Care During Chemotherapy and Beyond


(val ROO bi sin)

Trade name:Valrubicin®

Valrubicin is the generic for the trade chemotherapy drug Valstar®. In some cases, health care professionals may use the trade name Valstar ® when referring to the generic drug name Valrubicin.

Drug type: Valrubicin is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug. Valrubicin is classified as an “anthracycline antiobiotic.” (For more detail, see "How this drug works," below.)

What This Drug Is Used For:

  • Valrubicin is for the treatment of bladder cancer.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How This Drug Is Given:

  • Valrubicin is given by intravesical instillation. This means it is given directly into the bladder through a urinary catheter. The bladder is emptied prior to instillation of Valrubicin in to the bladder by voiding. The urinary catheter is inserted through the urethra (the tube which carries urine from the bladder to the outside the body). The Valrubicin solution is injected into the catheter and the catheter is then removed. The patient is encouraged to roll from side to side and to lie on their backs to help the medication reach all areas of the bladder.
  • It is very important that the Valrubicin remains in the bladder for 2 hours before voiding.
  • Valrubicin is given as an outpatient procedure at a cancer center, doctor’s office or hospital.
  • It is important to maintain adequate hydration with this medication.

Side Effects:

Important things to remember about the side effects of Valrubicin:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • In general, local adverse reactions occur during or shortly after instillation and resolve within 1-7 days.

The following side effects are common (occurring in greater than 30%) for patients taking Valrubicin:

These side effects are less common side effects (occurring in about 10-29%) of patients receiving Valrubicin:

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C or higher, chills)
  • Signs of a reaction to this drug (wheezing; chest tightness; fever; itching; bad cough; seizures; or swelling of the face, tongue, lips or throat)
  • Always inform your health care provider if you experience any unusual symptoms

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Diarrhea (4-6 episodes in a 24-hour period).
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
  • Pain with passing urine or blood in the urine.
  • Not able to pass urine.

· Red-tinged urine after 24 hours of receiving medication.

Always inform your health care provider if you experience any unusual symptoms.


  • Before starting Valrubicin treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking Valrubicin.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Valrubicin is pregnancy category C (Valrubicin may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.)
  • For both men and women: Do not conceive a child (get pregnant) while taking Valrubicin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • If you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
  • Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Valrubicin can cause visual changes, dizziness and tiredness. If you have any of these symptoms, use caution when driving a car, using machinery, or anything that requires you to be alert.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking Valrubicin, to monitor side effects and check your response to therapy

How This Drug Works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. “Normal” cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. Chemotherapy will kill all cells that are rapidly dividing. The “normal” cells will grow back and be healthy but in the meantime, side effects occur.

Valrubicin is classified as an antitumor antibiotic. Antitumor antibiotics are made from natural products produced by species of the soil fungus Streptomyces. These drugs act during multiple phases of the cell cycle and are considered cell-cycle specific. There are several types of antitumor antibiotics:

Anthracyclines: Valrubicin, Doxorubicin, Daunomycin, Mitoxantrone, and Idarubicin

Chromomycins: Dactinomycin and Plicamycin

Miscellaneous: Mitomycin and Bleomycin

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit