Irinotecan Hydrochloride interactions

Conditions

Conditions in which Irinotecan Hydrochloride needs care, as documented in this source.

• Bone Marrow Failure Disorders

  Major

  Irinotecan induces myelosuppression, causing leukopenia, thrombocytopenia and anemia. Deaths due to sepsis following severe neutropenia have been reported in patients treated with irinotecan. Hold irinotecan if neutropenic fever occurs or if the absolute neutrophil count drops <1000/mm3. After recovery to an absolute neutrophil count =1000/mm3, subsequent doses of irinotecan should be reduced. Therapy with irinotecan should be administered cautiously in patients who have received previous irradiation therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

  1 source

  1. "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn (2001):

• Diarrhea

  Major

  Irinotecan liposomal can cause severe and life-threatening diarrhea. Do not administer Irinotecan liposomal to patients with bowel obstruction. It is recommended to withhold treatment with irinotecan liposomal for Grade 2-4 diarrhea and to initiate appropriate clinical measures for diarrhea of any severity. The dose of irinotecan liposomal should be reduced according to manufacturer indications following recovery to Grade 1 diarrhea. Care should be exercised when using this agent in patients at risk of diarrhea episodes.

  1 source

  1. "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals (2015):

• Neutropenia

  Major

  Irinotecan liposomal can cause severe or life-threatening neutropenia and fatal neutropenic sepsis. In patients receiving irinotecan liposomal in combination with 5-FU and LV, the incidence of Grade 3 or 4 neutropenia and neutropenic fever/neutropenic sepsis was higher among Asian patients compared to White patients. Individuals who are homozygous for the UGT1A1*28 allele are at increased risk for neutropenia. It is recommended to monitor complete blood cell counts on Days 1 and 8 of every cycle and more frequently if clinically indicated and to withhold treatment if the absolute neutrophil count is below 1500/mm ^3 or if neutropenic fever occurs. Therapy could be resumed when the ANC is 1500/mm^ 3 or above. The dose of irinotecan liposomal should be reduced according to manufacturer indications for Grade 3-4 neutropenia or neutropenic fever following a recovery in subsequent cycles. Care is recommended when using this agent in neutropenic patients and in those patients homozygous for the UGT1A1*28 allele.

  1 source

  1. "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals (2015):

• Kidney Diseases

  Moderate

  The influence of renal impairment on the pharmacokinetics of irinotecan has not been evaluated. Therefore, caution should be undertaken in patients with impaired renal function. Irinotecan hydrochloride is not recommended for use in patients on dialysis.

  1 source

  1. "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn (2001):

• Liver Diseases

  Moderate

  Irinotecan clearance is diminished in patients with hepatic impairment. The magnitude of these effects is proportional to the degree of liver impairment as measured by elevations in total bilirubin and transaminase concentrations. However, the tolerability of irinotecan in patients with hepatic dysfunction (bilirubin greater than 2 mg/dl) has not been assessed sufficiently, and no recommendations for dosing are made by the manufacturers. Therapy with irinotecan should be administered cautiously to patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

  2 sources

  1. Abigerges D, Chabot GG, Armand JP, Herait P, Gouyette A, Gandia D "Phase I and pharmacologic studies of the camptothecin analog irinotecan administered every 3 weeks in cancer patients." J Clin Oncol 13 (1995): 210-21
  2. "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn (2001):

• Liver Failure

  Moderate

  The metabolism of irinotecan liposomal has not been evaluated. Irinotecan is primary metabolized by the liver to a biologically active metabolite. The pharmacokinetic disposition of irinotecan liposomal in patients with hepatic impairment has not been formally assessed. Therapy with irinotecan liposomal should be administered cautiously to patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

  1 source

  1. "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals (2015):

• Lung Diseases, Interstitial

  Moderate

  Irinotecan can cause severe and fatal interstitial pulmonary disease (IPD). Risk factors include preexisting-existing lung disease. It is recommended to withhold treatment with irinotecan in patients with new or progressive dyspnea, cough, and fever, pending diagnostic evaluation and to discontinue treatment in patients with a confirmed diagnosis of IPD. Exercise caution when using this agent in patients presenting symptoms of dyspnea and patients with pulmonary impairment.

  2 sources

  1. "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn (2001):
  2. "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals (2015):