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Irinotecan Hydrochloride: Brands, Price & Uses in Bangladesh
Irinotecan Hydrochloride is a topoisomerase I inhibitor chemotherapy agent with the following evidence-based uses: Established/FDA-approved uses Metastatic colorectal cancer and more.
About Irinotecan Hydrochloride
Indications of Irinotecan Hydrochloride
Irinotecan Hydrochloride is a topoisomerase I inhibitor chemotherapy agent with the following evidence-based uses:
Established/FDA-approved uses
- Metastatic colorectal cancer, first-line combination therapy: Irinotecan Hydrochloride in combination with 5-fluorouracil and leucovorin (the FOLFIRI regimen) as first-line treatment.
- Metastatic colorectal cancer, second-line/monotherapy: Irinotecan Hydrochloride as a single agent for patients whose disease has recurred or progressed following fluorouracil-based chemotherapy.
Guideline-supported / combination-therapy uses
- Used within combination regimens (e.g. FOLFIRI, FOLFIRINOX) for advanced colorectal and pancreatic cancers, per oncology treatment guidelines; these uses require combination with other cytotoxic or biologic agents and physician-directed protocol selection.
Off-label uses (not FDA-approved, but reported in oncology literature/practice)
- Small-cell lung cancer, gastric cancer, and certain pediatric solid tumors, used in specialist oncology settings only.
Irinotecan Hydrochloride must only be prescribed and administered by, or under the supervision of, a physician experienced in the use of cancer chemotherapeutic agents.
Dosage & Administration of Irinotecan Hydrochloride
Irinotecan Hydrochloride is given only as an intravenous infusion, prepared and administered by qualified oncology personnel; it must never be given by any other route.
| Regimen | Dose | Schedule |
|---|---|---|
| Single-agent, weekly schedule | 125 mg/m² IV over 90 minutes | Days 1, 8, 15, 22, then 2-week rest; repeat cycle |
| Single-agent, every-3-week schedule | 350 mg/m² IV over 90 minutes | Once every 3 weeks |
| FOLFIRI combination (weekly-based) | 125 mg/m² Irinotecan Hydrochloride with leucovorin and 5-fluorouracil | Days 1, 8, 15, 22 of a 6-week cycle |
| FOLFIRI combination (biweekly-based) | 180 mg/m² Irinotecan Hydrochloride with leucovorin and 5-fluorouracil | Days 1, 15, 29 (every 2 weeks) |
Doses are individualized and may be reduced or delayed based on hematologic parameters, diarrhea severity, hepatic function, and UGT1A1 genotype, per physician assessment. Premedication with antiemetics is routinely used, and acute cholinergic-type diarrhea occurring during or shortly after infusion is managed with atropine (unless contraindicated). See Precautions and Warnings for management of severe diarrhea and myelosuppression.
Side Effects of Irinotecan Hydrochloride
Very common
- Nausea and vomiting
- Diarrhea (both early-onset cholinergic-type and late-onset — see Precautions and Warnings for management)
- Neutropenia, anemia, thrombocytopenia
- Abdominal pain, anorexia
- Alopecia (hair loss)
- Fatigue/asthenia
Serious/less common
- Febrile neutropenia and neutropenic sepsis
- Severe dehydration and electrolyte imbalance secondary to diarrhea
- Interstitial lung disease
- Thromboembolic events
- Renal impairment (usually secondary to dehydration/sepsis)
- Infusion-related reactions and acute cholinergic syndrome (sweating, salivation, abdominal cramping, early diarrhea, visual disturbance) during/shortly after infusion
Contraindications of Irinotecan Hydrochloride
Irinotecan Hydrochloride is absolutely contraindicated in:
- Patients with known severe hypersensitivity to Irinotecan Hydrochloride or any component of the formulation.
- Patients with severe bone marrow suppression (pre-existing severe neutropenia or significant marrow failure) at baseline.
Frequently Asked Questions about Irinotecan Hydrochloride
What is Irinotecan Hydrochloride used for?
Irinotecan Hydrochloride is a chemotherapy medicine used mainly to treat metastatic colorectal cancer, either combined with other chemotherapy drugs (such as 5-fluorouracil and leucovorin) or alone in patients whose cancer has returned after previous treatment.
What are the most serious risks of Irinotecan Hydrochloride?
Irinotecan Hydrochloride carries boxed warnings for severe diarrhea (which can occur early during infusion or later, and can be life-threatening if not treated promptly with loperamide) and severe myelosuppression (low blood counts, which can lead to serious infection). It must only be given under the supervision of an experienced cancer specialist.
Can Irinotecan Hydrochloride be used during pregnancy?
No. Irinotecan Hydrochloride can harm an unborn baby and should be avoided during pregnancy. It should be used in pregnancy only if clearly necessary and after the physician has judged that the benefit outweighs the risk. Women and men should use effective contraception during and after treatment as advised by their doctor.
What should I do if I get diarrhea while on Irinotecan Hydrochloride?
Diarrhea occurring more than 24 hours after an infusion of Irinotecan Hydrochloride should be treated promptly with loperamide as directed by your physician, and you should contact your care team immediately if diarrhea is severe, persistent, or accompanied by fever, since this can become life-threatening without prompt treatment.
Does Irinotecan Hydrochloride interact with other medicines?
Yes. Irinotecan Hydrochloride interacts significantly with strong CYP3A4 inhibitors (e.g. certain antifungals, some antibiotics) and inducers (e.g. rifampin, certain anti-seizure medicines), which can raise or lower drug levels and affect safety or effectiveness. Always tell your oncologist about all medicines and supplements you are taking.
Is genetic testing needed before starting Irinotecan Hydrochloride?
Some patients may be tested for a genetic variation (UGT1A1*28) before starting Irinotecan Hydrochloride, as patients with this variation are at higher risk of severe low blood counts; your oncologist will advise whether this testing is appropriate for you.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.