Generic Name: idarubicin hydrochloride
Product Name: Zavedos
Indication: What Zavedos is used for
Zavedos is used to treat a type of leukaemia in adults known as AML (acute myelogenous leukaemia). It works by stopping cancer cells from growing and multiplying.
Zavedos may be used alone or in combination with other chemotherapy.
Ask your doctor if you have any questions about why Zavedos has been prescribed for you. Your doctor may have prescribed it for another reason.
Zavedos is only available with a doctor’s prescription.
It is not addictive.
Action: How Zavedos works
Idarubicin is a cytotoxic agent. It is a DNA intercalating agent which reacts with topoisomerase II and has an inhibitory effect on nucleic acid synthesis. The compound has a high lipophilicity which results in an increased rate of cellular uptake compared with doxorubicin and daunorubicin.
Zavedos capsules contain idarubicin hydrochloride as the active ingredient.
It also contains microcrystalline cellulose, glyceryl palmito-stearate, titanium dioxide, gelatin and TekPrint SW-9008 black ink.
Dose advice: How to use Zavedos
Before you take Zavedos capsules
When you must not take it
Do not take Zavedos if you have an allergy to:
- Any medicine containing idarubicin hydrochloride;
- Other similar medicines for cancer, e.g. daunorubicin, doxorubicin, epirubicin, mitozantrone;
- Any of the ingredients listed here.
Symptoms of an allergic reaction to Zavedos may include:
- Shortness of breath, wheezing or difficulty breathing;
- Swelling of the face, lips, tongue or other parts of the body;
- Rash, itching or hives on the skin.
Do not take the medicine if you have:
- Severe kidney problems;
- Severe liver problems;
- Severe heart problems including heart failure, abnormal heartbeat or a recent heart attack;
- A severe infection, with signs such as fever, severe chills, sore throat or mouth ulcers;
- Reduced number of red or white blood cells or platelets;
- Previously received the full course of treatment with the maximum dose of idarubicin or other similar medicines, e.g. daunorubicin, doxorubicin, epirubicin, mitozantrone.
Do not take the medicine if you are pregnant or trying to become pregnant. Do not take the medicine if your partner is trying to become pregnant. This medicine may cause birth defects if you or your partner is taking it.
Do not take the medicine if you are breastfeeding or intend to breastfeed. It is not known whether Zavedos can pass into the breast milk and affect the child. If you have any concerns about breastfeeding, consult your doctor.
Do not take Zavedos after the expiry date printed on the pack, or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Before you start to take it
Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.
Tell your doctor if you have:
- Kidney disease;
- Liver disease;
- Heart disease;
- Had previous treatment with Zavedos or any other chemotherapy;
- Had previous radiation therapy;
- Had a bone marrow transplant;
- Bone marrow depression, a blood disorder with low platelet, red blood and white blood cell counts;
- Infection or high temperature, severe chills, sore throat or mouth ulcers;
- Stomach ulcers, or vomiting blood or bleeding from the back passage.
Taking other medicines
Tell your doctor if you are taking any other medicines, including those you buy without a prescription from a pharmacy, supermarket or health food store.
Some medicines and Zavedos may interfere with each other. These include:
- Other medicines for cancer;
- Some medicines for heart problems, including calcium channel blockers, used to treat high blood pressure and angina;
- Certain medicines that may affect your liver and kidney function, e.g. some antibiotics and antifungals;
These medicines may increase some side effects of Zavedos including the effects on the heart, blood cells, the stomach or bowels, and reduce the body’s ability to fight infection.
If you are concerned about taking any other medications whilst having Zavedos treatment, ask your doctor or pharmacist.
They have more information on medicines to be careful with or avoid while taking Zavedos.
Taking Zavedos capsules
Take the capsules exactly as instructed by your doctor.
How much to take
Your doctor or pharmacist will tell you exactly how much to take.
How to take Zavedos capsules
Before taking Zavedos, examine the capsules to make sure they are intact.
Swallow the capsules whole with a glass of water. The capsules should not be opened, sucked, bitten or chewed.
Wash your hands immediately after taking the medicine.
If the powder inside the capsules accidentally has direct contact with your mouth, skin or eye, wash the area immediately and thoroughly with water.
When to take it
Zavedos capsules may be taken with a light meal.
Only take your dose in the days agreed with your doctor or pharmacist.
Take the capsules at about the same time of day. This will have the best effect and also help you to remember when to take the medicine.
How long to take it
Zavedos is usually taken for 3 days.
Continue taking the medicine for as long as your doctor tells you to.
If you take too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 131 126), or go to Accident and Emergency at your nearest hospital if you think you or anyone else may have taken too much Zavedos. Do this even if there are no signs of discomfort or poisoning. You will need urgent medical attention.
Overdose may result in nausea, vomiting, bleeding from the stomach.
