irinotecan sucrosofate at a glance
Medicine class
Cytotoxic topoisomerase I inhibitor
Licensed role
Combination treatment for metastatic pancreatic adenocarcinoma in adults
Administration
A diluted intravenous infusion given by trained oncology professionals; it must not be injected as a bolus
Important toxicity
Diarrhoea and reduced blood-cell counts require prompt recognition and management
What is irinotecan sucrosofate used for?
UK-licensed uses in adults with metastatic adenocarcinoma of the pancreas include:
First-line treatment with oxaliplatin, fluorouracil and leucovorin.
Treatment with fluorouracil and leucovorin after progression following gemcitabine-based therapy.
How does irinotecan sucrosofate work?
Irinotecan is converted to the active metabolite SN-38. Both interfere with topoisomerase I, an enzyme involved in DNA repair during replication, causing DNA damage that particularly affects rapidly dividing cells. Liposomal encapsulation prolongs circulation and alters distribution compared with non-liposomal irinotecan.
irinotecan sucrosofate preparations and strengths
Dispersion for infusion
Route: Intravenous
Strengths: 4.3 mg/mL
How to take irinotecan sucrosofate
Healthcare professionals trained in anticancer treatment prepare, dilute and administer it into a vein. It must not be given undiluted or as a bolus injection. Supportive treatments may be given for nausea, vomiting or early cholinergic symptoms.
Follow the oncology team's diarrhoea-management instructions and keep prescribed rescue medicines available.
Avoid grapefruit and grapefruit juice because they may increase irinotecan exposure.
Tell the team promptly about side effects rather than waiting for the next appointment.
irinotecan sucrosofate side effects
Common or expected effects
- Diarrhoea
- Nausea or vomiting
- Reduced appetite
- Tiredness or weakness
- Low white-cell count, anaemia or low platelets
- Abdominal discomfort or sore mouth
- Dehydration or altered blood electrolyte levels
Get urgent medical advice
- Fever, chills or infection associated with reduced white-cell counts
- Severe or persistent diarrhoea, dehydration or bowel inflammation
- Severe infusion or allergic reaction
- Blood clot symptoms, including sudden chest pain, breathlessness or limb swelling
- New or worsening cough, breathlessness or fever suggesting lung inflammation
- Sepsis, severe bleeding or marked reduction in blood cells
irinotecan sucrosofate in pregnancy
Irinotecan sucrosofate may harm an unborn baby and should not be used during pregnancy unless clearly necessary. Discuss pregnancy, pregnancy planning and fertility preservation with the specialist team before treatment. Effective contraception is advised during treatment and for seven months afterwards for women who could become pregnant; men should use condoms during treatment and for four months afterwards.
irinotecan sucrosofate while breastfeeding
Breastfeeding is contraindicated because of possible serious effects in the infant. It should not restart until one month after the final treatment.
irinotecan sucrosofate interactions
The oncology team should review prescription, over-the-counter and herbal products before treatment.
Strong CYP3A4 inducers, including carbamazepine, phenytoin, phenobarbital, rifampicin and rifabutin
May reduce irinotecan and SN-38 exposure and potentially reduce treatment activity.
St John's wort
May reduce irinotecan exposure and should not be used unless the specialist determines otherwise.
Strong CYP3A4 inhibitors, including clarithromycin, itraconazole, voriconazole and some HIV antivirals
May increase exposure and toxicity; specialist review or substitution is needed.
Common questions about irinotecan sucrosofate
Answers are fully visible for fast scanning and source review.
What cancer is irinotecan sucrosofate used to treat?
Its UK licence covers metastatic pancreatic adenocarcinoma in adults, used with other anticancer treatments.
Is it used as a first treatment for pancreatic cancer?
It is licensed as part of a first-line combination for adults with metastatic pancreatic adenocarcinoma.
Can it be used after gemcitabine treatment?
Yes. It is licensed with fluorouracil and leucovorin after metastatic pancreatic cancer has progressed following gemcitabine-based therapy.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.