# Idarubicin

Source: https://onco.cc/drugs/idarubicin/  
OnCo record `idarubicin` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Idarubicin is an anthracycline chemotherapy approved in 1990 for adult acute myeloid leukaemia, given with cytarabine in 3+7 induction and FLAG-Ida salvage and in acute promyelocytic leukaemia protocols. Randomised trials showed more complete remissions than with daunorubicin, which is why centres prefer it; heart damage, marrow suppression and extravasation injury are the class risks.

## Summary

Idarubicin was approved in 1990 for adult acute myeloid leukaemia as part of combination induction. Four randomised trials totalling 823 newly diagnosed patients (Memorial Sloan Kettering, Southeastern Cancer Study Group, US multicentre and GIMEMA) compared idarubicin with daunorubicin, each with cytarabine, and showed higher complete remission rates and, in some, longer survival with idarubicin; it is a standard induction anthracycline (for example in the 3+7 and the FLAG-Ida salvage regimens) and in acute promyelocytic leukaemia protocols with all-trans retinoic acid. Cardiotoxicity, severe myelosuppression and extravasation injury are the class risks.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-10
- Tags: nci-list; generic
- Brand: Idamycin PFS
- Modality: Anthracycline (topoisomerase II inhibitor)
- Mechanism: 4-demethoxy analogue of daunorubicin; more lipophilic, with an active metabolite (idarubicinol); intercalates DNA and inhibits topoisomerase II.
- Approvals: US 1990: Adult acute myeloid leukaemia, as a component of combination induction chemotherapy

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Idarubicin
- US label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=idarubicin
- NCI drug page: https://www.cancer.gov/about-cancer/treatment/drugs/idarubicinhydrochloride

## Connected records

- drugs: [Cytarabine](https://onco.cc/drugs/cytarabine/), [Daunorubicin](https://onco.cc/drugs/daunorubicin/)
- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [Acute promyelocytic leukaemia](https://onco.cc/cancers/apl/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Topoisomerase-I inhibitors (and ADC payloads)](https://onco.cc/technologies/topoisomerase-inhibitors/)
- companies: [Pfizer (incl. Seagen)](https://onco.cc/companies/pfizer/)
- trials: [A Global Study of Midostaurin in Combination With Chemotherapy to Evaluate Safety, Efficacy and Pharmacokinetics in Newly Diagnosed Pediatric Patients With FLT3 Mutated AML](https://onco.cc/trials/nct03591510/), [ALL R3 (UKALLR3)](https://onco.cc/trials/ukallr3/), [Combination Chemotherapy With or Without G-CSF in Treating Older Patients With Acute Myeloid Leukemia](https://onco.cc/trials/nct00002719/), [Combination Chemotherapy, Biological Therapy, and Bone Marrow Transplantation in Treating Patients With Acute Myeloid Leukemia](https://onco.cc/trials/nct00002658/), [Study of Magrolimab in Combination With Azacitidine Versus Physician's Choice of Venetoclax in Combination With Azacitidine or Intensive Chemotherapy in Patients With TP53 Mutant Acute Myeloid Leukemia That Have Not Been Treated](https://onco.cc/trials/nct04778397/)
- key papers: [ALL R3: mitoxantrone versus idarubicin in first relapse of childhood acute lymphoblastic leukaemia](https://onco.cc/key-papers/paper-all-r3-mitoxantrone-relapsed-childhood-all-parker-lancet-2010/)

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