Health

Medications

Medications

Here is a list of some of the medications Sean is on during his chemo:

Irinotecan:
(eye-rye-no-TEE-can)

Trade names: Camptosar®

Other names: Camptothecin-11, CPT-11

Chemocare.com uses generic names in all descriptions of drugs. Camptosar is the trade name for irinotecan. Camptothecin-11 and CPT-11 are other names for irinotecan. In some cases, health care professionals may use the trade name camptosar or other names camptothecin-11 or CPT-11 when referring to the generic drug name irinotecan.

Drug type: Irinotecan is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug. This medication is classified as a “plant alkaloid” and “topoisomerase I inhibitor.” (For more detail, see “How this drug works” section below).

What this drug is used for:

Metastatic colon or rectal cancer

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How this drug is given:

This medication is given by infusion through a vein (intravenously, IV).
There is no pill form of this medication.
Irinotecan is an irritant. An irritant is a chemical that can cause inflammation of the vein through which it is given. If the medication escapes from the vein it can cause tissue damage. The nurse or doctor who gives this medication must be carefully trained. If you experience pain or notice redness or swelling at the IV site while you are receiving irinotecan, alert your health care professional immediately.
The amount of irinotecan that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side effects:
Important things to remember about the side effects of irinotecan:

Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
The side effects of irinotecan and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in greater than 30%) for patients taking irinotecan:

Diarrhea; two types early and late forms.
Early diarrhea: Occurring within 24 hours of receiving drug, accompanied by symptoms runny nose, increased salivation, watery eyes, sweating, flushing, abdominal cramping. (This can occur while the drug is being administered. If so, alert your healthcare professional promptly. Medication can be given to stop and/or lessen this early side effect).
Late diarrhea: Occurring greater than 24 hours of receiving drug, usually peaks at about 11 days after treatment. Because of concerns of dehydration and electrolyte imbalances with diarrhea it is important to be in contact with health care professionals for monitoring, and for medication and diet modifications advice.
Nausea and vomiting.
Weakness.
Low white blood cell count. (This can put you at increased risk for infection).
Low red blood cell count (anemia).

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 10 days
Nadir: 14-16 days
Recovery: 21-28 days

Hair loss
Poor appetite
Fever
Weight loss

These side effects are less common side effects (occurring in about 10-29%) of patients receiving irinotecan:

Constipation
Shortness of breath
Insomnia (see sleep problems)
Cough
Headache
Dehydration
Chills (see flu-like symptoms)
Skin rash (see skin reaction)
Flatulence (see abdominal pain)
Flushing of face during infusion
Mouth sores
Heartburn
Swelling of feet and ankles

Bevacizumab:

Trade Name: Avastin ®

Drug Type:

Bevacizumab is classified as a “monoclonal antibody” and “anti-angiogenesis” drug. (For more detail, see “How Bevacizumab Works” section below.)

What Bevacizumab Is Used For:

Treatment of metastatic colon or rectal cancer, used as part of a combination chemotherapy regimen.
Treatment for non-squamous, non-small cell lung cancer.
Treatment of metastatic breast cancer, used as part of a combination chemotherapy regimen.
Treatment of glioblastoma (GBM).
Treatment of metastatic renal cell carcinoma.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Bevacizumab Is Given:

Bevacizumab is given through an infusion into a vein (intravenous, IV). The first dose is given over 90 minutes. The infusion time can eventually be shortened to 30 minutes if well-tolerated.
The amount of Bevacizumab that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side Effects of Bevacizumab:

Important things to remember about the side effects of Bevacizumab:

Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
There is no data as to the frequency of adverse reactions that may be attributed to Bevacizumab alone. (In clinical studies Bevacizumab was used in combination with other chemotherapy medications).

The following side effects are common (occurring in greater than 30%) for patients taking Bevacizumab:

Generalized weakness
Pain
Abdominal pain
Nausea and vomiting
Poor appetite
Constipation
Upper respiratory infection
Low white blood cell count. This can put you at increased risk for infection.
Proteinuria
Nose bleed
Diarrhea
Hair loss
Mouth sores
Headache

These side effects are less common side effects (occurring in about 10-29%) of patients receiving Bevacizumab:

Shortness of breath
Dizziness
High blood pressure
Weight loss
Muscle aches and pains

These are rare but serious complications of Bevacizumab therapy:

Gastrointestinal perforation/ fistula formation/ wound healing complications
Hemorrhage (severe bleeding)
Hypertensive crisis (severe high blood pressure)
Nephrotic Syndrome – a condition marked by very high levels of protein in the urine (proteinuria), low levels of protein in the blood, swelling, especially around the eyes, feet and hands. This syndrome is caused by damage to the glomeruli (tiny blood vessels in the kidney that filter waste and excess water from the blood and send them to the bladder as urine).
Congestive heart failure in patients who have received prior treatment with anthracycline based chemotherapy, or radiation therapy to the chest wall.

Delayed effects:

Based on animal studies, Bevacizumab may disrupt normal menstrual cycles and impair fertility by several effects. Some parameters do not recover completely, or recover very slowly following discontinuation of the drug.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When To Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
Severe bleeding
Shortness of breath, difficulty breathing

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

Swelling of the feet or ankles. Sudden weight gain.
Abdominal pain
Nausea (interferes with ability to eat and unrelieved with prescribed medication).
Vomiting (vomiting more than 4-5 times in a 24 hour period).
Diarrhea (4-6 episodes in a 24-hour period).
Constipation unrelieved by laxative use.
Coughing up blood.
Black or tarry stools, or blood in your stools.
Blood in the urine.
Mouth sores (painful redness, swelling or ulcers).
Swelling, redness and/or pain in one leg or arm and not the other.
Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decreased amount of urine, or dizziness.

Leucovorin:

Other Names: Calcium Leucovorin, Citrovorum Factor, Folinic Acid

Drug Type:

Leucovorin is a reduced folic acid. Leucovorin is used in combination with other chemotherapy drugs to either enhance effectiveness, or as a “chemoprotectant.” (For more detail, see “How Leucovorin Works” section below).

What Leucovorin Is Used For:

In combination with fluoruracil to treat cancers such as; colon and rectal, head and neck, esophageal, and other cancers of the gastrointestinal tract.
As an antidote to effects of certain chemotherapy drugs such as methotrexate.
Treatment of megaloblastic anemia when folic acid deficiency is present.

Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Leucovorin Is Given:

As an injection or short infusion through the vein (intravenous, IV).
As a tablet by mouth.
As an injection into the muscle (intramuscular, IM).
The amount of Leucovorin that you will receive and how it will be given depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose, route and schedule.

Leucovorin Side Effects:

Important things to remember about the side effects of Leucovorin:

The side effects with treatment of Leucovorin are likely attributable to other chemotherapy medications being given in combination with Leucovorin.
When given in combination with fluorouracil (5-FU) the side effects of fluorouracil may be more severe. (see fluorocuracil).
When given in combination with methotrexate, Leucovorin is given to lessen the side effects of methotrexate. (see methotrexate)

The following are possible side effects of Leucovorin:

Allergic reaction: rash, itching, facial flushing. Rarely severe.
Nausea and vomiting (rare)




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