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Irinotecan liposomal Side Effects

Medically reviewed by Last updated on Sep 22, 2023.

Applies to irinotecan liposomal: intravenous solution.


Intravenous route (Solution)

Fatal neutropenic sepsis occurred in 0.8% of patients receiving irinotecan liposome. Severe or life-threatening neutropenic fever or sepsis occurred in 3% and severe or life-threatening neutropenia occurred in 20% of patients receiving irinotecan liposome in combination with fluorouracil and leucovorin. Withhold irinotecan liposome for absolute neutrophil count below 1500/mm(3) or neutropenic fever. Monitor blood cell counts periodically during treatment.Severe diarrhea occurred in 13% of patients receiving irinotecan liposome in combination with fluorouracil and leucovorin. Do not administer irinotecan liposome to patients with bowel obstruction. Withhold irinotecan liposome for diarrhea of Grade 2 to 4 severity. Administer loperamide for late diarrhea of any severity. Administer atropine, if not contraindicated, for early diarrhea of any severity.

Serious side effects

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

Less common

Incidence not known

Other side effects

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

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."

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

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

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.