epirubicin, an antibiotic antineoplastic drug. ▪ INDICATIONS: It is used as an adjuvant therapy to treat breast cancer with axillary node involvement following resection. ▪ CONTRAINDICATIONS: Factors that prohibit its use include severe hepatic disease, baseline neutrophil count less than 1500 cells/mm3, severe myocardial insufficiency, recent myocardial infarction, pregnancy, lactation, systemic infections, and known hypersensitivity to this drug, anthracyclines, or anthracenediones. ▪ ADVERSE EFFECTS: Life-threatening effects are thrombocytopenia, leukopenia, anemia, neutropenia, secondary acute myelocytic leukemia, sinus tachycardia, premature ventricular contractions, bradycardia, and extrasystoles. Other serious adverse effects include increased blood pressure and chest pain. Common side effects include nausea, vomiting, anorexia, mucositis, diarrhea, amenorrhea, hot flashes, hyperuricemia, rash, necrosis at the injection site, reversible alopecia, infection, febrile neutropenia, lethargy, fever, and conjunctivitis.