liposomal irinotecan

Diarrhea (early onset) and other early side effects of liposomal irinotecan:

• Starts during your infusion or up to one day after.
• You may have other side effects such as excessive sweating, belly cramps, runny nose, watery eyes or mouth, face or neck flushing or pinpointed pupils.
• Let your healthcare team know right away if this happens. Medication(s) may be given to you to control these side effects.

Diarrhea (delayed onset, may be severe):

• Starts one or more days after your dose.
• Take anti-diarrhea drug(s) as instructed by your healthcare team.
• Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
• Eat many small meals and snacks instead of 2 or 3 large meals.
• Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy

​See the Diarrhea pamphlet for more information.

Contact your health care team if no improvement or if severe

If diarrhea lasts more than 24 hours while taking anti-diarrhea drugs or if you have fever, get emergency medical help right away.

Nausea and vomiting

May occur in hours to days after your treatment. It is easier to prevent nausea than to treat it if it happens. 

To help prevent nausea:

• Take anti-nausea medication(s) as prescribed to you by your doctor.
• Drink clear liquids and have small meals. Get fresh air and rest.
• Do not eat spicy, fried foods or foods with a strong smell.
• Limit caffeine (e.g. coffee, tea) and alcohol.

If you have nausea or vomiting:

• Take anti-nausea medication(s) as prescribed to you by your doctor. 
• Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Abnormal liver lab tests

• You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. Talk to your health care team if this happens.
• Your doctor may monitor your liver regularly with a blood test.

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.

Low appetite

• You may not feel like eating or you may lose weight.
• Try to eat foods that you like and eat small meals throughout the day. 
• You may need to take meal supplements to help keep your weight up.
• Talk to your health care team if you have a low appetite.
• See our Loss of appetite pamphlet for more information.

Fatigue (tiredness)

• Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
• Pace yourself, do not rush. Put off less important activities. Rest when you need to.
• Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
• Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

Hair thinning or loss 

• Use a gentle soft brush and avoid hair sprays, bleaches, dyes and perms.
• In most cases, your hair will grow back after treatment, but the texture or colour may change. 

Unusual bleeding or bruising (may be severe)

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

• 38.3°C (100.9°F) or higher at any time OR
• 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

• Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
• Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
• Do not eat or drink anything hot or cold right before taking your temperature.
• Wash your hands often.
• Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Blood clot

Blood clots can cause pain, swelling and hardening of the vein in the affected body part.

The blood clot may be more severe and  block an artery or vein (blood vessels) and cause :

• Blood clot in your lungs: you can start to cough, have problems  breathing, have pain in your chest or cough up blood
• Blood clot in your brain (stroke): you can have trouble seeing, speaking, or using your arms and legs
• Blood clot in your heart (heart attack): you can have chest pain, shortness of breath, pain in your belly or arms.

Mouth sores

You may have round, painful, white or gray sores inside your mouth. They can occur on the tongue, lips, gums, or inside your cheeks. In more severe cases they may make it hard swallow, eat or to brush your teeth. They usually last 1 to 2 weeks.

To help prevent mouth sores: 

• Take care of your mouth by gently brushing and flossing regularly.
• Rinse your mouth often. Do not use mouthwashes with alcohol.
• Instead, try a homemade mouthwash:
• Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.

If you have mouth sores:

• Check with your health care team as soon as you notice mouth or lip sores or if it hurts to swallow.
• Avoid hot, spicy, acidic, hard or crunchy foods.  Your doctor may prescribe a mouthwash to relieve mouth sores and prevent infection.

See the Mouth Care pamphlet for more information.