Irinotecan

Topoisomerase inhibitor

MECHANISM OF ACTION

Binds to DNA topoisomerase preventing re-ligation of cleaved DNA

MECHANISM OF KIDNEY INJURY

CLINICAL KIDNEY SYNDROME

myelosuppresion and diarrhea (acute and chronic)

CARDIOVASCULAR ADVERSE EFFECTS

LYTE ABNORMALITIES

RISK FACTORS

MITIGATION STRATEGIES

SUGGESTIONS

Consider irinotecan 50 mg/m2 weekly after HD or on non-HD days or avoid use3

NOTES/COMMENTS

eGFR < 30 ml/min, consider 25% reduction ADDIKD

PHARMACOKINETICS

Molecular Weight

586

Volume of Distribution

Plasma Protein Binding

99%

Metabolism

Bioavailability

Half-life elimination

6-12 hours

Time to peak

Excretion

Urine, 11-20%

Dialyzable?

Consider irinotecan 50 mg/m2 weekly after HD or on non-HD days or avoid use

REF:

ADDIKD
Uptodate

PATHOLOGY SLIDES:

ENTRY UPDATES:

Raad Chowdhury

United States

Sep 25, 2022

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