Irincoam Injection
Irinotecan Hydrochloride Trihydrate
100mg
Dr. Reddy's Laboratories.
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Available as:
Indications
Irincoam Injection is used for:
Carcinoma of the colon or rectum
Adult Dose
Intravenous
Colorectal Cancer
Indicated as first-line therapy (with 5-fluorouracil and leucovorin) for metastatic colorectal cancer (CRC); it is also indicated for CRC that has recurred or progressed following intial fluorouracil-based therapy
Monotherapy
Patients should be premedicated with antiemetic agents
Atropine treatment should be considered in patients that experience cholinergic symptoms
Regimen 1 (Weekly): 125 mg/m² IV infusion over 90 minutes on days 1, 8, 15, 22, then 2 weeks off, then repeat
Regimen 2 (Once Every 3 Weeks): 350 mg/sq.meter IV infusion over 30-90 minutes q3Weeks
Adjust dose per protocol
Combination therapy
Patients should be premedicated with antiemetic agents
Atropine treatment should be considered in patients that experience cholinergic symptoms
Regimen 1 (6 week cycle with infusional 5-fluorouracil/ leucovorin): 180 mg/m² IV infusion over 30-90 minutes once on days 1, 15, and 29 IV (infuse over 30-90 min), followed by infusion with leucovorin and 5-fluorouracil; next cycle begins on day 43
Regimen 2 (6 week cycle with bolus 5-fluorouracil/ leucovorin): 125 mg/sq.meter on days 1, 8, 15, and 22 (infuse over 90 min), followed by bolus doses of leucovorin and 5-fluorouracil
Adjust dose per protocol
Hepatic impairment: Dose reduction may be necessary.
Child Dose
Not recommended
Renal Dose
Administration
Reconstitution: Dilute in 5% dextrose injection (preferred) or 0.9% sodium chloride injection to a final concentration of 0.12-2.8 mg/ml.
Contra Indications
Patients with a known hypersensitivity to the drug or its excipients.
Precautions
Early diarrhea is usually transient and infrequently severe. It may be accompanied by cholinergic symptoms of rhinitis, increased salivation, miosis, lacrimation, diaphoresis, flushing, and intestinal hyperperistalsis that can cause abdominal cramping. Bradycardia may also occur.
Late diarrhea can be life threatening since it may be prolonged and may lead to dehydration, electrolyte imbalance, or sepsis.Late diarrhea can be complicated by colitis, ulceration, bleeding, ileus, obstruction, and infection. Cases of megacolon and intestinal perforation have been reported.
Lactation: not known if excreted in breast milk, do not nurse
Pregnancy-Lactation
Interactions
Diuretics increase risks of dehydration secondary to vomiting/diarrhoea; prophylactic dexamethasone as an antiemetic may enhance lymphocytopenia; prochlorperazine may increase incidence of akathisia; antineoplastic agents (myelosuppression and diarrhoea). St John's wort, ketoconazole may reduce irinotecan exposure.
Adverse Effects
Side effects of Irinotecan Hydrochloride Trihydrate :
>10%
Anemia (>90%),Leukopenia (>90%),Neutropenia (>90%),Thrombocytopenia (>90%),Elevated bilirubin (88%),Diarrhea (85%),Nausea (79%),Asthenia (70%),Abdominal pain (63%),Vomiting (60%),Alopecia (43%),Fever (42%),Constipation (41%),Anorexia (34%),Mucositis (32%),Pain (31%),Dyspnea (28%),Cough (27%),Dizziness (23%),Infection (22%),Rash (19%)
1-10%
Abdominal fullness (10%),AST increased (10%),Dyspepsia (10%),,Edema (10%),Ascites/jaundice (9%),Vasodilation (9%),Thromboembolism (9%),Hypotension (6%),Neutropenic fever (2-6%)
Frequency Not Defined
Headache,Insomnia,Orthostatic hypotension
Potentially Fatal: Fatal sepsis due to myelosuppression; severe, chronic diarrhoea.
Mechanism of Action
Irinotecan, a derivative of camptothecin, works by inhibiting the enzyme topoisomerase I thereby interfering with the coiling and uncoiling of DNA during replication and causing irreparable damage.
Note
Irincoam 100mg Injection manufactured by Dr. Reddy's Laboratories.. Its generic name is Irinotecan Hydrochloride Trihydrate. Irincoam is availble in Nepal.
Farmaco Nepal drug index information on Irincoam Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.