{"id":4541,"date":"2025-03-31T18:12:11","date_gmt":"2025-03-31T18:12:11","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/irinotecan-hydrochloride-txt\/"},"modified":"2025-03-31T18:12:11","modified_gmt":"2025-03-31T18:12:11","slug":"irinotecan-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/irinotecan-hydrochloride-txt\/","title":{"rendered":"irinotecan hydrochloride.txt"},"content":{"rendered":"

irinotecan hydrochloride <\/h1>\n

CLINICAL USE <\/H3>
\nTreatment of metastatic colorectal cancer resistant to fluorouracil, or in conjunction with fluorouracil

DOSE IN NORMAL RENAL FUNCTION <\/H3>Without 5-FU: 350 mg\/m2 every 3 weeksWith 5-FU: 180 mg\/m2 every 2 weeks

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :677.2<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :65<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 20<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :110\u2013234 litres\/m2<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :14

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function and monitor closely
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function and monitor closely
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Reduce dose (50\u201380 mg\/m2) and monitor closely. Increase as tolerated

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR <10 mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR 10 to 20 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antipsychotics: avoid concomitant use with clozapine (increased risk of agranulocytosis)\n
  • Antivirals: metabolism possibly inhibited by atazanavir (increased risk of toxicity)

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>

    IV infusion <\/H4>

    Rate of Administration <\/H4>Over 30\u201390 minutes

    Comments<\/H4>Dilute in 250 mL sodium chloride 0.9% or glucose 5%

    OTHER INFORMATION <\/H4>Manufacturer advises avoiding use in renal impairment due to lack of dataMetabolism is primarily hepatic: where irinotecan is rapidly converted to active metabolite SN-38 by hepatic carboxylesterase enzymesExcretion is predominantly biliary: 64% excreted in faeces. The mean 24 hr urinary excretion of irinotecan and SN-38 (its active metabolite) was 19.9% and 0.25% respectivelyInfrequent reports of renal insufficiency due to inadequate hydrationTransient, mild to moderate increase in serum creatinine reported in 7.3% patients
    \n","protected":false},"excerpt":{"rendered":"

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