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Epirubicin (4′-epidoxorubicin) is a sterioisomer of the anthracycline doxorubicin. It can be used as treatment or prophylaxis after transurethral resection (TUR) in patients with superficial bladder cancer. After TUR for superficial bladder cancer, intravesical epirubicin prophylaxis decreases recurrence rates compared with placebo or TUR alone. The drug can be used as a single dose or in an induction and maintenance regimen. However, this second option may not be as effective as single-dose treatment in patients at high risk of recurrence. Epirubicin is as effective as doxorubicin and intravesical immunotherapy with bacillus Calmette-Guerin (BCG) in patients with a low risk of recurrence but may have a better tolerability profile. The drug has shown promise in combination regimens with BCG and interferon-α-2b.