Irinotecan

When should one not use Irinotecan

• If you are allergic to irinotecan or any of the other ingredients of this medicine.
• If you have chronic inflammatory bowel disease (IBD) and/or blockage of the bowel.
• If you are a breastfeeding woman.
• If your bilirubin level is higher than 3 times the upper limit of the normal range.
• If you have severe bone marrow failure.
• If you have a poor physical condition (WHO performance status higher than 2).
• If you are taking or have recently taken St John's wort (a herbal medicine).
• If you are going to take or have recently taken live attenuated vaccines (vaccines against yellow fever, chicken pox, shingles, measles, mumps, rubella, tuberculosis, rotavirus, influenza) and during the 6 months after stopping the chemotherapy.

Common side effects of this drug are:

• Diarrhoea
• Vomiting
• Nausea
• Abdominal pain
• Fever

Other General Warnings

• You have Gilbert's syndrome, an inherited condition that can cause increased bilirubin levels and jaundice (yellow skin and eyes).
• You experience diarrhoea that lasts more than 24 hours, or if you get lightheaded, dizzy, or faint.
• You develop any signs of infection, such as fever (38°C or higher), chills, pain when passing urine, a new cough, or bringing up sputum after using this medicine.
• You are taking medicines such as aspirin or aspirin-containing medicines, warfarin, or vitamin E.
• You are unable to take fluids by mouth due to nausea and vomiting.
• You develop symptoms of an acute cholinergic syndrome like runny nose, increased saliva, excess tears in the eyes, sweating, flushing, abdominal cramps, and diarrhoea.
• You develop a new or worsening cough, trouble breathing, and fever after using this medicine.
• You notice chest pain, shortness of breath, swelling, pain, redness, or warmth in an arm or leg.
• You have pain in your belly and you cannot move your bowels, especially if you also have bloating and loss of appetite.
• You recently received treatment with pelvic or abdominal radiotherapy.
• You have kidney or heart disorders.
• You experience sores in the mouth, mouth pain, bleeding, or even trouble eating.
• You are planning to have surgery or any procedure.

How Does It Work?

Interactions with other medicines

• Some medicines can affect the way Irinotecan works or this medicine itself can reduce the effectiveness of other medicines taken at the same time.
• Tell your doctor about all medicines, supplements, or herbals you are currently taking or might take to avoid any possible interaction.
• Particular care should be taken if you are taking medicines used to treat fits/seizures (carbamazepine, phenobarbital, phenytoin, and fosphenytoin), medicines used to treat fungal infections (ketoconazole, itraconazole, voriconazole and posaconazole), medicines used to treat bacterial infections (clarithromycin, erythromycin, and telithromycin), medicines used to treat tuberculosis (rifampicin and rifabutin), St. John's Wort (a herbal medicine), live attenuated vaccines, medicines used to treat HIV (indinavir, atazanavir, and others), medicines used to suppress your body's immune system to prevent transplant rejection (cyclosporine and tacrolimus), medicines used to treat cancer (regorafenib, crizotinib, idelalisib, cetuximab, and apalutamide), vitamin K antagonists (blood thinners like warfarin), medicines used to relax muscles used during general anaesthesia and surgery (suxamethonium), 5-fluorouracil/folinic acid, and bevacizumab (a blood vessel growth inhibitor).
• Avoid taking laxatives and stool softeners while taking Irinotecan.

Overdose

Missed a Dose