Irinotecan Hydrochloride Concentrated Injection
Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about IRINOTECAN SZ.
It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of treating you with IRINOTECAN SZ against the expected benefits it will have for you.
Ask your doctor if you have any concerns about being treated with this medicine.
Keep this leaflet. You may need to read it again.
What IRINOTECAN SZ is used for
IRINOTECAN SZ is used to treat bowel cancer, which has spread to other parts of the body. Cancer, which has spread, cannot be treated by surgery alone and one of the options in this situation is treatment with an anticancer medicine, known as chemotherapy.
IRINOTECAN SZ may be used once spread of cancer beyond the bowel is first diagnosed. At this time IRINOTECAN SZ will be given in combination with other anticancer medicines. Alternatively, IRINOTECAN SZ is used alone when the cancer has not responded or has returned after initial treatment.
Ask your doctor if you have any questions about why IRINOTECAN SZ has been prescribed for you. Your doctor may have prescribed it for another purpose.
Use in children
It is not known if IRINOTECAN SZ is safe and effective in the treatment of children.
Before you are given IRINOTECAN SZ
When IRINOTECAN SZ must not be given
IRINOTECAN SZ must not be given if you:
- are allergic to irinotecan hydrochloride or any of the ingredients listed at the end of this leaflet
- are or may become pregnant
- are breastfeeding or intend to breastfeed.
Before treatment with IRINOTECAN SZ
You should only be treated with IRINOTECAN SZ by a doctor who is experienced in treating patients with cancer. Treatment will normally take place in a hospital because of the need for hospital facilities and skilled personnel.
It is likely that your doctor will give you one or more medicines before administering IRINOTECAN SZ to help you stop vomiting or feeling sick after the treatment. You will probably also have a blood test before each treatment.
You should tell your doctor if:
- you are 65 years of age or older
- you have or have had liver disease, kidney disease or heart disease
- you have previously been treated with radiation therapy
- you have diabetes or asthma
- you have constipation or difficulty urinating
- you have hereditary fructose intolerance
- you have Crigler-Najjar syndrome or Gilbert’s syndrome
- you are going to be vaccinated (have an injection to prevent a certain disease).
If you have not told your doctor about any of the above, tell your doctor before you are given IRINOTECAN SZ.
Taking other medicines
Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from a pharmacy, supermarket or health food shop.
Some medicines and IRINOTECAN SZ may interfere with each other. In particular, tell your doctor if you are taking:
- laxatives (e.g. for constipation)
- diuretics (medicines which make you pass urine more frequently e.g. for heart disease)
- any medicine for nausea or diarrhoea
- dexamethasone (may be used to treat skin diseases, asthma or other allergic disorders)
- anticonvulsants used to treat seizures
- St Johns Wort, a herbal medicine used to treat depression
- ketoconazole used to treat fungal infections.
Ask your doctor or other health care professional if you are not sure about this list of medicines.
You may need to take different amounts of your medicines or you may need to use different medicines.
Your doctor will advise you.
How IRINOTECAN SZ is given
IRINOTECAN SZ will be given to you by your doctor. It is diluted and given by slow infusion into a vein over a period of 90 minutes.
It is recommended that IRINOTECAN SZ be given in different treatment courses depending on whether IRINOTECAN SZ is given alone or in combination with other anticancer medicines.
When IRINOTECAN SZ is given in combination, treatment courses are of 6 weeks duration given either weekly or fortnightly. Rest periods of 1 or 2 weeks are incorporated into the 6 week courses.
When IRINOTECAN SZ is given alone, treatment courses include IRINOTECAN SZ being given weekly for 4 weeks followed by a 2 week rest period and IRINOTECAN SZ being given once every 3 weeks.
Depending on your response, treatment courses may be repeated more than once.
It is recommended that treatment with IRINOTECAN SZ should be interrupted if you get severe diarrhoea or other intolerable side effects.
The recommended dose for IRINOTECAN SZ varies between 125 mg/m2 and 350mg/m2 (based on body surface area), depending on the dosing schedule.
Your doctor will decide the dose of IRINOTECAN SZ to be given.
Ask your doctor if you want more information about the dose of IRINOTECAN SZ and the other medicines you will be receiving and how they are given.
After your first treatment course, the dose of IRINOTECAN SZ may be increased by your doctor if you have not had too many side effects.
Your doctor will lower the dose or stop treatment if you have serious side effects, particularly diarrhoea or changes appearing in your blood tests.
In case of overdose
Overdose is unlikely as treatment will be given in hospital under the supervision of a doctor. The possible effects of overdose are the same as those listed below under Side effects.
Tell your doctor immediately if you do not feel well while being given IRINOTECAN SZ.
While you are using IRINOTECAN SZ
Things you must do
Keep all appointments with your doctor and always discuss with your doctor any problems during or after treatment with IRINOTECAN SZ.
Tell your doctor as soon as possible if diarrhoea occurs.
