(idarubicin hydrochloride)

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Adverse Reactions

6 ADVERSE REACTIONS

The following clinically significant adverse reactions are described elsewhere in the labeling:

Cardiomyopathy [see Warnings and Precautions (5.1)]
Secondary Malignancies [see Warnings and Precautions (5.2)]
Severe Local Tissue Necrosis with Extravasation [see Warnings and Precautions (5.3)]
Severe Myelosuppression [see Warnings and Precautions (5.4)]
Tumor Lysis Syndrome [see Warnings and Precautions (5.5)]
Hypersensitivity [see Warnings and Precautions (5.6)]

6.1 Clinical Trials and Postmarketing Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The safety of IDAMYCIN PFS in combination with cytarabine has been evaluated in four controlled clinical studies with 823 patients with AML randomized to receive idarubicin hydrochloride (n=401) or daunorubicin (n=422) [see Clinical Studies (14)].

Southeastern Cancer Study Group (SEG)

Table 3 below lists the adverse reactions that occurred in patients with AML who received idarubicin hydrochloride in the Southeastern Cancer Study Group (SEG) study.

Table 3: Adverse Reactions (≥5%) in Patients with AML Who Received Idarubicin Hydrochloride as Induction Therapy in the SEG Trial

Adverse Reactions

Idarubicin with Cytarabine

(N=110)

Daunorubicin with Cytarabine

(N=118)

All Grades

%

All Grades

%

Infection

95

97

Nausea/Vomiting

82

80

Alopecia

77

72

Abdominal Pain/Diarrhea

73

68

Hemorrhage

63

65

Mucositis

50

55

Dermatologic

46

40

Mental Status Changes

41

34

Pulmonary Disorders

39

39

Fever

26

28

Headache

20

24

Cardiac Disorder

16

24

Peripheral Neuropathy

7

9

Clinically relevant adverse reactions in <5% of patients who received idarubicin hydrochloride included pulmonary allergy, seizure, and cerebellar adverse reactions.

Other Clinical Trials

The following additional adverse reactions associated with the use of idarubicin hydrochloride were identified in clinical studies or postmarketing reports. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Cardiac

Asymptomatic declines in Left Ventricular Ejection Fraction (LVEF)
Chest pain
Congestive heart failure
Myocardial infarction
Serious arrhythmias including atrial fibrillation

Dermatologic

Bullous erythrodermatous rash (palms and soles)
Generalized rash
Radiation recall (skin reaction)
Urticaria

Gastrointestinal

Severe enterocolitis with perforation

Hepatic

Increased ALT/AST

Renal

Renal impairment
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