Irinotecan (Campto®)
Irinotecan (pronounced i-ri-no-tee-can) is a chemotherapy drug that is given as a treatment for some types of cancer. It is most commonly used to treat bowel cancer. This information describes irinotecan, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy and about bowel cancer.
If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.
- What irinotecan looks like
- How it is given
- Possible side effects
- Less common side effects
- Additional information
What irinotecan looks like
Irinotecan is a clear yellow fluid.
How it is given
Irinotecan may be given:
- as a drip (infusion) through a fine tube (cannula) inserted into a vein
- through a central line, which is inserted under the skin into a vein near the collarbone, or into a PICC line which is inserted into a vein in the crook of your arm.
Possible side effects
Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given irinotecan, and may be different if you are having more than one chemotherapy drug.
We have outlined the most common side effects and those that are less common, so that you can be aware of them if they occur. However, we have not included those which are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.
Increased sweating, production of saliva, stomach cramps and diarrhoea This is a particular group of side effects that are known as acute cholinergic syndrome. They happen because irinotecan can cause the cells in the body to release too much of a chemical called acetylcholine. The side effects tend to occur during, or within the first 24 hours after an infusion of irinotecan.
These symptoms can usually be prevented or controlled by a drug called atropine. The atropine is given as an injection under the skin (subcutaneously), which can be repeated if necessary.
Delayed diarrhoea If diarrhoea occurs as a delayed side effect (occurring more than 24 hours after an infusion) it can usually be easily controlled but may occasionally be severe. If you get diarrhoea and abdominal cramps, start taking the anti-diarrhoea medicine (usually loperamide) that you have been given. These medicines should be taken exactly as you have been instructed by the hospital treating you, which may be different from the instructions on any printed leaflets provided by the manufacturer.
Normally your doctor will tell you to take two tablets or capsules to start with and then one every two hours until you have not had a loose bowel movement for 12 hours. If loperamide does not work quickly (certainly if you still have diarrhoea after 48 hours) it is important that you contact the hospital. You may become dehydrated if you have a lot of diarrhoea. In some situations you may be asked to take liquids to re-hydrate you and replace any salts that you have lost. Antibiotics are also sometimes given if diarrhoea occurs.
Feeling sick (nausea) and vomiting If you do feel sick it may begin a few hours after the treatment is given and can last for up to a day. Your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled or continues tell your doctor, who can prescribe other anti-sickness drugs which may be more effective.
Loss of appetite This is usually mild and may last a day or so. A dietitian or specialist nurse at your hospital can give advice on boosting your appetite, coping with eating difficulties and maintaining weight.
Lowered resistance to infection Irinotecan can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin a few days after treatment has been given and your resistance to infection usually reaches its lowest point in the second week after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal before your next course of chemotherapy is due.
Contact your doctor or the hospital straightaway if:
- Your temperature goes above 38ºC (100.5ºF)
- You suddenly feel unwell (even with a normal temperature).
You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.
Bruising or bleeding Irinotecan can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.
Anaemia (low number of red blood cells) While having treatment with irinotecan you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these are a problem.
Hair loss This usually starts 3–4 weeks after the first dose of irinotecan, although it may happen earlier. Hair may be lost completely. You may also have thinning and loss of eyelashes, eyebrows and other body hair. Hair loss is temporary and all your hair will grow again once the treatment ends.
Tiredness and a general feeling of weakness You may feel very tired. It is important to allow yourself plenty of time to rest.
Less common side effects
Sore mouth and ulcers Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.
Taste changes You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes.
Muscle cramps Tell your doctor if you have muscle cramps, so that suitable painkillers can be prescribed.
Temporary effect on liver function Irinotecan may cause changes in the way that your liver works, though your liver will return to normal when the treatment is finished. You are very unlikely to notice any problems but your doctor will check your liver is working properly before each treatment.
Skin changes Irinotecan can cause a rash which may be itchy. Your doctor can prescribe medicines to help with this.
Additional information
Other medicines Some medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.
Contraception It is not advisable to become pregnant or father a child while taking irinotecan, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.
