Irotin 40 - Injection Irinotecan Hydrochloride Trihydrate - 20mg/ml 1 40mg vial(s) / 40mg vial EDCL Introduction: Irotin 40 is used in the treatment of cancer of colon and rectum. It shows its working by stopping or slowing down the growth of cancer cells. Irotin 40 is given as an IV infusion into vein by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side... Uses of Irotin 40: Cancer of colon and rectum Side effects of Irotin 40: FatigueNauseaVomitingWeaknessHair lossFeverAnemia (low number of red blood cells)DiarrheaDecreased white blood cell count (neutrophils)Decreased appetiteMucosal inflammation How to use Irotin 40: Your doctor or nurse will give you this medicine. Kindly do not self administer. How Irotin 40 works: Irotin 40 is an anti-cancer medication. It works by suppressing the activity of an enzyme (topoisomerase I) involved in DNA multiplication of the cancer cells. This slows the growth of cancer cells and eventually kills them. What if you forget to take Irotin 40?: If you miss a dose of Irotin 40, please consult your doctor. Indication: Carcinoma of the colon or rectum Administration: Reconstitution: Dilute in 5% dextrose injection (preferred) or 0.9% sodium chloride injection to a final concentration of 0.12-2.8 mg/ml. Adult Dose: Intravenous Colorectal Cancer Indicated as first-line therapy (with 5-fluorouracil and leucovorin) for metastatic colorectal cancer (CRC); it is also indicated for CRC that has recurred or progressed following intial fluorouracil-based therapy Monotherapy Patients should be premedicated with antiemetic agents Atropine treatment should be considered in patients that experience cholinergic symptoms Regimen 1 (Weekly): 125 mg/m² IV infusion over 90 minutes on days 1, 8, 15, 22, then 2 weeks off, then repeat Regimen 2 (Once Every 3 Weeks): 350 mg/sq.meter IV infusion over 30-90 minutes q3Weeks Adjust dose per protocol Combination therapy Patients should be premedicated with antiemetic agents Atropine... Child Dose: Not recommended Contraindication: Patients with a known hypersensitivity to the drug or its excipients. Mode of Action: Irinotecan, a derivative of camptothecin, works by inhibiting the enzyme topoisomerase I thereby interfering with the coiling and uncoiling of DNA during replication and causing irreparable damage. Precaution: Early diarrhea is usually transient and infrequently severe. It may be accompanied by cholinergic symptoms of rhinitis, increased salivation, miosis, lacrimation, diaphoresis, flushing, and intestinal hyperperistalsis that can cause abdominal cramping. Bradycardia may also occur. Late diarrhea can be life threatening since it may be prolonged and may lead to dehydration, electrolyte imbalance, or sepsis.Late diarrhea can be complicated by colitis, ulceration, bleeding, ileus, obstruction, and infection. Cases of megacolon and intestinal perforation have been reported. Lactation: not known if excreted in breast milk, do not nurse Side Effect: >10% Anemia (>90%),Leukopenia (>90%),Neutropenia (>90%),Thrombocytopenia (>90%),Elevated bilirubin (88%),Diarrhea (85%),Nausea (79%),Asthenia (70%),Abdominal pain (63%),Vomiting (60%),Alopecia (43%),Fever (42%),Constipation (41%),Anorexia (34%),Mucositis (32%),Pain (31%),Dyspnea (28%),Cough (27%),Dizziness (23%),Infection (22%),Rash (19%) 1-10% Abdominal fullness (10%),AST increased (10%),Dyspepsia (10%),,Edema (10%),Ascites/jaundice (9%),Vasodilation (9%),Thromboembolism (9%),Hypotension (6%),Neutropenic fever (2-6%) Frequency Not Defined Headache,Insomnia,Orthostatic hypotension Potentially Fatal: Fatal sepsis due to myelosuppression; severe, chronic diarrhoea. Interaction: Diuretics increase risks of dehydration secondary to vomiting/diarrhoea; prophylactic dexamethasone as an antiemetic may enhance lymphocytopenia; prochlorperazine may increase incidence of akathisia; antineoplastic agents (myelosuppression and diarrhoea). St John's wort, ketoconazole may reduce irinotecan exposure.