Advanced CRC in combination w/ 5-fluorouracil & folinic acid in patients w/o prior chemotherapy or as single agent in patients who have failed an established 5-fluorouracil-containing treatment regimen. Small cell lung cancer in combination w/ cisplatin.
AdultMonotherapyPreviously untreated patient 350 mg/m2 as IV infusion over 30-90 min every 3 wk. Combination therapyPreviously untreated patient 180 mg/m2 as IV infusion over 30-90 min once every 2 wk, followed by infusion w/ folinic acid & 5-fluorouracil. In combination w/ cisplatin Initially 65 mg/m2 as IV infusion over 30-90 min & cisplatin 30 mg/m2 in repeated 6-wk cycles on days 1 & 8 every 21 days. Patient w/ bilirubin up to 1.5x ULN 350 mg/m2, 1.5-3x ULN 200 mg/m2.
Hypersensitivity. Temporarily discontinue if neutropenic fever occurs or ANC <1,000/mm3. Not to be used in patients w/ severe bone marrow failure. Patients w/ gastric cancer; extensive irradiation; poor ECOG performance status; cholinergic symptoms; late diarrhea; chronic inflammatory bowel disease &/or obstruction; nausea & vomiting; dizziness; preexisting lung disease; WHO performance status = 2. Patients who received previous pelvic/abdominal irradiation; baseline serum total bilirubin levels ≥1 mg/dL; reduced UGT1A1 activity. Monitor infusion site for signs of inflammation. Avoid extravasation & vaccination w/ live vaccine. Concomitant use w/ pneumotoxic drugs, radiation therapy, colony-stimulating factors. Not to be used in hereditary fructose intolerance. May affect ability to drive & use machines. Monitor liver function before initiation & mthly thereafter. Not recommended in renal impairment. Women of childbearing potential should avoid pregnancy. Not to be used during pregnancy & lactation. Elderly ≥65 yr.
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