Irinox

40 mg

100 mg

300 mg

💉 Dosage & Administration

• Strengths: supplied as a 2 mL vial with 40 mg or a 5 mL vial with 100 mg irinotecan 

• Common dosing:

  • Single-agent regimens:

    • 125 mg/m² IV over ~90 min once weekly for 4 weeks, followed by 2 weeks off; repeating cycles 

    • Or 350 mg/m² IV every 3 weeks .

  • Combination (e.g., FOLFIRI): 180 mg/m² IV over 30–90 min on Days 1, 15, 29 of a 6-week cycle

  • Elderly or with hepatic issues: lower starting dose (e.g., 300 mg/m² every 3 weeks for patients ≥ 70) and cautious dosing in liver impairment 

• Before each dose: premedicate with antiemetics (e.g., dexamethasone + 5‑HT₃ blocker); atropine may help prevent acute cholinergic symptoms 

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⚠️ Key Side Effects & Warnings

1. Diarrhea:

   • Early onset during/shortly after infusion—often mild, can include cholinergic symptoms (e.g., salivation, cramps); treat with atropine 

   • Late-onset (> 24 h later) may be severe and life-threatening—manage with loperamide, fluids, electrolytes, antibiotics if necessary; dose reductions may be required .

2. Myelosuppression:

   • Neutropenia, febrile neutropenia, sepsis—monitor blood counts; delay or reduce dose if ANC < 1,000/mm³ .

3. UGT1A1 genetic considerations:

   • Patients with homozygous *28/*28 genotype at higher risk of severe neutropenia; dose reductions recommended 

4. Other serious risks:

   • Hypersensitivity reactions, pulmonary toxicity (interstitial lung disease), renal impairment from dehydration, embryo-fetal harm—avoid in pregnancy and during breastfeeding 

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🧪 Preparation & Handling

• Dilute to 0.12–2.8 mg/mL in 5% dextrose (preferred) or saline; use within 4 h at room temperature or 48 h refrigerated (protected from light). Discard unused vials after single use 

• Handle as a cytotoxic drug—wear gloves; flush skin/mucosa with water if exposed .

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💡 Summary

• Irinox 40 mg (irinotecan) is a powerful chemotherapy agent aimed at topoisomerase I in colorectal cancer.

• Requires careful dosing schedules, premedication, and vigilant monitoring for diarrhea and neutropenia.

• Genetic testing (UGT1A1) and patient-specific factors (age, liver function) guide dose adjustments.

• Proper infusion preparation and safety protocols are crucial due to stability and toxicity.

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✅ What to Discuss with Your Doctor

• Treatment schedule (weekly vs. every-3-weeks) and combination vs. single-agent use

• Genetic testing for UGT1A1 *28 status

• Preventive measures for diarrhea and low blood counts

• Potential drug interactions and precautions if undecided about pregnancy or breastfeeding.