Introduction
Campto is used in the treatment of cancer of colon and rectum. It shows its working by stopping or slowing down the growth of cancer cells.
Campto is given as an IV infusion into vein by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
The most common side effects of this medicine include fatigue, nausea, vomiting, weakness, and hair loss. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Inform your doctor if you notice fever, sore throat, and continuous episodes of diarrhea. Regular blood tests are required to check your blood cells along with heart, liver, and blood uric acid levels.
Before taking it, tell your doctor if you have heart disease, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy.
Uses of Campto
- Cancer of colon and rectum
Side effects of Campto
Common
- Fatigue
- Nausea
- Vomiting
- Weakness
- Hair loss
- Fever
- Anemia (low number of red blood cells)
- Diarrhea
- Decreased white blood cell count (neutrophils)
- Decreased appetite
- Mucosal inflammation
How to use Campto
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Campto works
Campto is an anti-cancer medication. It works by suppressing the activity of an enzyme (topoisomerase I) involved in DNA multiplication of the cancer cells. This slows the growth of cancer cells and eventually kills them.
What if you forget to take Campto?
If you miss a dose of Campto, please consult your doctor.
Indication
Carcinoma of the colon or rectum
Administration
Reconstitution: Dilute in 5% dextrose injection (preferred) or 0.9% sodium chloride injection to a final concentration of 0.12-2.8 mg/ml.
Adult Dose
Intravenous
Colorectal Cancer
Indicated as first-line therapy (with 5-fluorouracil and leucovorin) for metastatic colorectal cancer (CRC); it is also indicated for CRC that has recurred or progressed following intial fluorouracil-based therapy
Monotherapy
Patients should be premedicated with antiemetic agents
Atropine treatment should be considered in patients that experience cholinergic symptoms
Regimen 1 (Weekly): 125 mg/m² IV infusion over 90 minutes on days 1, 8, 15, 22, then 2 weeks off, then repeat
Regimen 2 (Once Every 3 Weeks): 350 mg/sq.meter IV infusion over 30-90 minutes q3Weeks
Adjust dose per protocol
Combination therapy
Patients should be premedicated with antiemetic agents
Atropine treatment should be considered in patients that experience cholinergic symptoms
Regimen 1 (6 week cycle with infusional 5-fluorouracil/ leucovorin): 180 mg/m² IV infusion over 30-90 minutes once on days 1, 15, and 29 IV (infuse over 30-90 min), followed by infusion with leucovorin and 5-fluorouracil; next cycle begins on day 43
Regimen 2 (6 week cycle with bolus 5-fluorouracil/ leucovorin): 125 mg/sq.meter on days 1, 8, 15, and 22 (infuse over 90 min), followed by bolus doses of leucovorin and 5-fluorouracil
Adjust dose per protocol
Hepatic impairment: Dose reduction may be necessary.
Child Dose
Not recommended
Contraindication
Patients with a known hypersensitivity to the drug or its excipients.
Mode of Action
Irinotecan, a derivative of camptothecin, works by inhibiting the enzyme topoisomerase I thereby interfering with the coiling and uncoiling of DNA during replication and causing irreparable damage.
Precaution
Early diarrhea is usually transient and infrequently severe. It may be accompanied by cholinergic symptoms of rhinitis, increased salivation, miosis, lacrimation, diaphoresis, flushing, and intestinal hyperperistalsis that can cause abdominal cramping. Bradycardia may also occur.
Late diarrhea can be life threatening since it may be prolonged and may lead to dehydration, electrolyte imbalance, or sepsis.Late diarrhea can be complicated by colitis, ulceration, bleeding, ileus, obstruction, and infection. Cases of megacolon and intestinal perforation have been reported.
Lactation: not known if excreted in breast milk, do not nurse
Side Effect
>10%
Anemia (>90%),Leukopenia (>90%),Neutropenia (>90%),Thrombocytopenia (>90%),Elevated bilirubin (88%),Diarrhea (85%),Nausea (79%),Asthenia (70%),Abdominal pain (63%),Vomiting (60%),Alopecia (43%),Fever (42%),Constipation (41%),Anorexia (34%),Mucositis (32%),Pain (31%),Dyspnea (28%),Cough (27%),Dizziness (23%),Infection (22%),Rash (19%)
1-10%
Abdominal fullness (10%),AST increased (10%),Dyspepsia (10%),,Edema (10%),Ascites/jaundice (9%),Vasodilation (9%),Thromboembolism (9%),Hypotension (6%),Neutropenic fever (2-6%)
Frequency Not Defined
Headache,Insomnia,Orthostatic hypotension
Potentially Fatal: Fatal sepsis due to myelosuppression; severe, chronic diarrhoea.
Interaction
Diuretics increase risks of dehydration secondary to vomiting/diarrhoea; prophylactic dexamethasone as an antiemetic may enhance lymphocytopenia; prochlorperazine may increase incidence of akathisia; antineoplastic agents (myelosuppression and diarrhoea). St John's wort, ketoconazole may reduce irinotecan exposure.