Health Guide
Drug Guide

Irinotecan (Intravenous route)

Pronunciation:

eye-ri-noe-TEE-kan

Brand Names:

Dosage Forms:

Warnings:

Intravenous route(Solution)

Early and late forms of diarrhea can occur. Early diarrhea may be accompanied by cholinergic symptoms which may be prevented or ameliorated by atropine; late diarrhea can be life threatening and should be treated promptly with loperamide. Monitor patients with diarrhea and give fluid and electrolytes as needed. Institute antibiotic therapy if patients develop ileus, fever, or severe neutropenia. Interrupt irinotecan and reduce subsequent doses if severe diarrhea occurs. Severe myelosuppression may occur .

Classifications:

Therapeutic

Antineoplastic Agent

Pharmacologic

Topoisomerase I Inhibitor

Uses of This Medicine:

Irinotecan injection is given together with other medicines to treat patients with metastatic cancer (a cancer that has already spread) of the colon or rectum.

Irinotecan belongs to the group of medicines called antineoplastics (cancer medicines). It interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal cells may also be affected by the medicine, other effects may also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may occur after treatment with irinotecan has been stopped. Be sure that you have discussed with your doctor the possible side effects of this medicine as well as the good it can do.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, irinotecan is used in certain patients with the following medical conditions:

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Appropriate studies have not been performed on the relationship of age to the effects of irinotecan injection in the pediatric population. Safety and efficacy have not been established.

Older adults

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of irinotecan injection in the elderly. However, elderly patients are more likely to have severe diarrhea, which may require caution and an adjustment in the dose for patients receiving irinotecan.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Proper Use of This Medicine:

A doctor or other trained health professional will give you this medicine in a hospital or cancer treatment center. This medicine is given through a needle placed in one of your veins.

Irinotecan often causes nausea and vomiting. However, it is very important that you continue to receive this medicine even if you begin to feel ill. You may receive other medicines to help with the nausea and vomiting. Ask your doctor for other ways to lessen these effects.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Make sure your doctor knows if you are pregnant before you receive this medicine. Using this medicine while you are pregnant can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have chills; fever; hives; hoarseness; itching; rash; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you receive the medicine.

While you are being treated with irinotecan, and after you stop treatment, do not have any immunizations (vaccinations) without your doctor's approval. Irinotecan may lower your body's resistance, and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not get live vaccines (e.g., nasal influenza or flu vaccine). Try to avoid persons who have taken live vaccines. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should wear a protective face mask that covers the nose and mouth.

Irinotecan may cause diarrhea, which can last long enough and be severe enough to cause serious medical problems. If diarrhea occurs while you are being treated with irinotecan:

Irinotecan can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are needed for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

Call your doctor right away if you have an unexplained fever, cough, shortness of breath, trouble with breathing, or wheezing after receiving this medicine. These may be symptoms of a serious lung problem.

This medicine may increase your risk of having blood clots. Tell your doctor right away if you start having a sudden and severe headache, trouble with breathing, or problems with vision, speech, or walking.

This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. This medicine may also cause blurred vision or other vision problems. If any of these side effects occur, do not drive, use machines, or do anything else that could be dangerous if you are not alert or not able to see well. If these reactions are especially bothersome, check with your doctor.

Ketoconazole (Nizoral®) and St. John's wort should not be used while you are receiving irinotecan. If you are using St. John's Wort, it should be discontinued at least 2 weeks before the first cycle of irinotecan. If you are using ketoconazole, it should be discontinued at least 1 week before starting irinotecan treatment.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Anxiety
black, tarry stools
blood in the urine or stools
blurred vision
changes in skin color
chest pain or discomfort
chest tightness or heaviness
chills
clay colored stools
cold hands and feet
confusion
constricted pupils
cough or hoarseness
dark urine
diarrhea with or without stomach cramps or sweating
dizziness
fainting
fast, slow, or irregular heartbeat
fever
full or bloated feeling or pressure in the stomach
headache
increased production of saliva
increased tear production
itching
lightheadedness when getting up suddenly from a lying or sitting position
loss of appetite
low blood pressure or pulse
lower back or side pain
nausea or vomiting
numbness or tingling in the face, arms, or legs
pain
pain in the chest, groin, or legs, especially calves of the legs
pain in the shoulders, arms, jaw, or neck
painful or difficult urination
pale skin
pinpoint red spots on the skin
redness or swelling of the leg
runny nose
severe headache of sudden onset
shortness of breath or troubled breathing
skin rash
slow breathing
slurred speech
sore throat
stomach pain
stopping of the heart
sudden and severe weakness in the arm or leg on one side of the body
sudden loss of coordination
sudden vision changes
sweating
swelling
swelling of the abdomen or stomach area
temporary blindness
tenderness, pain, or swelling of the arm, foot, or leg
trouble with speaking or walking
ulcers, sores, or white spots on the lips or in the mouth
unconsciousness
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
vomiting of blood
warm, red feeling over the body
yellow eyes or skin
Less common
Bleeding gums
coughing up blood
decreased urination
difficulty with swallowing
dryness of the mouth
increased menstrual flow or vaginal bleeding
increased thirst
nosebleeds
paralysis
prolonged bleeding from cuts
sneezing
wheezing
wrinkled skin
Rare
Decreased amount of urine
decreased frequency of urination
fast, irregular, or troubled breathing
hives
increased blood pressure
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid weight gain
Incidence not known
Abdominal or stomach pain and tenderness
agitation
bloated or full feeling
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
coma
constipation
depression
heartburn or indigestion
hostility
irritability
lethargy
muscle pain and cramps
muscle twitching
pain in the stomach, side, or abdomen, possibly radiating to the back
pain or discomfort in the arms, jaw, back, or neck
rectal bleeding
severe abdominal or stomach cramping or burning
severe and continuing nausea
stupor
swelling of the face, lower legs, ankles, fingers, or hands
tightness in the chest
unusual tiredness or weakness
vomiting of material that looks like coffee grounds

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Acid or sour stomach
belching
blistering, peeling, redness, or swelling of the palms of hands or bottoms of the feet
cracked lips
excess air or gas in the stomach or intestines
feeling of constant movement of self or surroundings
numbness, pain, tingling, or unusual sensations in the palms of hands or bottoms of feet
passing gas
right upper abdominal or stomach pain and fullness
sensation of spinning
sleepiness or unusual drowsiness
sleeplessness
stomach discomfort, upset, or pain
trouble sleeping
unable to sleep
weight loss
Incidence not known
Hiccups

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 10/12/2016

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