Applies to irinotecan: intravenous solution.
Warning
Intravenous route (Solution)
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 and reduce subsequent doses if severe diarrhea occurs. Severe myelosuppression may occur.
Serious side effects of Irinotecan
Along with its needed effects, irinotecan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking irinotecan:
More common
- Anxiety
- black, tarry stools
- blood in the urine or stools
- blurred vision
- changes in skin color
- chest pain or discomfort
- chest tightness or heaviness
- chills
- clay colored stools
- cold hands and feet
- confusion
- constricted pupils
- cough or hoarseness
- dark urine
- diarrhea with or without stomach cramps or sweating
- dizziness
- fainting
- fast, slow, or irregular heartbeat
- fever
- full or bloated feeling or pressure in the stomach
- headache
- increased production of saliva
- increased tear production
- itching or skin rash
- lightheadedness when getting up suddenly from a lying or sitting position
- loss of appetite
- low blood pressure or pulse
- lower back or side pain
- nausea or vomiting
- numbness or tingling in the face, arms, or legs
- pain
- pain in the chest, groin, or legs, especially calves of the legs
- pain in the shoulders, arms, jaw, or neck
- painful or difficult urination
- pale skin
- pinpoint red spots on the skin
- redness or swelling of the leg
- runny nose
- severe headache of sudden onset
- slow breathing
- slurred speech
- sore throat
- stomach pain
- stopping of the heart
- sudden and severe weakness in the arm or leg on one side of the body
- sudden loss of coordination
- sudden vision changes
- sweating
- swelling
- swelling of the abdomen or stomach area
- temporary blindness
- tenderness, pain, or swelling of the arm, foot, or leg
- troubled breathing
- trouble with speaking or walking
- ulcers, sores, or white spots on the lips or in the mouth
- unconsciousness
- unpleasant breath odor
- unusual bleeding or bruising
- unusual tiredness or weakness
- vomiting of blood
- warm, red feeling over the body
- yellow eyes or skin
Less common
- Bleeding gums
- coughing up blood
- decreased urination
- difficulty with swallowing
- dryness of the mouth
- increased menstrual flow or vaginal bleeding
- increased thirst
- nosebleeds
- paralysis
- prolonged bleeding from cuts
- sneezing
- wrinkled skin
Rare
- Decreased amount of urine
- decreased frequency of urination
- fast, irregular, or troubled breathing
- hives
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- rapid weight gain
Incidence not known
- Abdominal or stomach pain and tenderness
- agitation
- bloated or full feeling
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- coma
- constipation
- depression
- heartburn or indigestion
- hostility
- irritability
- lethargy
- muscle pain and cramps
- muscle twitching
- pain in the stomach, side, or abdomen, possibly radiating to the back
- pain or discomfort in the arms, jaw, back, or neck
- rectal bleeding
- severe abdominal or stomach cramping or burning
- severe and continuing nausea
- stupor
- swelling of the face, lower legs, ankles, fingers, or hands
- tightness in the chest
- unusual tiredness or weakness
- vomiting of material that looks like coffee grounds
Other side effects of Irinotecan
Some side effects of irinotecan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Acid or sour stomach
- belching
- blistering, peeling, redness, or swelling of the palms of hands or bottoms of the feet
- cracked lips
- excess air or gas in the stomach or intestines
- feeling of constant movement of self or surroundings
- numbness, pain, tingling, or unusual sensations in the palms of the hands or bottoms of feet
- passing gas
- right upper abdominal or stomach pain and fullness
- sensation of spinning
- sleepiness or unusual drowsiness
- stomach discomfort, upset, or pain
- trouble sleeping
- weight loss
Incidence not known
- Hiccups
For Healthcare Professionals
Applies to irinotecan: intravenous solution.
Gastrointestinal
Very common (10% or more): Late diarrhea (23%), nausea (16%), dehydration (15%), abdominal pain (15%), Grade 3 diarrhea (15%), constipation, flatulence, stomatitis, dyspepsia, mucositis
Common (1% to 10%): Grade 4 diarrhea, early diarrhea, anorexia, constipation, abdominal enlargement
Uncommon (0.1% to 1%): Intestinal obstruction, ileus, megacolon, GI hemorrhage
Rare (less than 0.1%): Colitis, ischemic colitis, ulcerative colitis, pancreatitis[Ref]
Hematologic
Very common (10% or more): Neutropenia (54%) [Grade 3 neutropenia (30%), Grade 4 neutropenia (24%)], leucopenia (38%)
Common (1% to 10%): Anemia, neutropenic fever, thrombocytopenia, neutropenic infection, thrombophlebitis
Uncommon (0.1% to 1%): Biliary sepsis[Ref]
Metabolic
Very common (10% or more): Decreased appetite (49%), weight loss (20%), hypokalemia, hypomagnesemia, dehydration
Common (1% to 10%): Hypoglycemia, hyponatremia, hypophosphatemia, dehydration[Ref]
Dermatologic
Very common (10% or more): Alopecia (22%), sweating, rash[Ref]
Respiratory
Very common (10% or more): Dyspnea, cough, rhinitis
Common (1% to 10%): Pneumonia, pulmonary embolism[Ref]
Nervous system
Very common (10% or more): Dizziness (23%), headache (17%)
Common (1% to 10%): Cholinergic syndrome, dysgeusia[Ref]
Cardiovascular
Common (1% to 10%): Hypotension, myocardial infarction
Uncommon (0.1% to 1%): Vasodilation
Postmarketing reports: Myocardial ischemic events[Ref]
Hepatic
Common (1% to 10%): Hypoalbuminemia, increased bilirubin, increased alanine aminotransferase, increased aspartate aminotransferase, increased international
Frequency not reported: Hepatic steatosis, steatohepatitis[Ref]
Other
Very common (10% or more): Asthenia (20%), chills, edema
Common (1% to 10%): Pain, fever[Ref]
Hypersensitivity
Uncommon (0.1% to 1%): Mild allergic reactions
Rare (less than 0.1%): Severe anaphylaxis[Ref]
Renal
Uncommon (0.1% to 1%): Renal insufficiency[Ref]
Musculoskeletal
Very common (10% or more): Back pain (15%)[Ref]
Immunologic
Very common (10% or more): Bacterial, fungal. and viral infections[Ref]
Local
Common (1% to 10%): Infusion related reaction[Ref]
Psychiatric
Common (1% to 10%): Confusion[Ref]
