Friday, October 14, 2016

irinotecan


Generic Name: irinotecan (EYE ri noe TEE kan)

Brand Names: Camptosar


What is irinotecan?

Irinotecan is a cancer medication that interferes with the growth and spread of cancer cells in the body.


Irinotecan is used to treat cancers of the colon and rectum. It is usually given with other cancer medicines in a combination chemotherapy.


Irinotecan may also be used for purposes not listed in this medication guide.


What is the most important information I should know about irinotecan?


Do not use irinotecan if you are pregnant. It could harm the unborn baby. Irinotecan can cause severe diarrhea, which can be life-threatening if it leads to dehydration. Diarrhea can occur soon after your injection or more than 24 hours later.

Your doctor may recommend you have an anti-diarrhea medicine such as loperamide (Imodium) available at all times while you are receiving irinotecan. Take the anti-diarrhea medication at the first sign of loose or frequent bowel movements.


Call your doctor if you still have diarrhea after 24 hours of taking anti-diarrhea medicine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.


Do not receive a "live" vaccine while using irinotecan, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

What should I discuss with my healthcare provider before receiving irinotecan?


You should not use irinotecan if you are allergic to it.

To make sure you can safely receive irinotecan, tell your doctor if you have any of these other conditions:



  • liver or kidney disease;




  • diabetes;




  • asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;




  • an intestinal disorder or obstruction;




  • Gilbert's syndrome;




  • fructose intolerance (irinotecan contains sorbitol); or




  • if you are receiving radiation treatment to your abdomen or pelvic area.




FDA pregnancy category D. Do not use irinotecan if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether irinotecan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using irinotecan.

How is irinotecan given?


Your doctor may recommend a DNA test before your first dose of irinotecan. Some people are genetically more likely to have certain side effects from irinotecan.


Irinotecan is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Irinotecan must be given slowly, and the IV infusion can take up to 90 minutes to complete.


You may be given other medications to prevent nausea, vomiting, diarrhea, and other side effects while you are receiving irinotecan. You may need to keep using these medications for at least a day after your irinotecan injection.


Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when irinotecan is injected. If any of the medicine gets on your skin, wash right away with soap and water. Irinotecan can cause severe diarrhea, which can occur soon after your injection or more than 24 hours later. You can easily become dehydrated if you have ongoing diarrhea. You may also develop a severe infection or a serious electrolyte imbalance.

Your doctor may recommend you have an anti-diarrhea medicine such as loperamide (Imodium) available at all times while you are receiving irinotecan. Take the anti-diarrhea medication at the first sign of loose or frequent bowel movements.


Call your doctor if you still have diarrhea after 24 hours of taking anti-diarrhea medicine. Do not take loperamide for longer than 2 full days without your doctor's advice.

To be sure this medication is not causing harmful effects, your blood may need to be tested often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.


If you need surgery, tell the surgeon ahead of time that you are using irinotecan.

What happens if I miss a dose?


Call your doctor for instructions if you miss an appointment for your irinotecan injection.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include some of the serious side effects listed in this medication guide.


What should I avoid while using irinotecan?


Avoid using a laxative or stool softener during treatment with irinotecan.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.


Do not receive a "live" vaccine while using irinotecan, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), oral polio, typhoid, chickenpox (varicella), BCG (Bacillus Calmette and Guérin), and nasal flu vaccine. Irinotecan may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Irinotecan side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • wheezing, feeling short of breath;




  • chest pain, dry cough;




  • pale skin, feeling light-headed, rapid heart rate, trouble concentrating;




  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;




  • runny nose, watery eyes, increased sweating, stomach cramps, and flushing (warmth, redness, or tingly feeling);




  • black, bloody, or tarry stools;




  • nausea or vomiting that keeps you from drinking enough fluids;




  • burning, pain, or swelling around the IV needle;




  • sudden numbness or weakness, problems with vision, speech, or balance;




  • swelling, rapid weight gain; or




  • feeling very thirsty or hot, being unable to urinate, heavy sweating, feeling light-headed, or hot and dry skin.



Less serious side effects may include:



  • dizziness;




  • temporary hair loss.




  • loss of appetite, constipation;




  • mild skin rash; or




  • redness or peeling of the skin on your hands and feet.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Irinotecan Dosing Information


Usual Adult Dose for Colorectal Cancer:

Either as a single agent or in combination with fluorouracil and leucovorin:
125 mg/m2 intravenously over 90 minutes once a week for four doses

or

as a single agent:
350 mg/m2 intravenously over 90 minutes every three weeks

or

in combination with fluorouracil and leucovorin:
180 mg/m2 intravenously over 90 minutes every other week for three doses.


What other drugs will affect irinotecan?


Before you are treated with irinotecan, tell your doctor about all other cancer medicines you have recently used.


Tell your doctor about all other medicines you use, especially:



  • atazanavir (Reyataz);




  • a diuretic (water pill);




  • ketoconazole (Extina, Ketozole, Nizoral, Xolegal);




  • rifabutin (Mycobutin);




  • rifampin (Rifadin, Rifater, Rifamate, Rimactane);




  • St. John's wort; or




  • seizure medicine such as carbamazepine (Carbatrol, Tegretol), phenobarbital (Solfoton), or phenytoin (Dilantin).



This list is not complete and other drugs may interact with irinotecan. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More irinotecan resources


  • Irinotecan Side Effects (in more detail)
  • Irinotecan Dosage
  • Irinotecan Use in Pregnancy & Breastfeeding
  • Irinotecan Drug Interactions
  • Irinotecan Support Group
  • 1 Review for Irinotecan - Add your own review/rating


  • irinotecan Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information

  • Irinotecan Prescribing Information (FDA)

  • Irinotecan MedFacts Consumer Leaflet (Wolters Kluwer)

  • Irinotecan Professional Patient Advice (Wolters Kluwer)

  • Camptosar Prescribing Information (FDA)

  • Camptosar Monograph (AHFS DI)

  • Camptosar Consumer Overview



Compare irinotecan with other medications


  • Colorectal Cancer


Where can I get more information?


  • Your doctor or pharmacist can provide more information about irinotecan.

See also: irinotecan side effects (in more detail)


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