irinotecan hydrochloride

Campto (UK), Camptosar

Pharmacologic class: Topoisomerase inhibitor

Therapeutic class: Hormonal antineoplastic

Pregnancy risk category D


Inhibits topoisomerase 1 (an enzyme that allows DNA replication) by binding to it. This action prevents religation of DNA strand, which results in breakage of double-stranded DNA and cell death.


Injection: 20 mg/ml in 2-ml and 5-ml vials

Indications and dosages

Metastatic colorectal cancer or recurrence or progression of metastatic colorectal cancer after fluorouracil (5-FU) therapy

Adults: 125 mg/m2 I.V. infused over 90 minutes on days 1, 8, 15, and 22, followed by a 2-week rest; given with leucovorin and 5-FU. Or, 180 mg/m2 I.V. infused over 90 minutes on days 1, 15, and 29 with leucovorin, 5-FU bolus, and 5-FU infusion followed by a 2-week rest. Or as monotherapy, 125 mg/m2 I.V. infused over 90 minutes weekly for 4 weeks, followed by a 2-week rest period; or, 350 mg/m2 I.V. infused over 90 minutes q 3 weeks as long as tolerable. Adjust dosage in increments based on tolerance and age.

Off-label uses

• Most cancers


• Hypersensitivity to drug

• Concurrent atazanavir use

• Pregnancy or breastfeeding


Use cautiously in:

• bone marrow depression, severe diarrhea

• patients undergoing radiation therapy

• elderly patients

• children.


Follow facility policy for handling antineoplastics. If skin contact occurs, wash with soap and water immediately and thoroughly. If mucous membrane contact occurs, flush with water.

• Dilute in dextrose 5% in water or normal saline solution, to a concentration of 0.12 to 1.1 mg/ml.

• Infuse within 6 hours if drug is stored at room temperature or within 24 hours if refrigerated.

• Give single dose by I.V. infusion over 90 minutes.

• Administer antiemetic to ease nausea and vomiting, as needed and prescribed.

Adverse reactions

CNS: insomnia, dizziness, asthenia, headache, akathisia

CV: vasodilation, orthostatic hypotension

EENT: rhinitis

GI: nausea, vomiting, constipation, diarrhea, flatulence, dyspepsia, abdominal pain or enlargement, stomatitis, anorexia

Hematologic: anemia, neutropenia, leukopenia, thrombocytopenia

Hepatic: hepatotoxicity

Metabolic: dehydration

Musculoskeletal: back pain

Respiratory: dyspnea, increased cough

Skin: alopecia, diaphoresis, rash

Other: weight loss, edema, fever, pain, chills, minor infections


Drug-drug. Dexamethasone: increased risk of lymphocytopenia

Diuretics: increased risk of dehydration

Laxatives: increased risk of diarrhea

Other antineoplastics: additive adverse effects

Drug-diagnostic tests. Alkaline phosphatase: increased level

Hemoglobin, neutrophils, white blood cells: decreased values

Patient monitoring

Assess CBC before each infusion. Withhold dose if neutrophil count is below 1,500 cells/mm3.

• Monitor infusion site for extravasation; if it occurs, flush with sterile water and apply ice.

• Assess fluid intake and output. Keep patient well hydrated.

• Monitor oral intake. Evaluate for nausea and vomiting.

• Assess for diarrhea. In severe diarrhea, expect to decrease dosage or withhold dose.

• Institute infection-control protocols to help prevent infection.

• Monitor liver function test results.

Patient teaching

• Inform patient that blood tests will be done before each dose.

• Instruct patient to report pain at infusion site; severe nausea or vomiting; severe, increased, or bloody diarrhea; infection; or injury.

Instruct patient to immediately report unusual tiredness or yellowing of skin or eyes.

• Tell patient that drug increases his risk of infection. Advise him to avoid crowds and other potential infection sources.

• Caution female patient not to breastfeed or become pregnant during therapy. Recommend barrier contraception.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.


A brand name for the camptothecin drug IRINOTECAN.
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Irinotecan (Irinotecan hydrochloride trihydrate) is the generic equivalent of Pfizer's Campto and is a cytostatic, a treatment for advanced colorectal cancer.
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Treatment of colorectal cancer: to sell all of its development, production and marketing activities, in all the countries covered by the licensing contract which Aventis holds for Campto, and in particular all the rights and obligations which Aventis holds under that licence and all other patents and intellectual property rights and/or know-how concerning Campto held by Aventis, including outside the countries covered by the licence.
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