Combination therapy Regimen 1: 125 mg/m2 as IV infusion for 90 min on days 1, 8, 15 & 22 followed by leucovorin 20 mg/m2 as IV bolus on same days. Administer 5-FU 500 mg/m2 immediately after leucovorin. Thereafter, the additional courses are repeated after every 6 wk (4 wk on therapy, 2 wk off therapy). Regimen 2: 180 mg/m2 as IV infusion over 90 min on days 1, 15, 29 followed by leucovorin 200 mg/m2 over 2 hr on days 1, 2, 15, 16, 29 & 30. Administer 5-FU 400 mg/m2 IV bolus immediately after administration of leucovorin, followed by infusional 5-FU 600 mg/m2 over 22 hr on days 1, 2, 15, 16, 29 & 30. Begin next course on day 43.
Can induce both early & late forms of diarrhoea; interrupt administration & reduce subsequent doses if severe diarrhoea occurs. Severe myelosuppression may occur; greater risk of myelosuppression in patients w/ abnormal glucuronidation of bilirubin (eg, those w/ Gilbert's syndrome) when receiving therapy. Avoid extravasation & monitor the infusion site for signs of inflammation. Premed w/ antiemetics starting at least 30 min before administration. Consider prophylactic & therapeutic administration of 0.25-1 mg of IV or SC atropine (unless clinically contraindicated) in patients experiencing rhinitis, increased salivation, miosis, lacrimation, diaphoresis, flushing, abdominal cramping, or diarrhoea (occurring during or shortly after infusion); symptoms may occur more frequently w/ higher doses. Patients who had previously received pelvic/abdominal irradiation. Careful monitoring of WBC w/ differential, Hb, & platelet count is recommended before each dose. Significant hepatic dysfunction. Avoid pregnancy in women of childbearing potential. Pregnancy & lactation. Childn. Elderly >65 yr.
Exacerbated adverse effects eg, myelosuppression & diarrhoea w/ other antineoplastic agents having similar adverse effects. May enhance lymphocytopenia & hyperglycemia (patients w/ history of DM or evidence of glucose intolerance) w/ dexamethasone. Not recommended w/ concurrent administration w/ irradiation.
Sign Out
