Valrubicin

Generic name: valrubicin
Brand name: Valstar
Dosage form: intravesical solution (40 mg/mL)
Drug class: Antibiotics / antineoplastics

Medically reviewed by A Ras MD.

What is valrubicin used for?

Valrubicin is a prescription medicine that is used to treat bladder cancer.

Description

Valrubicin Intravesical Solution, USP contains valrubicin (N-trifluoroacetyladriamycin-14-valerate), which is a semisynthetic analog of the anthracycline doxorubicin as a cytotoxic agent. The chemical name of valrubicin is (2 S– cis)-2-[1,2,3,4,6,11-hexahydro-2,5,12-trihydroxy-7-methoxy-6,11-dioxo-4-[[2,3,6-trideoxy-3-[(trifluoroacetyl)amino]-α-L- lyxo-hexopyranosyl]oxyl]-2-naphthacenyl]-2-oxoethylpentanoate. Valrubicin is an orange or orange-red powder that is highly lipophilic, soluble in methylene chloride, ethanol, methanol and acetone, and relatively insoluble in water. Its chemical formula is C 34H 36F 3NO 13 and its molecular weight is 723.65. The chemical structure is shown in FIGURE 1.

FIGURE 1. Chemical Structure of Valrubicin

Valrubicin Intravesical Solution, USP is intended for intravesical administration in the urinary bladder. It is supplied as a nonaqueous solution that should be diluted before intravesical administration. Each vial of Valrubicin Intravesical Solution, USP contains 200 mg valrubicin at a concentration of 40 mg/mL in 5 mL of 50% polyoxyl castor oil/50% v/v dehydrated alcohol, USP without preservatives or other additives. The solution is sterile and nonpyrogenic.

FIGURE 1. Chemical Structure of Valrubicin

Before taking valrubicin, tell your doctor:

If you are allergic to valrubicin; any part of this medicine; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
If you have any of these health problems: Small bladder, torn bladder or hole in the bladder, or a urinary tract infection (UTI).
If you have had any of these in the past 14 days: A biopsy, a procedure called transurethral resection (TUR), or damage to the urinary tract after a catheter has been placed.
If you are breast-feeding. Do not breast-feed while you take valrubicin and for 2 weeks after your last dose.

This is not a list of all drugs or health problems that interact with valrubicin.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take valrubicin with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take valrubicin?

Tell all of your health care providers that you take valrubicin. This includes your doctors, nurses, pharmacists, and dentists.
Have blood work checked as you have been told by the doctor. Talk with the doctor.
This medicine may lead to a complete response in about 1 in 5 people. Putting off having your bladder taken out may raise the chance of your cancer spreading. This can be deadly. Talk with your doctor to see if you need to think about having your bladder taken out.
This medicine may affect being able to father a child. Talk with the doctor.
If you are a man and have sex with a female who could get pregnant, protect her from pregnancy during treatment and for 3 months after your last dose.
If you are a man and your sex partner gets pregnant while you take valrubicin or within 3 months after your last dose, call your doctor right away.
This medicine may cause harm to the unborn baby if you take it while you are pregnant.
Use birth control that you can trust to prevent pregnancy while taking valrubicin and for 6 months after stopping valrubicin.
If you get pregnant while taking valrubicin or within 6 months after your last dose, call your doctor right away.

How is valrubicin best taken?

Use valrubicin as ordered by your doctor. Read all information given to you. Follow all instructions closely.

It is given through a catheter into the bladder.
You will need to try to keep valrubicin in your bladder for up to 2 hours, but no longer than 2 hours. This medicine will come out when you pass urine.
Drink plenty of liquids that do not have caffeine for several hours after getting valrubicin unless told to drink less liquids by your doctor. This helps to get rid of the drug from your bladder.

What do I do if I miss a dose?

Call your doctor to find out what to do.

What are the side effects of valrubicin that I need to call my doctor about immediately?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Worse pain or burning when passing urine or if these effects will not go away.
Not able to pass urine or change in how much urine is passed.
Blood in the urine.

What are some other side effects of valrubicin?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

Bladder irritation.
Passing urine more often.
Pain when passing urine.
Not able to control bladder.
Stomach pain.
Upset stomach.
It is normal to have red-colored urine for 24 hours after you get valrubicin. If you keep having bladder irritation or you keep passing red-colored urine, call your doctor right away.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If overdose is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.