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irinotecan

( eye-reen-oh-TEE-can )

Other Name(s): Camptosar®

Appearance: Clear, light-yellow solution mixed into larger bags of fluids

irinotecan patient.pdf

irinotcan pour le patient.pdf

irinotecan

Pronunciation:

eye-reen-oh-TEE-can

Other Name(s):

Camptosar®

Appearance:

Clear, light-yellow solution mixed into larger bags of fluids

This handout gives general information about this cancer medication.

You will learn:

who to contact for help
what the medication is
how it is given
what to expect while on medication

This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

Who do I contact if I have questions or need help?

My cancer health care provider is: _____________________________________________

During the day I should contact: _______________________________________________

Evenings, weekends and holidays: _____________________________________________

This page gives general information about this cancer medication.

You will learn:

who to contact for help
what the medication is
how it is given
what to expect while on this medication

This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

What is this treatment for?

For treating cancer of the colon, rectum or other cancers

What should I do before I start this treatment?

Tell your health care team if you have or had significant medical condition(s), such as:

liver, heart or lung problems
diabetes
hereditary fructose intolerance or
any allergies

Remember To:

Tell your health care team about all of the other medications you are taking.
Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.

You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.

How is this treatment given?

This drug is given by injection into a vein.

Other medications you may be given with this treatment

To Treat Diarrhea

The irinotecan in your treatment regimen can cause diarrhea. Diarrhea is when you have loose bowel movements (watery poo) or you need to have bowel movements (go poo) more often than usual. Diarrhea may start a few days after your treatment.

You will be given a medication called loperamide (Imodium®) to help treat your diarrhea. Take this medication only if you need it.

Keep your loperamide with you all the time. When diarrhea starts, take the loperamide right away.

If you start to have diarrhea:

Take 2 tablets (4 mg) of loperamide right away.
Take 1 tablet (2 mg) every 2 hours after that.
During the night you may take 2 tablets (4 mg) every 4 hours.
Keep taking loperamide until you have no diarrhea for 12 hours.

DO this while on treatment

DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.

DO NOT do this while on treatment

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DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. These may increase the quantity of the medication in your blood and increase the side effects.

DO this while on treatment

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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.

DO NOT do this while on treatment

Stop Icon

DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. These may increase the quantity of the medication in your blood and increase the side effects.

Will this treatment interact with other medications or natural health products?

Yes, this medication can interact with other medications, vitamins, foods, traditional medicines and natural health products. Interactions can make this medication not work as well or cause severe side effects.

Tell your health care team about all of your:

prescription and over-the-counter (non-prescription) medications
other drugs and substances, such as cannabis/marijuana (medical or recreational)
natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements, or traditional medicines

Check with your health care team before starting or stopping any of them.

Talk to your health care team BEFORE taking or using these :

Anti-inflammatory medications such as ibuprofen (Advil^® or Motrin^®), naproxen (Aleve^®) or Aspirin^®.
Over-the-counter products such as dimenhydrinate (Gravol^®)
Natural health products such as St. John’s Wort
Traditional medicines
Supplements such as vitamin C
Grapefruit juice
Alcoholic drinks
Tobacco
All other drugs or substances, such as marijuana or cannabis (medical or recreational)

What to do if you feel unwell, have pain, a headache or a fever

Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol^®) or ibuprofen (Advil^®)).
- Fever can be a sign of infection that may need treatment right away.
- If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.

How to check for fever:

Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).

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 (100.4°F) or higher for at least one hour.

If you do have a fever:

Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
Ask your health care team for the Fever pamphlet for more information.

If you do not have a fever but have mild symptoms such as headache or mild pain:

Ask your health care team about the right medication for you. Acetaminophen (Tylenol^®) is a safe choice for most people.

Talk to your health care team before you start taking ibuprofen (Advil^®, Motrin^®), naproxen (Aleve^®) or ASA (Aspirin^®), as they may increase your chance of bleeding or interact with your cancer treatment.

Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.

How will this treatment affect sex, pregnancy and breastfeeding?

Talk to your health care team about:

How this treatment may affect your sexual health
How this treatment may affect your ability to have a baby, if this applies to you

This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

If there is any chance you may become pregnant, you and your partner together must use 2 effective forms of birth control at the same time until 6 months after your last dose. Talk to your health care team about which birth control options are best for you.
If you are a patient that can get somebody pregnant, you and your partner together must use 2 effective forms of birth control at the same time until 3 months after your last dose. Talk to your health care team about which birth control options are best for you.

