IRINOTECAN

Topoisomerase I inhibitor anticancer

Dosage Forms

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Infusion

20 mg/ml

Uses

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  • Advanced colorectal cancer

Dose and Duration

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Colorectal cancer (monotherapy)
  • 350 mg/m² as IV infusion over 30−90 minutes every 3 weeks
Colorectal cancer (in combination with 5-fluorouracil and folinic acid)
  • 180 mg/m² as IV infusion over 30−90 minutes once every 2 weeks (given before folinic acid and fluorouracil)

Contraindications

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  • Chronic inflammatory bowel disease
  • Bowel obstruction
  • Children
  • Hypersensitivity to irinotecan
  • Bilirubin levels > 3 times the upper normal limit
  • Severe bone marrow failure

Side Effects

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  • Diarrhoea (can be severe), nausea and vomiting
  • Dehydration
  • Neutropenia, anaemia, thrombocytopenia
  • Fever
  • Acute cholinergic syndrome (asthenia)
  • Increased liver enzyme levels (ALT, AST, ALP)
  • Increased bilirubin levels

Interactions

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  • Ketoconazole (increased effect of irinotecan)
  • Clozapine (increased risk of agranulocytosis)
  • Atazanavir (increased risk of toxicity)

Pregnancy

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  • Do not use

Breast-feeding

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  • Discontinue breastfeeding

⚠️ Caution

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  • Monitor full blood count weekly. Reduce dose if neutrophil count is < 1000 cells/mm³
  • If diarrhoea occurs for more than 24 hours after administration, reduce subsequent doses
  • Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines