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Daunorubicin (Cerubidin)

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This page tells you about the chemotherapy drug daunorubicin and its possible side effects. There are sections about


What daunorubicin is

Daunorubicin is a drug used to treat acute leukaemias. It is also called by its brand name Cerubidin.


How daunorubicin works

Daunorubicin is a type of chemotherapy called an anti tumour antibiotic. It blocks an enzyme called topoisomerase 2. If this enzyme is blocked, the cell's DNA gets tangled up and the cell cannot split into 2 new cancer cells. It also produces chemicals that are toxic to cancer cells.


How you have daunorubicin

Daunorubicin is a red liquid. You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. The tube stays in place as long as you need it.

You may have the drug injected into a fast running drip connected to your cannula or central line over about 10 minutes. Or you may have the drug running  through the drip over about an hour.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for daunorubicin depends on which type of leukaemia you have. We have a page about planning chemotherapy.

We've listed the side effects associated with daunorubicin below. You can use the links (underlined) to find out more about each side effect. Where there is no link please see our cancer drugs side effects section, or click on search at the top of the page.


Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C. You will have regular blood tests to check your blood cell levels
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
  • Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
  • Feeling or being sick – this is usually well controlled with anti sickness medicines
  • Hair loss – everyone treated with this drug will lose all or some of their head and body hair
  • A sore mouth
  • Red urine happens for a couple of days after your injection – this won't harm you and will go away on its own
  • Women may stop having periods (amenorrhoea) – this may only be temporary
  • Loss of fertility – you may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these effects.

  • Skin and nail changes – this drug can make your nails become darker, and can cause an itchy rash and reddening of the skin in areas that had radiotherapy in the past
  • Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or continues for more than 3 days
  • Inflammation around the drip siteif you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse straight away

Rare side effects

Fewer than 1 in 100 people have these effects.

  • A high temperature (fever) and chills
  • Abdominal (tummy) pain
  • Heart damage – daunorubicin can cause temporary damage to the muscles of the heart, which may change the rhythm of the heartbeat. In most people this will go back to normal after the treatment is completed. You will have heart checks during treatment

Important points to remember

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)
  • Other drugs you are having

Coping with side effects

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


Do not breastfeed during this treatment because the drug may come through in the breast milk.


Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.


More information about daunorubicin

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 4 August 2014