Skip to main content

Irinotecan liposomal Side Effects

Medically reviewed by Last updated on Aug 2, 2022.


Commonly reported side effects of irinotecan liposomal include: fever. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to irinotecan liposomal: intravenous solution


Intravenous route (Solution)

Fatal neutropenic sepsis has been reported with irinotecan liposome therapy. Life-threatening neutropenia, life-threatening neutropenic fever or sepsis, and severe diarrhea has been reported with irinotecan liposome therapy in combination with fluorouracil and leucovorin. Monitor blood cell counts periodically. Withhold treatment for absolute neutrophil count below 1500/mm(3), neutropenic fever. Severe diarrhea has been reported. Withhold treatment for grade 2 or higher diarrhea. Administer atropine for early diarrhea and administer loperamide for late diarrhea. Do not administer to patients with bowel obstruction.

Side effects requiring immediate medical attention

Along with its needed effects, irinotecan liposomal 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 liposomal:

More common

  • Confusion
  • decreased urination
  • diarrhea (severe)
  • dizziness
  • dry mouth
  • fainting
  • fever
  • lightheadedness
  • rapid breathing
  • sunken eyes
  • thirst
  • unusual tiredness or weakness
  • wrinkled skin

Less common

  • Black, tarry stools
  • chest pain or discomfort
  • chills
  • confusion
  • cough
  • fast heartbeat
  • lightheadedness, dizziness, or fainting
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • rapid, shallow breathing
  • shortness of breath
  • slow or irregular heartbeat
  • sore throat
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising

Incidence not known

  • Difficulty with breathing or swallowing
  • hives, itching, or skin rash
  • nausea
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • reddening of the skin, especially around the ears
  • tightness in the chest

Side effects not requiring immediate medical attention

Some side effects of irinotecan liposomal 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

Less common

  • Abdominal or stomach pain
  • feeling of warmth
  • increased sweating
  • runny nose
  • sneezing
  • stuffy nose
  • tearing of the eyes
  • watering of the mouth
  • weakness

For Healthcare Professionals

Applies to irinotecan liposomal: intravenous dispersion


Very common (10% or more): Diarrhea (70%), nausea (61%), vomiting (54%), abdominal pain (34%), constipation (18%), stomatitis, mucosal inflammation

Common (1% to 10%): Gastroenteritis, oral candidiasis, colitis, hemorrhoids

Uncommon (0.1% to 1%): Esophagitis, proctitis[Ref]


Very common (10% or more): Alopecia (22%)

Uncommon (0.1% to 1%): Rash maculopapular, nail discoloration[Ref]


Very common (10% or more): Anemia (33%), neutropenia (15%), leukopenia, thrombocytopenia

Common (1% to 10%): Lymphopenia, febrile neutropenia

Uncommon (0.1% to 1%): Biliary sepsis[Ref]


Common (1% to 10%): Hypoalbuminemia, increased bilirubin, increased alanine aminotransferase, increased aspartate aminotransferase, increased international normalized ratio[Ref]


Common (1% to 10%): Infusion related reaction[Ref]


Very common (10% or more): Decreased appetite (49%), weight loss (20%), hypokalemia, hypomagnesemia, dehydration

Common (1% to 10%): Hypoglycemia, hyponatremia, hypophosphatemia, dehydration[Ref]

Nervous system

Very common (10% or more): Dizziness (12%)

Common (1% to 10%): Cholinergic syndrome, dysgeusia[Ref]


Very common (10% or more): Fatigue (37%), asthenia (24%), pyrexia (20%), enema peripheral (19%)[Ref]


Common (1% to 10%): Acute renal failure[Ref]


Common (1% to 10%): Septic shock, sepsis[Ref]


Common (1% to 10%): Back pain[Ref]


Common (1% to 10%): Insomnia[Ref]


Common (1% to 10%): Pneumonia, pulmonary embolism, embolism, dyspnea, dysphonia[Ref]


Common (1% to 10%): Hypotension, deep vein thrombosis

Uncommon (0.1% to 1%): Thrombosis[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Onivyde (irinotecan liposomal)." Merrimack Pharmaceuticals (2015):

Further information

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

Some side effects may not be reported. You may report them to the FDA.