Camptosar

Drugs

Generic Name: Irinotecan hydrochloride
Product Name: Camptosar

Indication of Camptosar
Action of Camptosar
Dose advice of Camptosar
Schedule of Camptosar
Common side effects of Camptosar
Uncommon side effects of Camptosar

Indication of Camptosar:

Camptosar is used as a component of first-line therapy in the treatment of metastatic cancer of the colon or rectum. It can also be used in such patients whose disease has recurred or progressed following initial therapy.

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Action of Camptosar:

Irinotecan hydrochloride is an antineoplastic that works by inhibiting the enzyme topoisomerase I. Topoisomerase I relieves tension on DNA by inducing single strand breaks in the DNA. When it is inhibited by Irinotecan, these breaks cannot be repaired, and cell division cannot occur. Irinotecan is also converted to SN-38, which is a much more powerful inhibitor of topoisomerase I, but its exact role in the action of Camptosar is unclear.

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Dose advice of Camptosar:

Premedication with antiemetic medications is recommended, at least 30 minutes before administration.Combination therapy in first line treatment of metastatic colon and rectal cancer.- Camptosar should be administered via intravenous infusion over 90 minutes.- Leucovorin should follow Camptosar, and 5-fluorouracil should be administered following leucovorin.- In a 6 week regimen, 125mg/m2 should be administered on days 1, 8, 15 and 22, followed by a two week rest.- Dose should be appropriately reduced if neutropaenia develops.- An alternative regimen sees 180mg/m2 being administered on days 1, 15 and 29, followed by a 2 week rest.Single agent in recurrence or progression:- A six week cycle similar to the 125mg/m2 one above can be used.- 350mg/m2 can be administered once every 3 weeks as an alternative.- Dosage adjustments should be made in the presence of neutropaenia.Preparation of solution:- Camptosar should be diluted in 5% glucose (preferred) or 0.9% sodium chloride to a final concentration of 0.12-2.8mg/ml.- Other drugs should not be added to the infusion solution.- The diluted solution is stable for 24 hours at 25C or 48 hours when refrigerated, but should be used as soon as possible to reduce microbiological hazard.

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Schedule of Camptosar:

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Common side effects of Camptosar:

- Suppression of bone marrow and resulting decrease in white blood cells, red blood cells and platelets, placing the patient at increased risk of infection, anaemia and bleeding.- Moderate nausea and vomiting.- Loss of appetite.- Dehydration.- Increased salivation.- Rhinitis.- Sweating.- Flushing.- Intestinal hypermotility (which may result in abdominal cramps and diarrhoea).- Changes in liver enzymes.- General weakness.- Hair loss.- Shortness of breath.- Cough.Diarrhoea - early (related to the direct cholinergic effect of the camptothecan in the bowel wall) and late due to mucositis Haematological - Irinotecan will suppress the production of all blood cells Liver - Raised liver function tests transient and rapidly reversible.Skin- A mild pruritic rash that subsides with subsequent treatments may occur.

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