Idarubicin (Zavedos) | Cancer Research UK
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What idarubicin is

Idarubicin is also called by its brand name Zavedos. It is a chemotherapy drug used to treat some types of cancer including acute myeloid leukaemia and advanced breast cancer.


How idarubicin works

One of the ways idarubicin works is by blocking an enzyme (called topoisomerase 2). If this enzyme is blocked the cell's DNA gets tangled up and the cell can't split into 2 new cancer cells. The cell then dies.


How you have idarubicin

Idarubicin is a red liquid. You have it into your bloodstream (intravenously). 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. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.

You can read our information about having chemotherapy into a vein.

Idarubicin also comes in 5mg red capsules and 10 mg red and white capsules. You should swallow the capsules whole with plenty of water and can take them with a light meal. It is very important that you take the capsules according to the instructions your doctor or pharmacist gives you. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for idarubicin depends on which type of cancer you have.

The side effects of idarubicin are listed 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 use the search box 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 that their energy levels are back to normal from 6 months to a year after their treatment ends
  • Feeling or being sick happens to 9 out of 10 people (90%) and usually starts about 2 to 4 hours after treatment begins and lasts a couple of days. It is usually possible to control this side effect with anti sickness injections and tablets. If you are still being sick, tell your doctor or nurse, as your anti sickness medicines may need to be changed
  • Loss of appetite
  • Hair loss – nearly everyone has complete head and body hair loss, which begins 2 to 5 weeks after the treatment starts. Your hair will grow back after your treatment ends
  • A sore mouth and throat can happen about 2 to 3 days after each treatment – you may have red, sore skin in your mouth as well as mouth ulcers. It usually clears up within 3 weeks of treatment finishing. Your nurse may give you a mouthwash to reduce this
  • Your urine may turn pink or red for up to 2 days after having idarubicin – this won't harm you
  • Diarrhoea – drink plenty of fluids and tell your doctor or nurse if the diarrhoea becomes severe, or lasts more than a couple of days
  • A high temperature (fever) and chills – taking paracetamol every 6 to 8 hours can help
  • Headaches

Occasional side effects

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

  • Inflammation around the drip siteif you notice any signs of redness, swelling or leaking at your drip site, tell your nurse straight away
  • Your skin may become more sensitive to the sun during your treatment and for several months afterwards. You need to cover up and stay in the shade. Use a high factor sun cream if you do go out
  • If you have had radiotherapy in the past, the skin in the treatment area may become dry and flaky. You may also have some pain and burning similar to sunburn
  • Your nails may become darker and white lines may appear on them
  • Black or brown discoloration may occur in the creases of your skin – this is particularly common in children
  • Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal after treatment. You will have regular blood tests to check how well your liver is working
  • Damage to heart muscle, which is usually temporary and may change the rhythm of the heartbeat. For a small number of people the change may be permanent. Your doctor or nurse will check your heart before and after your treatment
  • Stomach ache and bleeding from the small bowel – let your doctor or nurse know straight away if your stools look darker or you notice blood
  • Skin rashes or itching

Rare side effects

Fewer than 1 in 100 people have these effects.

  • An allergic reaction causing a raised temperature, shivering and a rash – let your doctor or nurse know straight away if you have this
  • 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 this treatment. 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
  • Painful joints due to raised uric acid levels in the blood
  • A second cancer or leukaemia may develop some years after idarubicin treatment but this is rare

High dose treatment

With high doses, or many treatments, there is a small risk that you may develop permanent heart problems.


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 this drug. Use reliable contraception throughout the treatment and men need to continue to do so for 3 months after treatment ends. 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 idarubicin

This information 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

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


Related information

We have information about advanced breast cancer.

You can also read about acute myeloid leukaemia.

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Updated: 6 February 2015