Do not breastfeed while on this treatment and for 7 days after your last dose.

What are the side effects of this treatment?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do	When to contact doctor?
More Common Side Effects (50 or more out of 100 people)

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

Starts during the infusion or within 24 hours
Some other symptoms include excessive sweating, belly cramps, runny nose, watery eyes, more saliva in the 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 symptoms

Diarrhea (delayed onset)

Starts more than 24 hours to a few days after your irinotecan dose.
May be severe in some cases with dehydration

If you have diarrhea :

Take anti-diarrhea drug(s) as instructed by your healthcare team. Refer to "How it is given" section for instructions on using loperamide (Imodium®)
Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol, until your diarrhea has stopped.
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.
If diarrhea lasts more than 24 hours while taking anti-diarrhea drugs or if you have fever, get emergency medical help right away.

See the Diarrhea pamphlet for more information.

Talk to 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.

Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours

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.

Talk to your health care team if no improvement or if severe

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.

Talk to your health care team if this bothers you

Pains or cramps in the belly

If you have constipation or diarrhea it may be causing the pain in your belly.
If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.

Talk to your health care team if no improvement or if severe

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.

Talk to your health care team if no improvement or if severe

Side effects and what to do	When to contact doctor?
Common Side Effects (25 to 49 out of 100 people)

Constipation (less common than diarrhea)

To help prevent constipation :

Drink more liquids and eat well. Drink at least 6 to 8 cups of liquids each day unless you have been told otherwise.
Be Active. Exercise can help to keep you regular.
Try to eat more fiber (e.g. fruits with skin, leafy greens and whole grains). If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation :

If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

Talk to your health care team if no improvement or if severe

Low platelets in the blood

Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

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 to prevent infection.
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.

Get emergency medical help right away

Side effects and what to do	When to contact doctor?
Less Common Side Effects (10 to 24 out of 100 people)

Cough; feeling short of breath

You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose.

Rarely this may be severe with chest pain, trouble breathing or coughing up blood. If this happens get medical help right away.

Talk to your health care team if no improvement or if severe

Trouble falling asleep

This may be caused by one of your medications and may improve once your body gets used to the medication or when your treatment ends.
Talk to your doctor if this bothers you.

Talk to your health care team if no improvement or if severe

Headache; muscle pain or cramps

Take your pain medication as prescribed by your doctor.
You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
Rest often and try light exercise as it may help.

Talk to your health care team if no improvement or if severe

Dizziness

You may feel light headed.
Lay down if this happens.
Get up and move slowly once you feel better.
Do not drive a motor vehicle or use machinery if you feel dizzy.

Talk to your health care team if no improvement or if severe

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.

Talk to your health care team if no improvement or if severe

Rash; dry, itchy skin

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

Use skin moisturizer.
Protect your skin from the sun and the cold.
Use sunscreen with UVA and UVB protection and a SPF of at least 30.

Talk to your health care team if no improvement or if severe

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.

Talk to your health care team as soon as possible

Heartburn; stomach upset

To help prevent heartburn:

Avoid fatty or spicy foods.
Remain upright after eating.
Drink clear liquids and eat small meals.

Talk to your health care team if no improvement or if severe

Mild swelling in arms and legs; puffiness

To help prevent swelling :

Eat a low-salt diet.
Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

Talk to your health care team if no improvement or if severe

Other rare, but serious side effects are possible with this treatment.

If you have any of the following, talk to your cancer health care team or get emergency medical help right away:

Swelling and hardening of a vein in your arms or leg
Feel confused, trouble seeing, speaking, or using your arms or legs
Severe or sudden belly pain, bloating or feeling of fullness and severe constipation
Pain in the centre of your belly that may extend to your back
Flushing, itchiness, rash, swollen lips, face or tongue, wheezing, chest and throat tightness
Fever, severe joint pain; lower back pain, swelling, pee less than usual and have unusual weight gain; muscle twitching, severe weakness or cramping and feel confused

For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.

Notes

August 2025 Updated/revised information sheet

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

irinotecan

Funding & Reimbursement

Symptom Management

Drug Safety and Administration