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Irinotecan often causes nausea and vomiting. It is very important that you continue to receive the medicine even if it makes you feel ill. Ask your health care professional about ways to lessen these effects.

Dosing

The dose of irinotecan will be different for different patients. The dose that is used may depend on a number of things, including the patient's size and whether or not other treatments are also being given. If you are receiving irinotecan at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of this medicine, ask your doctor.

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For irinotecan, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to irinotecan. Also tell your health care professional if you are allergic to any other substances.

Pregnancy Irinotecan may cause harm to the fetus when given during pregnancy. There are no adequate and well controlled studies in pregnant women. However, this medicine may be needed in serious diseases or other situations that threaten the mother's life. Be sure you have discussed this with your doctor.

Women who are able to bear children should use some kind of birth control during treatment with irinotecan.

Before receiving this medicine, make sure your doctor knows if you are pregnant.

Tell your doctor right away if you think you have become pregnant while receiving irinotecan.

Breast-feeding It is not known whether irinotecan passes into breast milk. However, irinotecan is not recommended during breast-feeding because it may cause unwanted effects in nursing babies.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of irinotecan in children with use in other age groups.

Older adults Patients greater than 65 years of age may be at an increased risk for severe diarrhea.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking irinotecan, it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon alfa (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or other cancer medicines The risk of dangerously low blood counts may be increased

• Azathioprine (e.g., Imuran) or
• Chlorambucil (e.g., Leukeran) or
• Corticosteroids (cortisone-like medicine) or
• Cyclophosphamide (e.g., Cytoxan) or
• Cyclosporine (e.g., Sandimmune) or
• Mercaptopurine (e.g., Purinethol) or
• Muromonab-CD3 (monoclonal antibody) (e.g., Orthoclone OKT3) or
• Mycophenolate (e.g., CellCept) or
• Tacrolimus (e.g., Prograf) The risk of infection may be increased because these medicines and irinotecan can all decrease your body's resistance to infection

• Diuretics (water pills) There may be an increased risk of serious problems caused by loss of body fluid if severe diarrhea or vomiting occurs during irinotecan treatment

• Laxatives Use of laxatives together with irinotecan may increase the risk of severe diarrhea

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) Irinotecan may cause these conditions to get worse and spread to other parts of your body.

• Infection Irinotecan may decrease your body's ability to fight an infection

• Liver disease The risk of dangerously low white blood cell counts may be increased.

• Lung disease An unusual side effect consisting of fever and of shortness of breath and other problems with the lungs has occurred, very rarely, in some people with lung disease who received irinotecan.