Example orders for Irinotecan (Camptosar) in colon cancer

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Irinotecan (Camptosar)

Original references may be found at Irinotecan (Camptosar)

Example regimen #1

• Irinotecan (Camptosar) 350 mg/m2 IV over 90 minutes on day 1

21-day cycles

Supportive medications:

• Ondansetron (Zofran) 8 mg IV 30 minutes prior to chemotherapy
• Dexamethasone (Decadron) 10 mg IV 30 minutes prior to chemotherapy
• Atropine 0.4 mg IV prn diaphoresis, visual changes, abdominal cramping, or diarrhea during or after irinotecan

Hydration:

• 500 ml NS at KVO rate as running IV for chemotherapy infusion. Give up to 500 ml NS.

Monitoring:

• Dose reduction of Irinotecan (Camptosar) to 300 mg/m2 IV over 90 minutes on day 1 is recommended for patients over 70 years old or with prior pelvic radiation.
• Hold for significant diarrhea, 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

Comments:

• In contrast to the original regimen, my institution does not specifically mandate that patients with ECOG performance status 2 or higher should have a dose reduction of irinotecan.