Valstar (Valrubicin) for bladder cancer

Overview
Valstar is approved by the U.S. Food and Drug Administration (FDA) to treat carcinoma in situ (CIS), a type of bladder cancer that has not spread beyond the bladder lining, in people who did not respond to Bacillus Calmette-Guérin therapy, a common bladder cancer treatment. It is for individuals who cannot safely have a cystectomy (surgery to remove the bladder). To receive Valstar, the bladder lining must be healthy enough, and the recipient must be able to handle having medicine placed in their bladder. Valstar is also known by its drug name, valrubicin.

Valstar is part of a group of cancer drugs called anthracycline topoisomerase inhibitors. It works by damaging the DNA in cancer cells in the bladder lining. This stops the cells from growing and causes them to die.

How do I take it?
Valstar is given intravesically, which means it is placed directly into the bladder, once a week for six weeks. Before starting treatment, doctors check the bladder for any perforations (tears) or other problems. Treatment should begin at least two weeks after any bladder surgery. The medicine must be warmed to room temperature before use but should not be heated. Valstar should always be used exactly as instructed by your health care provider.

Side effects
Common side effects of Valstar include urinary frequency, dysuria (painful urination), urinary urgency, bladder spasms, hematuria (blood in urine), bladder pain, urinary incontinence, cystitis (bladder inflammation), urinary tract infections, nocturia (frequent nighttime urination), local burning sensations, abdominal pain, and nausea.

Rare but serious side effects may include delayed cystectomy leading to metastatic bladder cancer (cancer spreading beyond the bladder), bladder perforation, and severe irritation of the bladder. Valstar may cause harm to an unborn fetus if taken during pregnancy. 

For more information about this treatment, visit:

Label: Valstar — Valrubicin Solution, Concentrate — DailyMed