Irinotecan

Diarrhea and Myelosuppression 

  • Early and late forms of diarrhea can occur. Early diarrhea may be accompanied by cholinergic symptoms which may be prevented or ameliorated by atropine. Late diarrhea can be life threatening and should be treated promptly with loperamide. Monitor patients with diarrhea and give fluid and electrolytes as needed. Institute antibiotic therapy if patients develop ileus, fever, or severe neutropenia. Interrupt irinotecan hydrochloride injection and reduce subsequent doses if severe diarrhea occurs.
  • Severe myelosuppression may occur. 

Monitoring data

  • Early diarrhea occurs during or shortly after infusion and is and may be accompanied by other cholinergic symptoms. May be prevented/ameliorated by atropine
  • Late diarrhea occurs 24 hrs after administration and may be life-threatening due to prolonged nature, dehydration, electrolyte imbalance, or sepsis. Should be treated promptly with loperamide
  • Patients with diarrhea should be carefully monitored. Give fluids and electrolyte replacement if dehydration occurs. Administer antibiotics if ileus, fever, or neutropenia develops.
  • If severe diarrhea occurs interrupt therapy and reduce subsequent doses.
  • Black box data revised May 2002

Patient counseling

Package inserts

Irinotecan

Additional information

Updated: January 2023