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Irinotecan Dosage

Medically reviewed by Drugs.com. Last updated on Apr 3, 2023.

Applies to the following strengths: 20 mg/mL

Usual Adult Dose for Colorectal Cancer

COMBINATION REGIMEN 1:
125 mg/m2 IV over 90 minutes on Days 1, 8,15, and 22 with LV 20 mg/m2 IV bolus on Days 1, 8, 15, and 22 followed by 5-FU 500 mg/m2 IV bolus on Days 1, 8, 15, and 22 every 6 weeks

COMBINATION REGIMEN 2:
180 mg/m2 IV over 90 minutes on Days 1, 15, and 29 with LV 200 mg/m2 IV over 2 hours on Days 1, 2, 15, 16, 29, and 30 followed by 5-FU 400 mg/m2 IV bolus on Days 1, 2, 15, 16, 29, and 30 and 5-FU 600 mg/m2 IV over 22 hours on Days 1, 2, 15, 16, 29, 30 (NOTE: 5-FU IV follows 5-FU bolus)

SINGLE AGENT REGIMEN 1:
125 mg/m2 IV over 90 minutes on Days 1, 8, 15, and 22 then 2-week rest

SINGLE AGENT REGIMEN 2:
350 mg/m2 IV over 90 minutes on Day 1 every 3 weeks

Comments:


Uses:

Renal Dose Adjustments

Caution recommended.

Liver Dose Adjustments

Caution recommended.

Dose Adjustments

DOSE REGIMEN MODIFICATIONS FOR COMBINATION REGIMEN 1:
IRINOTECAN:

LV:
5FU:
NOTE: Dose beyond dose level -2 by decrements of about 20% may be warranted for patients continuing to experience toxicity. Provided intolerable toxicity does not develop, treatment with additional cycles may be continued indefinitely if patients continue to experience clinical benefit.

DOSE REGIMEN MODIFICATIONS FOR COMBINATION REGIMEN 2:
IRINOTECAN:
LV:
5FU bolus:
5FU IV (NOTE: 5-FU IV follows 5-FU bolus):
NOTE: Dose beyond dose level -2 by decrements of about 20% may be warranted for patients continuing to experience toxicity. Provided intolerable toxicity does not develop, treatment with additional cycles may be continued indefinitely if patients continue to experience clinical benefit.

RECOMMENDED DOSE MODIFICATIONS FOR IRINOTECAN HYDROCHLORIDE INJECTION /5-FLUOROURACIL (5-FU)/LEUCOVORIN (LV) COMBINATION SCHEDULES:
NEUTROPENIA:
NEUTROPENIC FEVER:
OTHER HEMATOLOGIC TOXICITIES:
DIARRHEA:
OTHER NONHEMATOLOGIC TOXICITIES (excluding alopecia, anorexia, asthenia):
* For mucositis/stomatitis decrease only 5-FU, not irinotecan during a cycle of therapy.
* For mucositis/stomatitis decrease only 5-FU, not irinotecan at the start of subsequent cycles relative to the starting dose used in the previous cycle.

DOSE REGIMEN MODIFICATIONS FOR SINGLE AGENT REGIMEN 1:
IRINOTECAN:
NOTE: Subsequent doses may be adjusted to as high as 150 mg/m2 or to as low as 50 mg/m2 in 25 to 50 mg increments depending on individual patient tolerance. Provided intolerable toxicity does not develop, therapy with additional cycles may be continued indefinitely if patients continue to experience clinical benefit.

DOSE REGIMEN MODIFICATIONS FOR SINGLE AGENT REGIMEN 2:
IRINOTECAN:
NOTE: Subsequent doses may be adjusted to as low as 200 mg/m2 in 50 mg/m2 decrements depending on individual patient tolerance. Provided intolerable toxicity does not develop, therapy with additional cycles may be continued indefinitely if patients continue to experience clinical benefit.

RECOMMENDED DOSE MODIFICATIONS FOR SINGLE-AGENT SCHEDULES:
NEUTROPENIA:
Weekly Schedule:
Once Every Three Weeks Schedule:
OTHER HEMATOLOGIC TOXICITIES:
DIARRHEA:
Weekly Schedule:
Once Every Three Weeks Schedule:
OTHER NONHEMATOLOGIC TOXICITIES (excluding alopecia, anorexia, asthenia):
Weekly Schedule:
Once Every Three Weeks Schedule:

DOSE IN PATIENTS WITH REDUCED UGT1A1 ACTIVITY:

Precautions

US BOXED WARNINGS:
DIARRHEA:

Recommendations:
MYELOSUPPRESSION:

CONTRAINDICATIONS:

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Not recommended.

Other Comments

Administration advice:


Storage requirements:

Reconstitution/preparation techniques:

IV compatibility:

Patient advice:

Further information

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