Example orders for FOLFIRI in colon cancer

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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

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