Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Idarubicin. If you are concerned about side effects, discuss the risks and benefits of Idarubicin with your doctor.

The following side effects have been reported by at least 1% of people taking Idarubicin. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• Diarrhea
• fatigue
• headache
• hot flashes
• loss of appetite
• nausea
• skin and nail changes, discolouration
• temporary total loss of hair (returns after treatments end)
• urine turning reddish in colour (not blood) – this is normal, and lasts 1 to 2 days after each dose
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal pain
• severe diarrhea with or without blood in the stool
• signs of bleeding (e.g., bloody nose, blood in urine or stools, coughing blood, cuts that don't stop bleeding, unusual bleeding or bruising, black, tarry stools)
• signs of decreased red blood cells (Anemia; e.g., pale skin, fatigue, shortness of breath, rapid heartbeat)
• signs of dehydration (e.g., decreased urine, dry skin, dry and sticky mouth, sleepiness, dizziness, headache, thirst, confusion)
• signs of Gout (e.g., joint pain, swelling and warmth of joints)
• signs of Kidney Stones (e.g., lower back or side pain, painful or difficult urination)
• signs of infection (e.g., cough, Fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• skin rash or Hives and itching
• skin sensitivity of an area that has received radiation
• sores in mouth and on lips

Stop using the medication and seek immediate medical attention if any of the following occur:

• fever or chills
• painful or difficult urination with fever or chills
• severe stomach pain
• signs of Blood Clots (e.g., difficulty breathing, pain, swelling and warmth in one leg or arm, chest pain)
• signs of heart problems (e.g., fast or irregular heartbeat, swelling of lower legs, feet, and abdomen, wheezing, trouble breathing, or shortness of breath)
• signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• skin reaction at the injection site (e.g., pain, blistering, stinging or burning)
• symptoms of tumour lysis syndrome (e.g., producing less urine, cloudy urine, kidney problems, muscle spasms, nausea, shortness of breath)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Idarubicin.

Do not use Idarubicin if you:

• are allergic to idarubicin or any ingredients of the medication or the container
• are allergic to any anthracycline medication (such as Epirubicin, Daunorubicin, Mitoxantrone, Mitomycin C)
• have a history of severe heart disease
• have an irregular heart rhythm
• have an uncontrolled infection
• have had a recent Heart Attack
• have low blood cell counts caused by previous cancer treatment or radiation therapy
• have previously been treated with maximum allowable lifetime doses of any anthracycline drug (e.g., Doxorubicin, daunorubicin, epirubicin, idarubicin) or mitoxantrone
• have severely reduced heart function
• have severely reduced kidney function
• have severely reduced liver function

There may be an interaction between idarubicin and any of the following:

• Amiodarone
• amphotericin B
• "azole" antifungals (e.g., fluconazole, itraconazole, Voriconazole)
• BCG
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Verapamil) and other cardiac medications that lower the heart's ability to pump blood
• Carvedilol
• Clozapine
• Cyclosporine
• Deferiprone
• Dexamethasone
• Digoxin
• Dipyridamole
• dipyrone
• Dronedarone
• echinacea
• Fingolimod
• other cancer drugs, especially anthracyclines
• grapefruit juice
• Leflunomide
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• Pimecrolimus
• protein kinase inhibitors (e.g., Crizotinib, Dasatinib, imatinib, Nilotinib)
• quinidine
• quinine
• rifampin
• Roflumilast
• St John's wort
• Tacrolimus
• tenofovir
• Tofacitinib
• vaccines

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Idarubicin. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, decongestants, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Idarubicin.

Blood clotting: Idarubicin can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising or cuts that won't stop bleeding.

Gout and kidney stones: Idarubicin may increase the level of uric acid in the body as the cancer cells are destroyed. If you develop painful, warm and swollen joints or difficulty with urination, contact your doctor as soon as possible.

If you have a history of gout or kidney stones, discuss with your doctor how Idarubicin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Idarubicin, and whether any special monitoring is needed.

Heart problems: Idarubicin increases the risk of heart problems such as abnormal heart rhythm, Congestive Heart Failure, and a weakened heart (cardiomyopathy). Some of these problems occur early in treatment, while others occur later in treatment or after treatment is completed.

If you have existing heart disease, have had radiotherapy, have been treated with Idarubicin in the past, and are taking certain medications that act on the heart, you are more at risk of these problems.

If you have heart disease, your doctor should closely monitor your condition while you are receiving treatment with idarubicin.

Infection: As well as killing cancer cells, idarubicin can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people that have contagious infections.

Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Kidney function: The kidneys help remove idarubicin from the body. When they are not working well, the risk of side effects is increased.

If you have reduced kidney function or Kidney Disease, discuss with your doctor how Idarubicin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Idarubicin, and whether any special monitoring is needed.

Liver function: The liver helps remove idarubicin from the body. When the liver is not working well, the risk of side effects is increased.

If you have reduced liver function or liver disease, discuss with your doctor how Idarubicin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Idarubicin, and whether any special monitoring is needed.

Red blood cells: Idarubicin may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.

Secondary leukemia: Like other similar cancer medications, idarubicin has been linked to blood cancer, developing several years after treatment has finished. Talk to your doctor if you have concerns.

Tumour Lysis Syndrome: Idarubicin, like many other cancer medications, causes many cancer cells to be suddenly killed when treatment is first started. This can overwhelm the body with waste products from the cells. When this happens, you may experience nausea, shortness of breath, notice cloudy urine or joint pain. This is called tumour lysis syndrome. Your doctor may prescribe some medications to help your body get rid of the waste products. Make sure you understand how to use these medications and report any of these signs or symptoms to your doctor immediately.

Vaccines: The effectiveness of other vaccines while using Idarubicin may be decreased. Talk to your doctor about ensuring your vaccinations are up to date.

Pregnancy: There is a possibility of birth defects if either the father or mother is using idarubicin at the time of conception, or if it is taken during pregnancy. Effective birth control should be practiced while using Idarubicin as Idarubicin may harm the baby if used during pregnancy.

If you become pregnant while taking Idarubicin, contact your doctor immediately.

Breast-feeding: It is not known if idarubicin passes into breast milk. Due to the potential for serious harm to the baby, women receiving idarubicin should not breast-feed.

Seniors: Seniors appear to have an increased risk of severe side effects, such as heart attack, heart failure or developing irregular heart rhythms.