Irinotecan - Benefits, dosage and side effects

Irinotecan is a drug to treat colon cancer or pancreatic cancer that has spread (metastatic). This drug can be used as single therapyl or in combination with other anticancer drugs.

Irinotecan works by inhibiting the function of the topoisomerase I enzyme which results in disruption of DNA replication. This way of working can trigger cancer cell death.

irinotecan trademark: Actatecan, Irinol, Irinotecan Hydrochloride, Kabitec

What is Irinotecan

groupPrescription drugs
CategoryAnti cancer
BenefitTreat colorectal cancer or pancreatic cancer
Used byMature
Irinotecan for pregnant and lactating women Category D: There is positive evidence of risks to the human fetus, but the benefits may outweigh the risks, for example in dealing with life-threatening situations.

Irinotecan can be absorbed into breast milk, should not be used during breastfeeding.

Drug formInject

Precautions Before Using Irinotecan

Irinotecan injection should only be given by a doctor or medical officer under the supervision of a doctor. Here are the things you should pay attention to before using irinotecan:

  • Tell your doctor about any allergies you have. Irinotecan should not be given to patients who are allergic to this drug.
  • Tell your doctor if you have or have had liver disease, kidney disease, lung disease, gastrointestinal disease, intestinal obstruction, Gilbert's syndrome, or any blood disorder including anemia, neutropenia, or thrombocytopenia.
  • Tell your doctor if you have diabetes or fructose intolerance, as some irinotecan products contain sorbitol in them.
  • Tell your doctor if you are taking any medications, supplements, herbal products, or are undergoing radiotherapy.
  • Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy. Use effective contraception during treatment with irinotecan for up to 6 months afterward to prevent pregnancy.
  • Do not breastfeed the infant during treatment for up to 7 days after the last treatment with irinotecan has been completed.
  • Consult your doctor if you plan to vaccinate with live vaccines while on treatment with irinotecan.
  • Tell your doctor if you plan to have any surgery or medical procedures while you are being treated with irinotecan.
  • Avoid close contact with people with infectious diseases that are easily transmitted while undergoing treatment with irinotecan, because it can increase your risk of contracting it.
  • Do not drive a vehicle or do activities that require alertness after using irinotecan, as this medicine can cause dizziness and blurred vision.
  • Report to your doctor if you have an allergic drug reaction, serious side effects, or overdose after using irinotecan.

Dosage and Instructions for Use Irinotecan

Irinotecan will be injected directly by a doctor or medical officer under the supervision of a doctor. The following is the irinotecan dosage for adults divided according to the condition to be treated:

  • Condition: Colorectal cancer that has spread (metastasized)

The dose as a single therapy is 350 mg/m2 body surface area (LPT) given by infusion over 30–90 minutes, every 3 weeks. When combined with fluorouracil and folinic acid, the dose is 180 mg/m2 LPT administered through the nose for 30–90 minutes, every 2 weeks.

  • Condition: Metastatic pancreatic cancer

The dose is 80 mg/m2 LPT given by infusion over 90 minutes, every 2 weeks. The drug will be combined with fluorouracil and leucovorin.

How to Use Irinotecan Properly

Irinotecan injection will be given in a hospital or health facility by a doctor or medical officer under the supervision of a doctor through a vein (intravenous / IV).

During treatment with irinotecan, you will undergo regular complete blood counts to monitor your disease condition, response to therapy, and possible side effects.

Follow the doctor's advice and recommendations while undergoing treatment with irinotecan. Do not stop taking medication without consulting your doctor first.

Irinotecan Interactions with Other Drugs

The following are some of the effects of interactions that may occur when irinotecan is used with other medicines:

  • Decreased effectiveness of live vaccines, such as BCG vaccine or typhoid vaccine
  • Increased risk of bleeding when used with vitamin K . antagonists
  • Increased immunosuppressant effects and risk of bone marrow damage when used with other immunosuppressant drugs, such as tacrolimus or ciclosporin
  • Increased irinotecan levels when used with ketoconazole, bevacizumab, gemfibrozil, atazanavir, or clarithromycin
  • Decreased effectiveness of irinotecan when used with rifampicin, phenobarbital, phenytoin, or carbamazepine

Side Effects and Dangers of Irinotecan

Tell your doctor or medical officer if the following side effects do not subside or get worse:

  • Hair loss
  • Hard to sleep
  • Ulcer
  • Nausea and vomiting
  • Loss of appetite
  • Diarrhea
  • Back pain
  • Constipation

Report to your doctor if you have an allergic drug reaction or experience more serious side effects, such as:

  • Severe diarrhea that doesn't go away
  • Easy bruising or bloody stools
  • Chest pain or severe cough
  • Red, painful, swollen, at the injection site
  • Weak on one side of the body, speech becomes slurred, confused
  • An infectious disease that can be characterized by symptoms such as fever or chills that do not improve
  • Symptoms of anemia, which can be characterized by pale skin, weakness, lethargy, or unusual tiredness