What is Irinotecan Hydrochloride?

Chemotherapy drugs like irinotecan hydrochloride are used to treat different types of cancer, especially colon cancer that has spread to other parts of the body.

This medicine is a topoisomerase I inhibitor, and it works against the machinery that cancer cells use to copy DNA.

The drug Irinotecan was created from the natural compound camptothecin.

It is given through an IV and is normally mixed with other chemotherapeutics like 5-fluorouracil and Leucovorin.

Overview

Description

Irinotecan Hydrochloride is a chemical that is partly made in a lab that is similar to camptothecin, which is a poisonous alkaloid that comes from the Chinese tree Camptotheca acuminata.

It comes in vials that are stable for intravenous application and are a clear to pale yellow solution.

Uses of Irinotecan Hydrochloride

Primary Uses

Colorectal cancer that has spread

Adenocarcinoma of the pancreas

Small cell lung cancer, cervical cancer, and stomach cancer

Indications

5-fluorouracil and leucovorin are used as a first-line treatment for colon cancer that has spread.

Second-line treatment for people who have gotten worse on fluorouracil alone.

If you have recurrent or advanced pancreatic cancer, you can use the liposomal version with other drugs.

It is also being tested for use in other solid cancers, such as ovarian and non-small cell lung cancer.

Benefits

Enhanced overall survival and progression-free survival rates in people with metastatic colorectal cancer.

Reliable either alone or as part of a mixed regimen such as FOLFIRI.

Liposomal Irinotecan provides targeted delivery and extended medication exposure for pancreatic cancer patients.

In comparison to fluorouracil alone, it improves tumor shrinkage and response rate.

Side Effects

How Does Irinotecan Work?

Irinotecan is a prodrug that is converted in the liver to SN-38, a strong inhibitor of topoisomerase I.

Topoisomerase I is the enzyme that relaxes supercoiled DNA during replication and transcription.

SN-38 binds to the topoisomerase I-DNA complex, making it stable and stopping strand displacement, which results in DNA strand breaks.

This method causes cell cycle arrest and death, particularly in rapidly dividing tumor cells.

Dosage Guidelines

Monotherapy (second-line colorectal cancer): 125 mg/m² IV over 1.5 hours weekly for 4 weeks, forwarded by 14-day rest

Combination (FOLFIRI regimen): 180 mg/m² IV every 14 days with 5-FU and leucovorin

Liposomal formulation (pancreatic cancer): 70 mg/m² every 2 weeks (equivalent to 50 mg/m² Irinotecan free base)

Directions for Use

Only given in a clinical setting by trained medical experts.

Given through an IV over 90 minutes.

Before treatment, you may start to stay hydrated and avoid having diarrhea.

During the infusion, keep an eye out for hypersensitivity and take care of any signs right away.

When Not to Use

If you might be allergic to Irinotecan or any of its parts

Strong suppression of the bone marrow

During pregnancy and while breastfeeding (Category D)

People who have inflammatory bowel disease or prolonged diarrhea

Severe liver damage (bilirubin >2 mg/dL)

Drug Interactions

Safety Advice

Drinking alcohol might amplify symptoms like dizziness or diarrhea, so it’s best to stay away from it.

Do not use unless absolutely required during pregnancy; it is not safe and may harm the unborn child.

If you are nursing a baby, don’t feed your child for at least 1 week after your last dosage and during your therapy.

The medicine can cause drowsiness, lightheadedness, or vision problems. So, don’t drive while using it.

General Instructions

The only person who should give Irinotecan Hydrochloride Injection is a trained medical professional who knows how to use chemotherapeutic agents for cancer.

It is given through an IV, generally in a hospital or clinic. Before and after treatment, patients should drink a lot of water and tell any symptoms right away, such as severe diarrhea, fever, or signs of an infection.

Blood counts and liver activity need to be observed frequently with blood tests.

It is very important to stick to the dosing plan and not miss any doses unless your doctor tells you to.

Always discuss with a doctor about all of the drugs and vitamins you are taking.

Special Diet & Lifestyle Recommendations

Keep up good fluid intake to avoid dehydration.

Steer clear of foods that could aggravate diarrhea (such as highly fatty or spicy meals).

Eat easy on the stomach, modest, regular meals.

Avoid grapefruit juice and booze.

Comparison with Other Cancer Therapies

Irinotecan Hydrochloride is a topoisomerase I inhibitor that is mostly used to treat colon cancer that has spread, usually with other drugs like Folfiri.

Irinotecan is different from other types of chemotherapy because it targets DNA replication enzymes specifically.

This makes it very effective against some kinds of tumors.

Irinotecan has more systemic side effects, such as diarrhea and neutropenia, than targeted treatments (like cetuximab) or immunotherapies (like nivolumab).

But the fact that it works well with other drugs is very helpful in cases of advanced cancer, especially when other drugs stop working.

Precautions & Warnings

It is possible that pregnancy category D will cause harm to the fetus. It is not suggested unless it is manifestly required.

Due to the possibility of causing harm to the baby, nursing is not recommended.

Safety and efficacy in children’s utilization have not been thoroughly investigated.

Use in elderly patients is associated with an increased incidence of adverse effects, particularly neutropenia.

If it is clinically indicated, UGT1A1 genotyping should be performed in order to evaluate the risk of toxicity.

Can It Be Taken with Other Medicines?

Irinotecan Hydrochloride may interact with other drugs, so use cautious.

It is often given alongside 5-fluorouracil and Leucovorin to treat cancer.

Enzyme inducers (Phenytoin, rifampin), CYP3A4 inhibitors (Ketoconazole, Ritonavir), and herbal supplements like St.

John’s Wort can reduce its efficacy or raise its toxicity.

Before starting Irinotecan, tell your doctor about all prescription, over-the-counter, and supplement drugs.

Storage

The recommended storage temperature for vials is 20-25°C, or 68-77°F.

Avoid freezing and keep away from direct sunrays.

Use or store diluted solutions as the manufacturer says.

Usually, you should do this within 6 hours at room temperature or within 24 hours in the fridge.