How does this medicine work?

Irinotecan destroys cancer cells by interfering with a specific phase of cell life.

How is it given?

Irinotecan is given by intravenous (into the vein) infusion.

What are the side effects?

Common

  • low blood cell counts
  • sweating
  • increased saliva
  • severe diarrhea (see diarrhea management on the back of this page)
  • nausea
  • vomiting
  • loss of appetite
  • belly pain/cramping
  • hair loss

Occasional

  • mouth sores
  • fatigue (tired)
  • pain at injection site

Rare

  • change in liver function
  • change in kidney function
  • rash
  • itching of the skin
  • redness and warmth in the face

When should I call the clinic?

Call the hematology helpline 982403210 if:

  • fever
  • chills
  • diarrhea (more than 4 stools a day)
  • mouth sores

What else do I need to know?

Blood counts are lowest 10 to 21 days after the medicine is given.

It is important to follow the instructions for managing diarrhea with the medicine Imodium® on the back of this page.

You and your child should know the names of all the medicines he or she is taking. It is important to share this information with anyone involved in your child’s care.

What are the side effects?

Common

  • low blood cell counts
  • bleeding, anemia
  • nausea, vomiting
  • heartburn

Occasional

  • headache
  • stomach pain, cramping
  • muscle aches
  • edema (swelling)
  • rash
  • fever
  • tiredness
  • change in liver function

 

Rare

  • diarrhea
  • trouble swallowing
  • kidney problems

When should I call the clinic?

Call hematology helpline 982403210 if:

  • signs of infection (see below)
  • yellow eyes or skin
  • dark-colored urine
  • rapid weight gain
  • swelling of hands, feet, or ankles
  • unusual bruising or bleeding
  • signs of allergic reaction:
    • fever or chills
    • rash or hives
    • wheezing
    • trouble breathing – call 112

What else do I need to know?

While your child is receiving chemotherapy, the immune system is compromised, which means it has a decreased ability to fight infection. Watch for signs of infection such as fever, chills, cough, runny nose, or increased fatigue.

Chemotherapy is excreted in the body fluids up to 48 hours after the chemotherapy is given. This could be absorbed through a caregiver’s skin. Wear gloves when handling urine, stool, and vomit while the child is receiving chemotherapy and for 48 hours afterwards. Urine, stool, and vomit can be safely disposed of in septic tanks and sewer systems.

Any clothing or bed linens that are contaminated with urine, stool, or vomit should be washed separately from other laundry in hot water and detergent. Wear gloves when handling contaminated laundry.

Blood samples are needed to check the effects of the medicine. Complete blood counts should be done weekly for the first month, every 2 weeks during the second month, and every 2 to 3 months after that.

You and your child should know the names and doses of all the medicines he or she is taking. It is important to share this information with anyone involved in your child’s care.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call:

Hematology Clinic
3rd floor, Kedar
Opp.Krupa Petrol Pump,
Parimal Garden, Ambawadi
Clinic: 07926463219

Imodium® (loperamide)

for managing diarrhea after irinotecan

How does this medicine work?

Imodium® (loperamide) is an anti-diarrhea medicine.

These instructions are to be used only for diarrhea that occurs after irinotecan is given, not for any other diarrhea.

How do I give the Imodium?

Do not give Imodium before your child receives the irinotecan infusion.

Be aware of your child’s bowel movements. At the first sign that they are softer than usual or if your child has any increase in the number of bowel movements, begin giving Imodium.

If your child does not start taking the Imodium right away, the diarrhea may become severe and last several days or require hospital treatment.

Please follow these instructions carefully:

Give ______________( ___mg) at the first sign of diarrhea.

Continue giving ______________( ___mg) every 2 hours during the day, and ______________( ___mg) every 4 hours during the night until the normal pattern of bowel movements returns.

Do not give more than 16 mg (8 caplets or 80 ml) in 24 hours.

If the diarrhea returns, repeat the same doses and frequency.

What are the side effects of Imodium?

  • weakness
  • drowsiness
  • dizziness

When should I call the doctor?

Call the hematology helpline: 982403210 if:

  • no urine for 8 hours
  • weakness
  • drowsiness
  • dizziness
  • diarrhea does not stop

What else do I need to know?

While your child is taking Imodium, make sure you give lots of fluids such as:

  • water
  • 100% fruit juice (not apple or pear)
  • soup

Imodium can be given on an empty or full stomach. Do not give your child any laxatives without consulting the doctor.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call:

Hematology Clinic
3rd floor, Kedar
Opp.Krupa Petrol Pump,
Parimal Garden, Ambawadi
Clinic: 07926463219