Very high doses of Zavedos may cause severe damage to the heart within 24 hours and may seriously affect the production of new red and white blood cells within 1 or 2 weeks.
While you are taking Zavedos capsules
Things you must do
Keep all appointments with your doctor so that your progress can be checked. Zavedos lowers the number of white blood cells and platelets in your blood. This means that you have an increased chance of getting an infection or bleeding. Medicines such as Zavedos are also known to affect the heart particularly at high doses and after a long period of treatment. Regular tests to monitor your blood count, kidney and liver function and your heart will be required before, during and after treatment.
Tell your doctor immediately if you or your partner becomes pregnant while you are taking or just after you stop taking Zavedos. The medicine may cause birth defects if you or your partner is taking it. Use a proven method of birth control, such as the contraceptive pill or a condom, while taking the medicine and for at least 12 weeks after stopping treatment.
Tell any other doctors, dentists or pharmacists who treat you that you are taking Zavedos capsules.
If you are about to be started on any new medicine, remind your doctor, dentist or pharmacist that you are taking this medicine.
If you are going to have surgery, tell the surgeon, anaesthetist or dentist that you are using this medicine.
Things you must not do
Do not stop taking Zavedos, or change the dose, unless your doctor tells you to.
Do not start to take any other medicine before talking to your doctor or pharmacist.
Do not use this medicine to treat any other conditions unless your doctor tells you to.
Do not give your medicine to anyone else, even if they have the same condition as you.
Things to be careful of
Special care should be taken if it is necessary that you drive or operate machinery while undergoing treatment with Zavedos, especially if you are in a weakened condition.
Take the following precautions to reduce your risk of infection or bleeding:
- Avoid people who have infections. Check with your doctor immediately if you think you may be getting an infection, or if you get a fever, chills, cough, hoarse throat, lower back or side pain or find it painful or difficult to urinate;
- Be careful when using a toothbrush, toothpick or dental floss. Your doctor, dentist, nurse or pharmacist may recommend other ways to clean your teeth and gums. Check with your doctor before having any dental work;
- Be careful not to cut yourself when you are using sharp objects such as a razor or nail cutters;
- Avoid contact sports or other situations where you may bruise or get injured.
After using Zavedos
Keep Zavedos capsules in a cool dry place where the temperature stays below 25°C. Do not store Zavedos or any other medicines in the bathroom or near a sink. Do not leave it in the car or on window sills on hot days. Heat and dampness can destroy some medicines.
Keep your Zavedos capsules where children cannot reach them. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking this medicine or the expiry date has passed, return any remaining capsules to the pharmacist or the hospital for disposal.
Schedule of Zavedos
Zavedos is a Schedule 4 – prescription only medicine.
Side effects of Zavedos
Tell your doctor as soon as possible if you do not feel well during or after treatment with Zavedos. All medicines can have side effects. This medicine may have unwanted side effects in a few people. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects. Most of the side effects listed below are reversible.
Do not be alarmed by the following list of side effects. You may not experience any of them.
Ask your doctor to answer any questions you may have.
Tell your doctor or pharmacist if you notice any of the following:
- Red coloured urine for 1-2 days after treatment (this is normal and is no cause for alarm);
- Nausea and vomiting, diarrhoea, loss of appetite;
- Stomach pain and discomfort;
- Mouth ulcers, redness and irritation of the throat and mouth with difficulty in swallowing and eating;
- Skin changes such as darker areas of the skin and nails;
- Loss of hair;
- Hot flushes.
The above list includes the milder side effects of your medicine.
Tell your doctor immediately if you notice any of the following:
- Allergic reaction (swelling of the face, lips and tongue or other parts of the body, shortness of breath, wheezing or trouble breathing);
- Skin rash, itching, redness of the skin or hives;
- Signs of infection such as fever, chills, cough or mouth ulcers;
- Signs of anaemia such as headaches, shortness of breath when exercising, dizziness, looking pale;
- Bleeding or bruising more easily than normal;
- Shock due to a dangerous drop in blood pressure which may lead to collapse and coma – signs include rapid, shallow breathing, cold, clammy skin, a rapid, weak pulse, dizziness, weakness and fainting;
- Signs of sepsis or blood poisoning such as high fever, chills, headache, confusion, rapid breathing;
- Chest pain, abnormal heartbeat, fast heartbeat;
- Shortness of breath, swelling in the feet or legs due to fluid buildup;
- Vomiting blood or bleeding from the back passage, black sticky bowel motions (stools) or bloody diarrhoea.
The above list includes serious side effects that may require urgent medical attention.
Tell your doctor if you notice anything else that is making you feel unwell. Other side effects not listed above may also occur in some people.
Some of these side effects (for example, an increase in liver enzyme levels, high blood levels of uric acid) can only be found when your doctor does tests from time to time to check your prog
For further information talk to your doctor.