Generic Name: Irinotecan (eye-rin-oh-TEE-kan)
Trade Name: Camptosar®
How is this drug used? Irinotecan is FDA approved for the treatment of metastatic colon and rectal cancer. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Irinotecan belongs to a group of drugs classified as a topoisomerase I inhibitors. Irinotecan produces its anti-cancer effects by causing breaks in DNA while it is replicating. The breaks in the DNA caused by irinotecan ultimately cause cellular death.
How is irinotecan given (administered)? Irinotecan is administered intravenously (into a vein) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular treatment regimen being used and the overall health of the patient.
Irinotecan may cause irritation to the vein through which it is administered, and may cause damage to tissues it comes in contact with if it escapes from the vein. Patients who experience swelling, redness, or pain at the site of administration should tell their healthcare provider.
How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with irinotecan. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.
Patients will also be monitored for diarrhea and dehydration, as the diarrhea produced by irinotecan can become life-threatening.
What are the common (occur in 30% or more of patients) side effects of treatment with irinotecan?
• Abdominal pain and/or cramping
• Flushing, sweating
• Nausea and vomiting
• Low white blood cell levels – increases the risk of infection
• Low red blood cell levels – increases the risk of anemia
• Loss of appetite
• Loss of hair
What are the less common (occur in 10% to 29% of patients) side effects of treatment with irinotecan?
• Difficulty breathing
• Redness of face during administration of drug
• Mouth sores
• Swelling of feet and ankles
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Eat small meals frequently to help alleviate nausea.
• If patients have been prescribed an anti-nausea medication, they should be sure to take the prescribed doses.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should avoid laxatives because these may make diarrhea worse.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
When should patients notify their physician?
• Swelling of feet and ankles
• Difficulty breathing
• Persistent redness, swelling, tenderness at the site of administration
• Little or no urine output
• Dizziness, lightheadedness, fainting, signs of dehydration
• Flu or cold-like symptoms: fever, chills, sore throat, cough
• Signs of infection – redness, swelling, pus, tenderness
• Persistent or extreme nausea or vomiting
• Mouth sores
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
Copyright © 2010 CancerConnect Last updated 07/10.
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