Irinotecan

Other Names: Camptosar®

About this drug

Irinotecan is used to treat cancer. It is given in the vein (IV).

Possible side effects 

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Weakness
  • Fever
  • Infection
  • Hair loss: Most often hair loss is temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest and/or legs. You may also notice your hair getting thin. 
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt
  • Nausea and throwing up (vomiting)
  • Pain in your abdomen
  • Loose bowel movements (diarrhea)
  • Constipation (unable to move bowels)
  • Decreased appetite (decreased hunger)
  • Weight loss
  • Changes in your liver function
  • Pain

Note: Each of the side effects above was reported in 30% or greater of patients treated with irinotecan. Not all possible side effects are included above. 

Warnings and Precautions

  • Severe diarrhea and colitis which is swelling (inflammation) in the colon - symptoms are loose bowel movements (diarrhea), stomach cramping, and sometimes blood in the bowel movements. Very rarely, a hole in your stomach, small and/or large intestine can happen. 
  • Severe bone marrow depression which can be life-threatening
  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergicreaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
  • Changes in your kidney function which can cause kidney failure and be life-threatening
  • Inflammation (swelling) of the lungs, which can be life-threatening. You may have a dry cough or trouble breathing.
  • Blurred vision or other changes in eyesight as well as feeling dizzy can happen within 24 hours of receiving this medicine.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • It is important that you notify your doctor and/or nurse at the first sign of loose bowel movements (diarrhea) so they can provide you with anti-diarrhea medication and give you further instructions. Notify your doctor and/or nurse if you are taking anti-diarrhea medication and your symptoms have not improved, or are worsening.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss Be very careful when using knives or tools
  • Use an electric shaver instead of a razor
  • To help with hair loss, wash with a mild shampoo and avoid washing your hair everyday
  • Avoid rubbing your scalp, pat your hair or scalp dry
  • Avoid coloring your hair
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer
  • Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • Mouth care is very important. your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime. 
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat. 
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation. 
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • To help with decreased appetite, eat small, frequent meals
  • Eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.

Food and Drug Interactions

  • This drug may interact with grapefruit and grapefruit juice. Talk to your doctor as this could make side effects worse.
  • This drug may interact with other medicines. Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.
  • Avoid the use of St. John’s Wort while taking irinotecan as this may lower the levels of the drug in your body, which can make it less effective.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Pain in your chest
  • Dry cough
  • Trouble breathing
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Pain in your mouth or throat that makes it hard to eat or drink
  • No bowel movement in 3 days or when you feel uncomfortable
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Blood in your stool
  • Severe Abdominal pain that does not go away
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Decreased urine
  • Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment. Let your doctor know right away if you think you may be pregnant. 

  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breast feeding baby. 
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. 

Revised May 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.