Camptosar Disease Interactions

Irinotecan induces myelosuppression, causing leukopenia, thrombocytopenia and anemia. Deaths due to sepsis following severe neutropenia have been reported in patients treated with irinotecan. Hold irinotecan if neutropenic fever occurs or if the absolute neutrophil count drops <1000/mm3. After recovery to an absolute neutrophil count =1000/mm3, subsequent doses of irinotecan should be reduced. Therapy with irinotecan should be administered cautiously in patients who have received previous irradiation therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

Irinotecan clearance is diminished in patients with hepatic impairment. The magnitude of these effects is proportional to the degree of liver impairment as measured by elevations in total bilirubin and transaminase concentrations. However, the tolerability of irinotecan in patients with hepatic dysfunction (bilirubin greater than 2 mg/dl) has not been assessed sufficiently, and no recommendations for dosing are made by the manufacturers. Therapy with irinotecan should be administered cautiously to patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

The influence of renal impairment on the pharmacokinetics of irinotecan has not been evaluated. Therefore, caution should be undertaken in patients with impaired renal function. Irinotecan hydrochloride is not recommended for use in patients on dialysis.

Irinotecan can cause severe and fatal interstitial pulmonary disease (IPD). Risk factors include preexisting-existing lung disease. It is recommended to withhold treatment with irinotecan in patients with new or progressive dyspnea, cough, and fever, pending diagnostic evaluation and to discontinue treatment in patients with a confirmed diagnosis of IPD. Exercise caution when using this agent in patients presenting symptoms of dyspnea and patients with pulmonary impairment.