lymphoma, large cell	off-label use	109969005
Hodgkin's disease	off-label use	118599009
Osteosarcoma of bone	off-label use	307576001	DOID:3376
Malignant tumor of stomach	off-label use	363349007	DOID:10534
Metastatic Breast Carcinoma	off-label use
Myocardial infarction	contraindication	22298006	DOID:5844
Conduction disorder of the heart	contraindication	44808001
Chronic heart failure	contraindication	48447003
Hepatic failure	contraindication	59927004
Stomatitis	contraindication	61170000	DOID:9637
Acute infectious disease	contraindication	63171007
Cardiomyopathy	contraindication	85898001	DOID:0050700
Kidney disease	contraindication	90708001	DOID:557
Disease of liver	contraindication	235856003	DOID:409
Pregnancy, function	contraindication	289908002
Thrombocytopenic disorder	contraindication	302215000	DOID:1588
Neutropenic disorder	contraindication	303011007	DOID:1227
Breastfeeding (mother)	contraindication	413712001
Life-Threatening Cardiac Arrhythmias	contraindication
Severe Bone Marrow Depression	contraindication

🐶 Veterinary Drug Use

None

🐶 Veterinary products

None

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	7.85	acidic
pKa2	9.21	acidic
pKa3	9.92	acidic
pKa4	11.11	acidic
pKa5	8.6	Basic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

Target	Class	Pharos	UniProt	Type	Activity value (-log[M])	Bioact source
Tyrosine-protein kinase Fyn	Kinase	P06241	FYN_HUMAN	IC50	5.29	DRUG MATRIX
5-hydroxytryptamine receptor 4	GPCR		5HT4R_CAVPO	Ki	5.88	DRUG MATRIX
NS3	Enzyme		A3EZI9_9HEPC	IC50	6.12	CHEMBL
Genome polyprotein	Unclassified		A3EZJ3_9HEPC	IC50	6.12	CHEMBL

External reference:

ID	Source
4021192	VUID
N0000148638	NUI
D02214	KEGG_DRUG
56390-09-1	SECONDARY_CAS_RN
4021192	VANDF
4021193	VANDF
C0014582	UMLSCUI
CHEBI:47898	CHEBI
DM6	PDB_CHEM_ID
CHEMBL417	ChEMBL_ID
CHEMBL1200981	ChEMBL_ID
D015251	MESH_DESCRIPTOR_UI
DB00445	DRUGBANK_ID
5171	INN_ID
3Z8479ZZ5X	UNII
41867	PUBCHEM_CID
203213	RXNORM
8302	MMSL
90558	MMSL
d04454	MMSL
003716	NDDF
003717	NDDF
116108007	SNOMEDCT_US
349848009	SNOMEDCT_US
417916005	SNOMEDCT_US

Pharmaceutical products:

Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
Ellence	HUMAN PRESCRIPTION DRUG LABEL	1	0009-5091	INJECTION, SOLUTION	2 mg	INTRAVENOUS	NDA	32 sections
Ellence	HUMAN PRESCRIPTION DRUG LABEL	1	0009-5091	INJECTION, SOLUTION	2 mg	INTRAVENOUS	NDA	32 sections
Ellence	HUMAN PRESCRIPTION DRUG LABEL	1	0009-5093	INJECTION, SOLUTION	2 mg	INTRAVENOUS	NDA	32 sections
Ellence	HUMAN PRESCRIPTION DRUG LABEL	1	0009-5093	INJECTION, SOLUTION	2 mg	INTRAVENOUS	NDA	32 sections
Epirubicin Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0143-9202	INJECTION	2 mg	INTRAVENOUS	ANDA	26 sections
Epirubicin Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0143-9203	INJECTION	2 mg	INTRAVENOUS	ANDA	26 sections
EPIRUBICIN HYDROCHLORIDE	HUMAN PRESCRIPTION DRUG LABEL	1	59923-701	INJECTION	2 mg	INTRAVENOUS	ANDA	26 sections