What is the most important information I should know about irinotecan?
Irinotecan can cause severe diarrhea, which can be life-threatening if it leads to dehydration. You may be given medicines to prevent or quickly treat diarrhea.
Call your doctor whenever you have diarrhea during your treatment with irinotecan.
What is irinotecan?
Irinotecan is a cancer medicine 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 should I discuss with my healthcare provider before receiving irinotecan?
You should not use irinotecan if you are allergic to it.
To make sure irinotecan is safe for you, tell your doctor if you have:
- 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.
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. A healthcare provider will give you this injection.
The IV infusion can take up to 90 minutes to complete. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle.
If any of this medicine gets on your skin, wash right away with soap and water.
You may be given medicine to prevent nausea, vomiting, diarrhea, and other side effects.
Irinotecan can cause severe diarrhea, which can be life-threatening if it leads to dehydration.
Your doctor may recommend you keep anti-diarrhea medicine (such as loperamide or Imodium) on hand at all times. Take the anti-diarrhea medicine at the first sign of loose or frequent bowel movements. Do not take loperamide for longer than 2 full days without your doctor's advice.
Call your doctor whenever you have diarrhea during your treatment with irinotecan.
You may need frequent medical tests to be sure this medicine is not causing harmful effects. Your cancer treatments may be delayed based on the results of these tests.
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.
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), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Irinotecan may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
What are the possible side effects of irinotecan?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Also call your doctor at once if you have:
- severe or ongoing vomiting or diarrhea;
- nausea or vomiting that keeps you from drinking enough fluids;
- sudden chest pain or discomfort, wheezing, dry cough, feeling short of breath;
- pain, redness, numbness, and peeling skin on your hands or feet;
-
dehydration symptoms --feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; or
-
low blood cell counts --fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed.
Common side effects may include:
- diarrhea, constipation;
- nausea, vomiting, stomach pain, loss of appetite;
- weakness;
- fever, pain, or other signs of infection;
- abnormal liver function tests; or
- temporary hair loss.
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.
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 your current medicines and any you start or stop using, especially:
- nefazodone;
- St. John's wort;
-
an antibiotic --clarithromycin, erythromycin, telithromycin;
-
antifungal medicine --itraconazole, ketoconazole, voriconazole;
-
seizure medicine --carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; or
-
antiviral medicine to treat hepatitis or HIV/AIDS --atazanavir, boceprevir, cobicistat (Stribild, Tybost), delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir, telaprevir.
This list is not complete. Other drugs may interact with irinotecan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Where can I get more information?
Your doctor or pharmacist can provide more information about irinotecan.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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