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Irinotecan Disease Interactions

There are 4 disease interactions with irinotecan.

Major

Irinotecan (applies to irinotecan) myelosuppression

Major Potential Hazard, High plausibility. Applicable conditions: Bleeding, Bone Marrow Depression/Low Blood Counts, Fever, Infection - Bacterial/Fungal/Protozoal/Viral

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.

References

  1. (2001) "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn
Moderate

Irinotecan (applies to irinotecan) hepatic dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

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.

References

  1. Abigerges D, Chabot GG, Armand JP, Herait P, Gouyette A, Gandia D (1995) "Phase I and pharmacologic studies of the camptothecin analog irinotecan administered every 3 weeks in cancer patients." J Clin Oncol, 13, p. 210-21
  2. (2001) "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn
Moderate

Irinotecan (applies to irinotecan) renal impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

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.

References

  1. (2001) "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn
Moderate

Irinotecan liposomal (applies to irinotecan) interstitial lung disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Impairment

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.

References

  1. (2001) "Product Information. Camptosar (irinotecan)." Pharmacia and Upjohn
  2. (2015) "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals

Irinotecan drug interactions

There are 418 drug interactions with irinotecan.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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