Irinotecan

Brand name: Camptosar      

Generic name:Irinotecan  

Other names: Camptothecin-11, CPT-11 

Therapeutic Class: plant alkaloid and topoisomerase I inhibitor 

Manufacturer / Distributor: Pfizer  

Availability:  Irinotecan  is available by prescription only  

Indications: Irinotecan is used in the treatment of advanced colorectal cancer. The drug can be taken alone or in combination with other anti-cancer drugs such as 5-FU (fluorouracil).  

Irinotecan can be prescribed for other medical conditions not mentioned in this article; talk to your doctor or pharmacist for more information.  

Dosage form: Irinotecan comes as a liquid to be given intravenously into a vein 

Dosage: Irinotecan is given by intravenous injection over a period of about 90 minutes, usually in combination with other drugs. The usual dose is either 180 mg/m2 (milligram per square meter) of body surface area (BSA), every two weeks in polychemotherapy; or 350 mg/m2  in monochemotherapy every 3 weeks. However, in cases your body develops adverse reactions, the dosage can be reduced. Irinotecan should be administered by a specialist in oncology/hematology, or by competent nurse having experience in giving chemotherapy drugs.  

Overdose: the fact that Irinotecan is administered in hospital by medical professionals, the risk of overdose is greatly reduced; however, it can happen.  Irinotecan overdose often causes severe headache and reinforces the toxic effects of the medication. If you suspect that you are suffering from an overdose, contact your doctor immediately. There is no known antidote for Irinotecan overdose; however, your physician can intervene and prevent complications.   

Hours after receiving a Irinotecan injection, you may experience runny nose, increased saliva, shrinking pupils, watery eyes, sweating, flushing, diarrhea or mild stomach cramps; this does not mean you are overdosed. Most patients experience those side effects.  

Contraindication/Precautions: Irinotecan is contraindicated or should be used with precaution in the following conditions: 

·    allergy to Irinotecan or to one of its ingredients 

·     inflammatory bowel disease  

• Pregnancy or breastfeeding  
• low number of white blood cells  
• Bilirubinemia (presence of bilirubin in the blood) superior to three times than normal  
• Certain diseases: liver failure, kidney failure, or chronic lung disease.   

Mechanism of Action (MOA): Irinotecan is an antineoplastic (anticancer) agent; it kills cancer cells by interfering with their genetic material (DNA), which prevents them from reproducing or multiplying. 

Interactions: Talk you to your doctor before taking vitamins, nutritional supplements, or St. John's worth. In addition, it is important to tell your oncologist before taking any of the following drugs:  

• Atazanavir (Reyataz)
• Phenobarbital (Luminal)
• Carbamazepine (Carbatrol, Epitol, Tegretol)
• Phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin)
• Rifampin (Rifadin, Rimactane, in Rifamate and Rifater).

Side effects: by stopping the growth of cancer cells, Irinotecan also interfere with your healthy cells that multiply quickly; this often cause adverse effects.  Common Irinotecan side effects include: 

such as:  

• fatigue  
• sleepiness  
• Perte des cheveux 
• heartburn 
• weight loss 
• nausea and vomiting
• decreased appetite 
• formation of sores in the mouth 
• Bowel disorders (constipation or diarrhea).  

Although rare, Irinotecan can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:    

• shortness of breath or difficulty breathing 
• painful or difficulty swallowing 
• yellowing of the skin or eyes (jaundice) 
• skin disorders such as rash, hives or itching 
• Swelling of your arms, feet, ankles, or lower legs.