What is the difference between epirubicin and doxorubicin?

What is the difference between epirubicin and doxorubicin?

Epirubicin is a 4′-epimer of doxorubicin; the difference with the latter is in the reorientation (epimerization) of the hydroxyl group in the 4′ position of the daunosamine ring (Fig. 1).

Why is doxorubicin cardiotoxic?

Anthracycline-induced cardiotoxicity is due in large part to the generation of free radicals from doxorubicin through mitochondrial redox cycling of doxorubicin in the cardiomyocyte, which ultimately results in left ventricular dysfunction, and in the most severe cases, congestive heart failure.

Which antineoplastic drug is potent cardiotoxic?

The highest rate of cardiotoxicity occurs when trastuzumab is combined with anthracyclines. Studies have shown that the incidence of cardiotoxicity from trastuzumab does not depend on cumulative dose or treatment duration. Pertuzumab also causes cardiomyopathy, but the incidence rate is low.

How does doxorubicin affect the heart?

Doxorubicin May Cause Heart Damage While other anthracyclines (like epirubicin and mitoxantrone) may also cause heart damage, the chances are more common with doxorubicin. Doxorubicin causes both early and late heart damage (also called cardiotoxicity).

What class of drug is epirubicin?

Sugar
Epirubicin/Classification

How toxic is epirubicin?

Acute overdose with epirubicin will result in severe myelosuppression (within 10 – 14 days; mainly leukopenia and thrombocytopenia), gastrointestinal toxic effects (mainly mucositis) and acute cardiac complications (within 24 hours).

What type of cardiomyopathy is caused by doxorubicin?

Doxorubicin (Dox) is a highly effective anticancer drug but cause acute ventricular dysfunction, and also induce late-onset cardiomyopathy and heart failure. Despite extensive studies, the pathogenic sequelae leading to the progression of Dox-associated cardiomyopathy remains unknown.

How does doxorubicin cause cardiomyopathy?

Doxorubicin-induced cardiomyopathy is strongly linked to an increase in cardiac oxidative stress, as evidenced by reactive oxygen species (ROS) induced damage such as lipid peroxidation, along with reduced levels of antioxidants and sulfhydryl groups.

Is doxorubicin cardiotoxicity reversible?

Because severe doxorubicin cardiotoxicity is reversible in some patients, aggressive supportive therapy is warranted.

What drug can lead to cardiotoxicity?

Cytostatic antibiotics of the anthracycline class are the best known of the chemotherapeutic agents that cause cardiotoxicity. Alkylating agents such as cyclophosphamide, ifosfamide, cisplatin, carmustine, busulfan, chlormethine and mitomycin have also been associated with cardiotoxicity.

How does Adriamycin affect the heart?

Cardiotoxicity means permanent damage to the muscles of the heart or the functioning of the heart. Cardiotoxicity can be severe with Adriamycin treatment and may develop late during therapy, or within two to three months after the treatment has ended.

What are the side effects of epirubicin?

Side Effects

• Black, tarry stools.
• bleeding, redness, or ulcers in the mouth or throat.
• chest pain.
• cough or hoarseness.
• fever or chills.
• pain or burning in the mouth or throat.
• sores, ulcers, or white spots in the mouth or on the lips.
• swollen glands.