Irinotecan

• Treatment of metastatic colorectal cancer.

When should one not use Irinotecan

• If you have a known hypersensitivity or severe allergic reaction to irinotecan hydrochloride trihydrate or any of the other ingredients of the medicine.

Common side effects of this drug are:

• Delayed onset of diarrhea (occurring more than 24 hours after infusion, which can be severe and dehydrating)
• Bone marrow suppression leading to neutropenia (low white blood cell count increasing infection risk), anemia, and thrombocytopenia (low paltelet count)
• Nausea, vomiting, and loss of appetite
• Temporary hair loss (alopecia)
• Asthenia (weakness) and fatigue
• Early diarrhea and acute cholinergic syndrome (occurring during or shortly after infusion, characterized by sweating, fall in heart rate, abdominal cramping, lacrimation, and salivation)
• Abdominal pain and mild constipation
• Mild transient liver enzyme and bilirubin elevations
• Fever and transient speech disorders during infusion
• Severe, life-threatening neutropenia and bone marrow failure
• Interstitial pulmonary disease or severe shortness of breath
• Severe allergic or anaphylactoid reactions

Other General Warnings

• You experience severe, prolonged diarrhea (especially if it begins more than 24 hours after your infusion), as this requires immediate medical attention and aggressive hydration.
• You develop a fever, chills, or signs of infection while your blood counts are low.
• You experience sudden shortness of breath, cough, or breathing difficulties.
• You have a history of Gilbert's syndrome, as specialized monitoring is required.
• Keep all scheduled blood test appointments so your doctor can check your white blood cell counts and liver function before every cycle.
• Ensure you have your prescribed anti-diarrheal medication at home before your infusion begins, and know exactly how to use it at the very first sign of late diarrhea.
• Report any fever, chills, dizziness, or persistent diarrhea to your medical team immediately.
• Watch for early cholinergic symptoms during your infusion (like excessive sweating or abdominal cramps) and notify your nurse right away so they can treat it.
• Inform all your healthcare providers that you are taking this medication before undergoing any other medical procedures or dental work.

How Does It Work?

Interactions with other medicines

• Avoid St. John's wort (a herbal supplement), as it can significantly decrease irinotecan blood levels and effectiveness.
• Avoid live or attenuated vaccines during treatment and for several months afterward due to immunosuppression.
• Inform your doctor about all prescription drugs, over-the-counter medicines, and herbal supplements you are taking, especially strong CYP3A4 inhibitors (e.g., ketoconazole) or inducers (e.g., rifampicin, anticonvulsants) which alter drug clearance.
• Use caution with neuromuscular blocking agents, as irinotecan can prolong their activity.

Interactions with food items

Overdose

Missed a Dose