Irinotecan Hydrochloride Trihydrate

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Generic Name of Irinotecan Hydrochloride Trihydrate - Learn More

Irinotecan Hydrochloride Trihydrate

Irinotecan Hydrochloride Trihydrate Precaution - What You Need to Know

Before initiating Irinotecan Hydrochloride Trihydrate, it is essential for patients to consult their healthcare provider, particularly in the following situations:

- Bone Marrow Suppression: Irinotecan can cause severe bone marrow suppression, leading to neutropenia (low white blood cell count), anemia, and thrombocytopenia (low platelet count). Prior to therapy, a complete blood count (CBC) should be assessed. Patients with a history of bone marrow disorders or severe infections should be closely monitored during treatment.
- Liver Impairment: Irinotecan is metabolized in the liver, and patients with liver disease or hepatotoxicity should use this medication cautiously. Liver function tests should be monitored regularly.
- Gastrointestinal Issues: The drug can cause diarrhea, which can be severe and life-threatening in some cases. Prophylactic treatment with loperamide (an anti-diarrheal) may be required, and patients should be counseled on how to manage this side effect.
- Dehydration: Dehydration resulting from diarrhea and vomiting can lead to further complications, including kidney damage and electrolyte imbalances. Patients should stay hydrated and report symptoms of dehydration immediately.
- Pregnancy and Breastfeeding: Irinotecan is classified as pregnancy category D, meaning it has been shown to harm the fetus in animal studies. It should not be used during pregnancy unless the benefits outweigh the risks. Breastfeeding is also contraindicated, as the drug may pass into breast milk.

Irinotecan Hydrochloride Trihydrate Indication - Uses and Benefits

Irinotecan Hydrochloride Trihydrate is primarily indicated as a chemotherapeutic agent for the treatment of certain types of cancer. Its uses include:

- Colorectal Cancer: It is commonly used in combination with other drugs for the treatment of metastatic colorectal cancer (CRC), both in first-line and second-line therapy after disease progression.
- Small Cell Lung Cancer: Irinotecan is also used in combination with cisplatin for the treatment of extensive-stage small cell lung cancer (SCLC), providing improved survival outcomes.
- Other Malignancies: It is also being studied for its potential efficacy in the treatment of other solid tumors and cancers, including ovarian cancer, gastric cancer, and pancreatic cancer.

Irinotecan Hydrochloride Trihydrate Contraindications - Important Warnings

Irinotecan Hydrochloride Trihydrate is contraindicated in patients with the following conditions:

- Severe Bone Marrow Suppression: Irinotecan is not recommended in patients with severe bone marrow suppression or pre-existing low white blood cell count (neutropenia).
- Severe Hepatic Dysfunction: Irinotecan should not be used in patients with severe liver impairment (e.g., bilirubin levels greater than 3 times the upper limit of normal).
- Diarrhea-related Complications: In patients with a history of diarrhea or bowel disorders, particularly those who have a history of bowel obstructions or inflammatory bowel disease, Irinotecan is contraindicated due to the risk of exacerbating gastrointestinal issues.
- Pregnancy: It is contraindicated during pregnancy because of potential harm to the fetus, and the risk of teratogenicity and miscarriage is high.
- Breastfeeding: Irinotecan should not be used while breastfeeding as it can pass into breast milk and harm the infant.

Irinotecan Hydrochloride Trihydrate Side Effects - What to Expect

The most common and severe side effects associated with Irinotecan include:

- Gastrointestinal Toxicity:
- Diarrhea is a common and potentially life-threatening side effect. It can occur within 24 hours of administration (acute) or after several days (delayed). Irinotecan-induced diarrhea can be severe, causing dehydration and electrolyte imbalances, and may require the use of loperamide or other treatments to manage it.
- Nausea and Vomiting: Both nausea and vomiting are frequent and can be managed with antiemetic medications.
- Bone Marrow Suppression: Neutropenia (low white blood cell count) is a major concern with Irinotecan. Thrombocytopenia (low platelet count) and anemia may also occur, which could lead to an increased risk of infections and bleeding.
- Fatigue: A common side effect, fatigue or weakness is often reported in patients undergoing treatment with Irinotecan.
- Hair Loss: Like most chemotherapeutic agents, hair thinning or alopecia may occur.
- Liver Toxicity: Hepatotoxicity, including elevated liver enzymes and bilirubin levels, can occur, particularly in patients with existing liver dysfunction.
- Infections: Because of the suppression of the immune system, patients may be at increased risk of infections, including bacterial, fungal, or viral infections.
- Severe Allergic Reactions: Rare but possible, patients may experience symptoms like difficulty breathing, swelling of the face, or hives. Immediate medical attention is required in such cases.

