What Irinotecan is and what it is used for?
- Irinotecan is a plant alkaloid derived from the Camptotheca acuminata, also called the happy tree. This medicine blocks the action of an enzyme in cells called topoisomerase I, which is necessary for cell replication and tumor growth. Blocking this enzyme leads to breaks in the DNA, which leads to cancer cell death.
- Irinotecan can be given in combination with other cancer medicines to treat colorectal cancer that has spread to other parts of the body or that has progressed following previous treatment. It also may be used to treat other cancers, such as pancreatic and lung cancer, as determined by your doctor.
How Irinotecan is given?
- Irinotecan is given as an infusion into the vein over 90 minutes.
What should I know while receiving Irinotecan?
- An allergic reaction may happen during or shortly after the infusion, causing fever and chills, breathing difficulties, swelling of throat or face, or hives. Tell your nurse right away if you feel unwell during an infusion.
- If irinotecan leaks into the skin, it can cause severe tissue damage. Tell your nurse right away if you notice swelling, pain, or redness at the injection site during an infusion.
- Do not receive this drug when you are pregnant or breastfeeding.
- Men and women should use effective contraception during treatment and for at least 3 and 6 months after the last dose.
- Irinotecan may affect fertility. You can talk to your doctor about methods of preserving fertility before treatment starts.
- You will have regular blood tests to make sure you have enough blood cells and have adequate organ functions to receive irinotecan. The timing and dosing of your treatment may be changed based on the test results or side effects.
- There are many drugs may affect how irinotecan works.Tell your doctor about all the medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
- Do not receive any kind of vaccination without doctor's approval.
- The existing health problems may affect the use of irinotecan. You should let your doctor know if you have any other medical problems, especially liver problems, kidney problems, lung or breathing problems, or bowel disorders.
Common side effects
- Low white blood cell count
You may have a higher risk of getting infections. Try to stay away from crowds and wash hands often. Tell your doctor right away if you have repeated fevers, coughing, stuffy nose, painful urination or wound that becomes red and swollen.
- Low red blood cell count
You may look pale and get tired more easily. Let your doctor know if you experience any difficulty breathing or dizziness when changing positions.
- Diarrhea (Early onset)
Early diarrhea may occur shortly after an infusion within 24 hours. It is thought to be part of a cholinergic syndrome. It may be accompanied by other symptoms such as watery eyes, running nose, sweating, flushing, stomach cramping, excessive mouthwatering, or slow heartbeat.Your doctor will prescribe you a drug called atropine to prevent it happening.
- Diarrhea (Late onset)
Late diarrhea may occur more than one day after an infusion. Patients with severe diarrhea may lead to some life-threatening problems like dehydration, infection, or electrolyte imbalance. Your doctor will give you loperamide to take at home. Take loperamide exactly as your doctor told you.
Talk to your doctor and ask for advice. Drinking plenty of water and dietary changes can improve constipation.
- Nausea and vomiting
Medicines may be given before the treatment to prevent it happening. Eating and drinking often in small amounts may reduce the discomfort.
- Hair loss
It may begin 2-3 weeks after your first treatment. Your hair will usually grow back after treatment has finished.
- Weakness or fatigue
Try to pace yourself and rest as much as you need to. Speak to your doctors if you are feeling very tired. They can help you to manage it and might give you treatment.
- Loss of appetite
Try to eat in small quantities and have frequent meals. If your appetite does not get any better after a few days, tell your doctor.
- Changes in liver function
This is usually mild and unlikely to cause symptoms. Let your doctor know if you notice you have yellowing of the skin or eyes, dark or brown urine, or pain in abdomen.
Less common side effects
- Difficulty sleeping
Talk to your doctor if this bothers you. Treatments usually include lifestyle changes, medications, or a combination of both.
- Mouth sore
Your doctor may give you medicines that help you feel better. Good mouth care will help prevent mouth sores.
- Swelling in hands and feet
Tell your doctor if your hands, arms, legs, or feet feel puffy or tender. The doctor may give medicines to reduce your symptoms and suggest ways to prevent fluid buildup.
- Skin rash
A rash can be itchy, red, or painful. Tell your doctor about any skin changes that you have, they can give you medicines and advices that help you feel better.
- Cough or trouble breathing
You may have sore throat or stuffy nose without any signs of infection. Talk to your doctor if this side effect bothers you.
- Drink at least 6 to 8 glasses of water can help make your recovery a smoother process.
- Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarettes during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.
- Avoid eating grapefruit or drinking beverages containing grapefruit. This is because grapefruits can affect how irinotecan works and can worsen the side effects.
- Avoid the use of St. John's Wort as it may make irinotecan less effective.
- Your skin may more sensitive to sunlight and may burn more easily during treatment. You should stay out of the sun. If you must go out in the sun, wear protective clothing and use sunscreen.