Not to be used as IV bolus. Not to be initiated in patients w/ bowel obstruction. Patients w/ risk factors, w/ WHO performance status = 2; w/ need of immediate & prolonged antidiarrhoeal treatment combined w/ high fluid intake at onset of delayed diarrhoea. Administer prophylactic treatment w/ antiemetics prior to therapy. Homoyzygous (UGT1A1*6/*6 or UGT1A1*28/*28) or heterozygous (UGT1A1*6/*28) in allele UGT1A1*6, UGT1A1*28 of UGT. Increased risk of diarrhoea ie, previous abdominal/pelvic radiotherapy, w/ baseline hyperleucocytosis, performance status ≥2, concomitant neutropenia. Severe diarrhoea & haematological events. History of DM or evidence of glucose intolerance prior to therapy. Induced dehydration secondary to vomiting &/or diarrhea. Patients w/ asthma, experiencing acute & severe cholinergic syndrome. Risk factors associated w/ development of interstitial pulmonary disease eg, use of pneumotoxic drugs, radiation therapy & colony stimulating factors. Risk factors for cardiac disorders eg, underlying cardiac disease, previous cytotoxic chemotherapy, smoking, HTN, hyperlipidaemia. Perform liver function tests at baseline & before each cycle. Wkly monitoring of complete blood count. Patients w/ hyperbilirubinemia & prothrombin time >50%. Avoid extravasation & monitor infusion site for inflammation. May affect ability to drive & use machines. Concomitant use w/ strong CYP3A4 inhibitor (eg, ketoconazole) or inducer (eg, rifampicin, carbamazepine, phenobarb, phenytoin, St. John’s wort). Avoid vaccination w/ live vaccines. Diminished response to killed or inactivated vaccines. Hereditary fructose intolerance. Not to be used in patients w/ bilirubin >3 times ULN. Hepatic impairment. Not recommended in renal impairment. Take contraceptive measures during & at least 3 mth after therapy cessation. Avoid pregnancy in women of childbearing potential. Not to be used during lactation. Elderly.
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