Example orders for FOLFIRI in colon cancer

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FOLFIRI

FOLFIRI: FOLinic acid, Fluorouracil, IRInotecan

Original references may be found at FOLFIRI

Example regimen #1

• Folinic acid (Leucovorin) 400 mg/m2 IV over 2 hours on day 1, given during irinotecan infusion
• Fluorouracil (5-FU) 400 mg/m2 IV bolus over 10-15 minutes on day 1, given after irinotecan and leucovorin
• Fluorouracil (5-FU) 1200 mg/m2/day IV continuous infusion over 46 hours on days 1-2, given last after bolus 5-FU
• Irinotecan (Camptosar) 180 mg/m2 IV over 90 minutes on day 1, given first together with leucovorin

14-day cycles

Supportive medications:

• Ondansetron (Zofran) 8 mg IV 30 minutes prior to chemotherapy
• Dexamethasone (Decadron) 10 mg IV 30 minutes prior to chemotherapy
• Lorazepam (Ativan) 0.5-1 mg PO/IV prn nausea/anxiety
• Atropine 0.4 mg IV prn diaphoresis, visual changes, abdominal cramping, or diarrhea during or after irinotecan infusion

Monitoring:

• Hold if ANC <1000 or platelets <100 and notify physician.

Outpatient medications:

• Loperamide (Imodium) 4 mg PO x1 for each day's first episode of diarrhea; 2 mg PO prn each loose stool thereafter, up to a maximum of 16 mg per day