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Brand Name
Irinotecan Hydrochloride Trihydrate for Injection by Pharmaceutical Partners of Canada, Inc.
Common Name
How does this medication work? What will it do for me?

Irinotecan belongs to the group of cancer-fighting medications known as antineoplastics. It kills cancer cells by interfering with the genetic material DNA, which is necessary for their growth and reproduction. Irinotecan is usually used in combination with other medications to treat colon or rectal cancer.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The recommended dose and dosing schedule of irinotecan varies according to the stage of therapy, the stage of cancer, the response to therapy, and the person's body size. It is injected into a vein through a specially prepared site on the skin. The appropriate dose of irinotecan is usually given by an infusion over a period of about 90 minutes. The dose is usually given once weekly for 4 weeks, followed by a 2-week rest period.

This cycle is repeated until it is determined that treatment is completed. Very careful handling of this medication is required. Irinotecan is always used under the supervision of a doctor in a hospital or similar setting with access to sterile equipment for preparation.

As well as interfering with the genetic material DNA of cancer cells, irinotecan can interfere with some of your normal cells. This can cause a number of side effects such as hair loss and mouth sores. Irinotecan can cause nausea and vomiting, but it is important to keep using this medication.

Your doctor, nurse, or pharmacist can advise you on how to reduce the effects of nausea and vomiting. Keep track of any side effects and report them to your doctor as suggested in the section, "What side effects are possible with this medication?"

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss an appointment to receive irinotecan, contact your doctor as soon as possible to reschedule your appointment.

What form(s) does this medication come in?

Each mL of sterile, clear, colourless to pale yellow solution contains irinotecan HCl trihydrate 20 mg. Nonmedicinal ingredients: lactic acid, sorbitol, and water for injection. May contain sodium hydroxide or hydrochloric acid as pH adjusters.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to irinotecan or any ingredients of this medication
  • are taking an azole antifungal (e.g., fluconazole, ketoconazole, itraconazole)
  • have hereditary fructose intolerance
  • have taken ketoconazole within the past week
What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • constipation
  • decrease in or loss of appetite
  • feeling bloated
  • flatulence (gas)
  • headache
  • increased sweating
  • indigestion
  • nausea and vomiting
  • skin rash
  • stomach cramps or pain
  • temporary hair loss
  • weakness
  • weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • black, tarry stools
  • blood in urine or stools
  • dry mouth
  • fast or irregular breathing
  • increased thirst
  • pinpoint-sized red spots on skin
  • reduced urination
  • skin rash, hives, or itching
  • sores, ulcers, or white spots on lips or in mouth
  • swelling of the eyelids or around the eyes
  • tightness in chest
  • unusual and severe tiredness or weakness
  • unusual bleeding or bruising
  • wheezing
  • wrinkled skin

Seek immediate medical attention if any of the following occur:

  • cough or hoarseness (accompanied by fever or chills)
  • diarrhea, with or without stomach cramps or sweating
  • dizziness or lightheadedness
  • fainting
  • fever or chills
  • lower back or side pain (accompanied by fever or chills)
  • painful or difficult urination (accompanied by fever or chills)
  • runny or stuffy nose
  • shortness of breath or troubled breathing
  • sore throat
  • swelling of face, fingers, feet, or lower legs
  • swelling of stomach area

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Diabetes: If you have diabetes, your doctor should closely monitor your condition while you are taking irinotecan, as it may affect blood sugar control (by decreasing blood sugar levels).

Diarrhea: Diarrhea occurring more than 24 hours after treatment is a common side effect. Your doctor may recommend that you take oral (by mouth) loperamide if diarrhea occurs. It is important that diarrhea be treated promptly and aggressively if it occurs. If you are taking taking loperamide as directed by your doctor and diarrhea continues for more than 48 hours, get medical attention immediately. It is also important that you drink plenty of fluids if diarrhea occurs.

Drowsiness/reduced alertness : Irinotecan can cause fatigue, dizziness or vision changes. Avoid activities such as driving or operating machinery if the medication affects you in this way.

Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people with contagious infections and tell your doctor if you begin to notice signs of an infection, such as fever or chills.

Pregnancy: Practice effective birth control while using this medication. This medication can cause harm if used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if irinotecan passes into breast milk. Women should not breast-feed while using irinotecan due to the risk of harm to the infant.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between irinotecan and any of the following:

  • amphotericin B
  • antidiabetes medications
  • atazanavir
  • azathioprine
  • azole antifungal medications (e.g., fluconazole, ketoconazole, itraconazole)
  • cimetidine
  • colchicine
  • dexamethasone
  • diltiazem
  • diuretics (water pills)
  • epilepsy medications (e.g., phenytoin, carbamazepine)
  • flucytosine
  • fluoroquinolone antibiotics (e.g., ciprofloxacin)
  • ganciclovir
  • glucocorticoids (e.g., prednisone)
  • grapefruit juice
  • interferon
  • laxatives
  • leucovorin
  • macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
  • natalizumab
  • nifedipine
  • other cancer medications, especially fluorouracil
  • plicamycin
  • rifampin
  • St. John's wort
  • tacrolimus ointment
  • vaccines
  • verapamil
  • zidovudine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

The contents of this site are for informational purposes only. Always seek the advice of your physician or other qualified healthcare provider regarding any questions you may have about a medical condition.
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