IRINOTECAN

Irinotecan is an anti-cancer medication belonging to the camptothecin analog class. It received FDA approval on 24 August 2004 for treatment of metastatic carcinoma of the colon and rectum.

Irinotecan is a topoisomerase enzyme inhibitor used as a first-line therapy in combination with other anti-cancer medications to treat colon and rectum cancers and extensive-stage non-small cell lung cancer. It is also indicated to treat gastric cancers. Irinotecan is currently under investigation to treat ovarian and cervical cancer.

Irinotecan is a prescription drug available as an injection to be administered for over 90 minutes intravenously (into the vein), followed by other chemotherapeutic drugs. The drug will be prescribed and administered by the healthcare professional. It is normally administered no more than once a week, according to the schedule, on which days you receive irinotecan and on which days you dont receive the medication. Your doctor will determine the optimum schedule for you. Antiemetic medications may be given priorly to prevent nausea and vomiting associated with the treatment.

The common side effects of Irinotecan combination therapy are Alopecia (Hairfall), decreased body weight, abdominal pain, constipation, Diarrhea, reduced white blood cells, loss of appetite, nausea, and vomiting, anemia, dizziness, lack of energy, cough, difficulty in breathing, fever, infections, bleeding, and pain. Other serious side effects include increased liver enzymes, low platelet counts, blood clots, hypersensitivity reactions, and decreased bone marrow activity. There may be side effects during the drug infusion, such as itching in the skin, redness at the site of administration, and shortness of breath. Inform your physician if you face any of the symptoms

Irinotecan is intended to cause severe diarrhea. Report to the physician immediately if you face symptoms of diarrhea for the first time during treatment; black or bloody stools; symptoms of dehydration, inability to take fluids by mouth due to nausea or vomiting; or inability to get diarrhea under control within 24 hours. The drug may cause severe myelosuppression. Inform your doctor immediately if you have any symptoms related to myelosuppression, such as pale skin, weakness, dizziness, shortness of breath, and cough.

It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant or planning for pregnancy. Women should not get pregnant for at least six months after treatment ends. Men should not try to become fathers for at least 3 months after treatment ends. Do not breastfeed during treatment and for at least 7 days after your last dose of this medicine. Inform your physician if you have any kidney disease, liver disease, lung disease, blood/bleeding problems, or infection and about all the other prescribed, over-the-counter medicines, vitamins, nutritional supplements, or herbal medications you take. This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury.

Irinotecan requires cautious use in patients with kidney disease or those undergoing dialysis. Diarrhoea is a primary sign of irinotecan toxicity. Diarrhoea occurring more than 24 hours after administration may be severe and requires immediate treatment and close monitoring. If untreated, diarrhoea can result in dehydration and serious electrolyte imbalances, which may be life-threatening. Avoid laxatives and stool softeners during irinotecan treatment. Consume large volumes of water and rehydration fluids immediately upon symptom onset. Antidiarrheal treatment such as loperamide should be initiated. Inform your doctor of any serious side effects. Do not discontinue irinotecan without your doctor's advice. Do not take a double dose to compensate for a missed dose.

Pharmacia & Upjohn Co, US Food & Drug Administration, [Revised on Dec 2014] [Accessed on 1st June 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020571s048lbl.pdf I.D. Penman, C.W. Lees, Alimentary Tract and Pancreatic Disease, Davidson’s Principles and Practice of Medicine, 22nd Edition, 2014, 837-920. Edward Chu, Cancer Chemotherapy, Lange’s Basic and Clinical Pharmacology, 14th Edition, 2018, 948-976.