Daunorubicin (Cerubidin)

Daunorubicin is used to treat acute leukaemias. It is an anti tumour antibiotic and is also called by its brand name Cerubidin. It works by blocking 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.

Daunorubicin is a red liquid that you have through a drip into a vein (intravenous infusion). You may have the drug injected into a fast running drip over about 10 minutes. Or you may have it 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. There is information about planning chemotherapy in the main chemotherapy section.

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 just before your course of treatment starts and it stays in place as long as you need it.

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.

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

A temporary drop in the number of blood cells made by the bone marrow, causing

• 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, sore throat, pain passing urine or feel cold and shivery
• 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)

Some of these side effects can be life threatening, particularly infections. You should contact your treatment team if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue (tiredness) 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 – it is harmless and will go away on its own
• Daunorubicin may have a harmful effect on a developing baby – you should not become pregnant or father a child if you are having this drug. You need to talk about contraception with your doctor or nurse before having the treatment if there is any possibility you or your partner could become pregnant.
• Loss of fertility – we don’t know exactly how this drug affects fertility so do talk with your doctor before starting treatment if having a baby is important to you
• Women may stop having periods (amenorrhoea) – this may only be temporary

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

• Skin 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 site – if you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse immediately

Fewer than 1 in 100 people have these.

• Fever and chills
• Abdominal 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.

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

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. 

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

Breastfeeding is not advisable during daunorubicin treatment because the drug may come through in the breast milk

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, live vaccines include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines 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.