What is Irinotecan?

Irinotecan is a cancer (antineoplastic) medication.  Irinotecan belongs to a general group of chemotherapy drugs known as topoisomerase inhibitors. It is used to treat colon and rectal cancers.   

How does Irinotecan work?

Irinotecan interferes with the growth of cancer cells and slows their growth and spread in the body. Irinotecan stops the growth of cancer cells by preventing the development of elements necessary for cell division.   

What is Irinotecan used for?

•  Your doctor will determine the correct amount and frequency of treatment with irinotecan depending upon the type of cancer being treated and other factors. Talk to your doctor if you have any questions or concerns regarding the treatment schedule.

•  Irinotecan should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

•  Your doctor will probably want you to have regularly scheduled blood tests and other medical evaluations during treatment with irinotecan to monitor progress and side effects.

•  Skin accidentally exposed to irinotecan should be rinsed thoroughly with soap and warm water.

•  Medications to reduce or prevent nausea, vomiting, and diarrhea may be prescribed by your doctor for use during treatment with irinotecan. Loperamide (Imodium, Imotil, Kaopectate Caplet, Maalox Anti-Diarrheal, Pepto Diarrhea Control, and others) should be kept readily available to begin treatment for late diarrhea (generally occurring more than 24 hours after administration of irinotecan) at the first episode of poorly formed or loose stools or the earliest onset of bowel movements more frequent than normally expected for the patient.

•  Your healthcare provider will store irinotecan as directed by the manufacturer. If you are storing irinotecan at home, follow the directions provided by your healthcare provider.

How should I use irinotecan?

•  Irinotecan should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

 • Your doctor will determine the correct amount and frequency of treatment with irinotecan depending upon the type of cancer being treated and other factors. Talk to your doctor if you have any questions or concerns regarding the treatment schedule.

•  Your doctor will probably want you to have regularly scheduled blood tests and other medical evaluations during treatment with irinotecan to monitor progress and side effects.

•  Medications to reduce or prevent nausea, vomiting, and diarrhea may be prescribed by your doctor for use during treatment with irinotecan. Loperamide (Imodium, Imotil, Kaopectate Caplet, Maalox Anti-Diarrheal, Pepto Diarrhea Control, and others) should be kept readily available to begin treatment for late diarrhea (generally occurring more than 24 hours after administration of irinotecan) at the first episode of poorly formed or loose stools or the earliest onset of bowel movements more frequent than normally expected for the patient.

•  Skin accidentally exposed to irinotecan should be rinsed thoroughly with soap and warm water.

•  Your healthcare provider will store irinotecan as directed by the manufacturer. If you are storing irinotecan at home, follow the directions provided by your healthcare provider.

How Irinotecan is given?

Irinotecan is given by an injection in a vein over 90 minutes weekly for 3 weeks and then 1 off, or once every 3 weeks. The dose depends on your size, your age, whether you have had radiation to your abdomen/pelvis, how well your liver is working, your blood counts, and whether you have had any side effects such as diarrhea.   

Irinotecan side effects

While you are being treated with irinotecan, and after you stop treatment, do not have any immunizations (vaccinations) without your doctor’s okay. Try to avoid contact with people who have recently taken the oral polio vaccine. Check with your doctor about this.

Irinotecan may lower your blood counts (white blood cells, red blood cells, platelets). Your doctor will check your blood counts before and after each treatment to see how it affects your blood counts. Your doctor or nurse will give you specific instructions if your blood counts are low.

Irinotecan can decrease your white blood cell count, especially 21 days after the drug is given. This can increase your risk of getting an infection. Report fever of 100.5°F or higher, or signs of infection such as pain in passing your urine, or coughing, and bringing up sputum.

Irinotecan can decrease your platelet count. This can increase your risk of bleeding. DO NOT take any aspirin or aspirin–containing medicines. Report unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

During the drug infusion, tell your nurse if you start sweating, have abdominal cramping, or diarrhea. Your nurse will give you a special medicine to stop this reaction.

Irinotecan can cause nausea and vomiting. Ask your doctor or nurse to give you medicines to prevent or lessen this.

Irinotecan can cause severe diarrhea. It is very important to understand how to give yourself medicine to stop the diarrhea. Your doctor or nurse will give you instructions. Make sure you get the medicine right away, so that you will have it at home to stop the diarrhea immediately.   

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

The use of irinotecan may be dangerous if you have any of the conditions listed above.

• Irinotecan is in the FDA pregnancy category D. This means that irinotecan is known to be harmful to an unborn baby. Do not use irinotecan without first talking to your doctor if you are pregnant. Discuss with your doctor the appropriate use of birth control during treatment with irinotecan if necessary.

• It is not known whether irinotecan passes into breast milk. Do not take irinotecan without first talking to your doctor if you are breast feeding a baby.

•  If you are over 65 years of age, you may be more likely to experience side effects from irinotecan.

What happens if I overdose?

• If for any reason an overdose of irinotecan is suspected, seek emergency medical attention or contact your healthcare provider immediately.

• Symptoms of a irinotecan overdose tend to be similar to side effects caused by the medication, although often more severe.

What should I avoid while using irinotecan?

•  Avoid the use of laxatives during treatment with irinotecan.

• Irinotecan can lower the activity of your immune system making you susceptible to infections. Avoid contact with people who have colds, the flu, or other contagious illnesses and do not receive vaccines that contain live strains of a virus (e.g., live oral polio vaccine) during treatment with irinotecan. In addition, avoid contact with individuals who have recently been vaccinated with a live vaccine. There is a chance that the virus can be passed on to you.

• Skin accidentally exposed to irinotecan should be rinsed thoroughly with soap and warm water.

What other drugs will affect irinotecan?

• Before using irinotecan, tell your doctor if you are taking a diuretic medication (water pill), for high blood pressure or other reason. You may not be able to take irinotecan, or you may require a dosage adjustment or special monitoring during treatment if you are taking a diuretic.

•   Avoid the use of laxatives during treatment with irinotecan.

•    Drugs other than those listed here may also interact with irinotecan. Talk to your doctor and pharmacist before taking any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, during treatment with irinotecan.

Disclaimer:

Information on this page is provided for general information purposes. You should not make a clinical treatment decision based on information contained in this page without consulting other references including the package insert of the drug, textbooks and where relevant, expert opinion. We cannot be held responsible for any errors you make in administering drugs mentioned on this page, nor for use of any erroneous information contained on this page.