Neoquabin Dosage/Direction for Use

Epirubicin hydrochloride is administered intravenously by injection in a solution of sodium chloride 0.9% or water for injections into a fast-running infusion of sodium chloride 0.9% or glucose 5% over 3 to 5 minutes, or by infusion over up to 30 minutes. It is given as a single agent in usual doses of 60 to 90 mg per m² body surface as a single dose every 3 weeks; this dose may be divided over 2 or 3 days if desired. High dose regimens of 120 mg or more per m² every 3 weeks, or 45 mg per m² for 3 consecutive days every 3 weeks have been used. A regimen of 20 mg as a single weekly dose has also been tried and is reported to be associated with lower toxicity. Doses should be reduced if epirubicin is given with other antineoplastics, and should be halved in patients with moderate liver dysfunction serum bilirubin concentrations of 14-30 μg per mL while those with severe liver impairment (serum bilirubin greater than 30 μg per mL) should be given a quarter of the usual dose. Reduced doses are also recommended in those whose bone marrow function is impaired by age or previous chemotherapy or radiotherapy. A total cumulative dose of 0.9 to 1 g per m² should not generally be exceeded because of the risk of cardiotoxicity.
Epirubicin has also been given by intravesical instillation in the local treatment of bladder cancer. Instillation of 50 mg weekly as a 0.1% solution for 8 weeks has been suggested reduced to 30 mg weekly. If chemical cystitis develops for carcinoma in-situ, the dose may be increased, if tolerated to 80 mg weekly. For the prophylaxis of recurrence in patients who have undergone transurethral resection. 50 mg weekly for 4 weeks, followed by 50 mg instilled once a month for 11 months is the suggested regimen.
Blood counts should be made routinely during treatment with epirubicin and cardiac function should be carefully monitored. Liver function should be assessed before and if possible during therapy. Or as prescribed by the physician.