Diarrhoea is a common side effect of IRINOTECAN SZ. If untreated, severe diarrhoea can be life-threatening.
Your doctor will prescribe loperamide (a medicine to treat diarrhoea) for you to take in case you get diarrhoea after treatment. You should start taking loperamide, when you first have poorly formed or loose stools or bowel movements more frequent than you would normally expect.
You must tell your doctor if you cannot get diarrhoea under control within 24 hours after taking loperamide. You should not take loperamide for more than 48 hours.
Also tell your doctor if you develop a fever in addition to the diarrhoea.
In these cases, your doctor may give you antibiotics. If the diarrhoea or fever persists you may become dehydrated and need to go to hospital for treatment.
You may need to take antibiotics if there are changes in your blood tests indicating a lack of white blood cells. Symptoms of this may include frequent infections such as fever, severe chills, sore throat or mouth ulcers. If this persists, you may need to go to hospital for treatment. If you have severe stomach cramps you may need to be treated with antibiotics.
You must use a reliable method of contraception (birth control) while being treated with IRINOTECAN SZ.
If pregnancy occurs, consult your doctor.
Things you must not do
Because of the risk of diarrhoea, do not take laxatives during treatment courses with IRINOTECAN SZ. Talk to your doctor if you need more information about this.
Do not start taking any other medicines, prescription or not, without first telling your doctor or pharmacist.
IRINOTECAN SZ, like all other medicines, may cause unwanted side effects. Side effects are very common with anti-cancer medicines such as IRINOTECAN SZ and they may be severe. Deaths have occurred which, in some cases, may have been related to treatment.
Tell your doctor immediately if you get any of the following side effects:
- start to vomit
- develop a fever or any type of infection
- fainting, light-headedness or dizziness
- bloody or black stools
- cannot eat or drink due to nausea or vomiting.
The above side effects may be serious. You may need urgent medical attention.
Very common side effects (occurring in over 50% of patients) are:
- diarrhoea or stomach cramps; may occur early (during or shortly after a treatment) or late (usually more than 24 hours after treatment)
- nausea, vomiting, loss of appetite
- anaemia which may make you weak and light-headed or may cause you to faint
- increased risk of infections including severe infections
- hair loss.
Common side effects (occurring in 10-50% of patients) are:
- constipation, flatulence (passing wind), sore mouth, heartburn
- fever (increased body temperature), chills, headache, back pain or other types of pain, infection, fluid retention which results in swelling
- weight loss, dehydration
- runny nose or eyes, increased saliva, sweating or flushing
- skin rash
- coughing, difficulty breathing
- difficulty sleeping or dizziness.
Less common side effects (occurring in less than 10% of patients) are:
- increased risk of bleeding
- severe fever associated with a reduction in white blood cell numbers
- bleeding from the bowel
- jaundice (yellowing of skin and eyes)
- severe breathing difficulties
- generally feeling unwell
- abnormal manner of walking
- fungal infections (e.g. thrush)
- kidney problems
- Problems speaking.
In addition to the above side effects the following have also been reported:
- allergic reactions; some of the symptoms of an allergic reaction may include: rash, itching or hives on the skin. In more severe cases symptoms may also include shortness of breath, wheezing or difficulty breathing, swelling of the face, lips, tongue or other parts of the body
- pins and needles
- bloating or pain in upper stomach
- chest pains
Other side effects not listed above may happen in some people. Some of these side effects can only be found when your doctor does tests to check your progress.
Rare side effects of IRINOTECAN SZ have also been reported. These include effects on the heart and blood vessels such as:
- slowed heart beat
- blood clots
- swelling and redness along a vein, which is extremely tender when touched
- chest pains
- heart attack
Your doctor has information on monitoring for such side effects and their treatment. A very small number of patients have died suddenly while on IRINOTECAN SZ.
Tell your doctor as soon as possible if you experience any side effects, including any effects not listed above.
After taking IRINOTECAN SZ
Stored below 25°C. Do not Freeze.
Protect from Light.
What it looks like
IRINOTECAN SZ is a sterile, pale yellow, clear, aqueous solution with pH 3.0 – 3.8. It is available in 2 sizes: 40 mg/2 mL and 100 mg/5 mL. Each vial is for single use in one patient only and is contained in an outer carton.
The active ingredient in IRINOTECAN SZ is irinotecan hydrochloride trihydrate. There is 20 mg of irinotecan hydrochloride trihydrate in each 1 mL of IRINOTECAN SZ.
IRINOTECAN SZ also contains:
- Lactic acid
- Water for injections.
It might also contain sodium hydroxide or hydrochloric acid.
Sandoz Pty Ltd
ABN 60 075 449 553
Level 2, 19 Harris Street
Pyrmont NSW 2009
Tel: 1800 634 500
Australian Register Numbers
40 mg/2 mL: AUST R 173801
100 mg/5 mL: AUST R 172624
This leaflet was revised on 04 October 2016.
Published by MIMS May 2017