Irinotecan Hydrochloride Trihydrate Pregnancy Category ID - Safety Information

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Irinotecan Hydrochloride Trihydrate Mode of Action - How It Works

Irinotecan Hydrochloride Trihydrate is a topoisomerase I inhibitor that works by interfering with the DNA replication process within cancer cells.

- Inhibition of Topoisomerase I: The drug specifically targets and binds to the topoisomerase I enzyme, which is essential for DNA replication. By inhibiting topoisomerase I, Irinotecan prevents the enzyme from performing its normal function of relaxing the DNA during replication, leading to DNA damage.
- Cell Cycle Arrest: This DNA damage causes the cancer cells to become trapped in the S-phase (synthesis phase) of the cell cycle, preventing the cells from properly dividing. The resulting DNA strand breaks induce cell death (apoptosis), which helps shrink tumors.
- Selective Cytotoxicity: Irinotecan preferentially targets rapidly dividing cancer cells, making it an effective chemotherapeutic agent in the treatment of various cancers, including colorectal and lung cancers.

Irinotecan Hydrochloride Trihydrate Drug Interactions - What to Avoid

Irinotecan Hydrochloride Trihydrate may interact with several drugs and substances, which can alter its efficacy and increase the risk of adverse effects. Key interactions include:

- CYP3A4 Inhibitors/Inducers: Irinotecan is metabolized by the CYP3A4 enzyme, so drugs that inhibit or induce this enzyme can affect its activity. CYP3A4 inhibitors, such as ketoconazole, clarithromycin, and certain HIV protease inhibitors, can increase Irinotecan toxicity, while CYP3A4 inducers like phenytoin and rifampin can reduce its effectiveness.
- Loperamide (Anti-diarrheal): Patients are often prescribed loperamide to manage Irinotecan-induced diarrhea. However, caution is advised in overuse, as it can cause severe constipation and delay the resolution of other gastrointestinal side effects.
- Other Chemotherapeutic Agents: When combined with other chemotherapy agents, such as 5-fluorouracil (5-FU), oxaliplatin, or capecitabine, the risk of adverse effects such as neutropenia, diarrhea, and mucositis can increase. Combination therapy should be closely monitored.
- Anticoagulants: There may be an increased risk of bleeding when Irinotecan is used with anticoagulants (e.g., warfarin), and frequent monitoring of coagulation parameters is advised.

Irinotecan Hydrochloride Trihydrate Adult Dose - Recommended Dosage

The recommended adult dose of Irinotecan Hydrochloride Trihydrate varies depending on the type of cancer being treated and whether it is used alone or in combination with other chemotherapeutic agents.

- For Metastatic Colorectal Cancer (in combination with 5-fluorouracil and leucovorin):
The typical dose is 180 mg/m², administered as an intravenous infusion every 2 weeks.
- For Small Cell Lung Cancer (in combination with cisplatin):
The typical dose is 125 mg/m², given intravenously once every 3 weeks.

The dose may be adjusted based on the patient's tolerance and the presence of side effects. Dosage may also be altered in cases of bone marrow suppression or other complications.

Irinotecan Hydrochloride Trihydrate Child Dose - Dosage for Children

The use of Irinotecan in pediatric patients should be carefully considered based on the type of cancer and the child's overall health. For pediatric patients:

- For Pediatric Colorectal Cancer:
A typical dose for children is 20-50 mg/m², given once every 2 weeks, depending on the treatment regimen.
- Adjustments Based on Side Effects:
Pediatric dosing may be adjusted according to the child’s tolerance to the drug, particularly in cases of neutropenia or diarrhea. Close monitoring of blood counts and signs of toxicity is essential.

In pediatric use, Irinotecan therapy should be overseen by a pediatric oncologist, with careful monitoring for potential adverse effects.

Irinotecan Hydrochloride Trihydrate Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, dose adjustments of Irinotecan are generally not required unless there is concurrent hepatic dysfunction. However, Irinotecan should be used with caution in individuals with severe renal impairment. Kidney function should be closely monitored, especially in patients with creatinine clearance below 30 mL/min.