Article: Irinotecan

Irinotecan
Systematic (IUPAC) name
(S)-4,11-diethyl-3,4,12,14-tetrahydro-4-hydroxy- 3,14-dioxo1H-pyrano[3’,4’:6,7]-indolizino[1,2-b]quinolin- 9-yl-[1,4’bipiperidine]-1’-carboxylate
Identifiers
CAS number	100286-90-6
ATC code	L01XX19
PubChem	3750
DrugBank	APRD00579
Chemical data
Formula	C33H38N4O6
Mol. weight	586.678 g/mol 677.185 g/mol (hydrochloride)
Pharmacokinetic data
Bioavailability	NA
Metabolism	Hepatic glucuronidation
Half life	6 to 12 hours
Excretion	Biliary and renal
Therapeutic considerations
Pregnancy cat.	D (Au, U.S.)
Legal status	POM (UK), ℞-only (U.S.)
Routes	Intravenous

Irinotecan is a chemotherapy agent that is a topoisomerase 1 inhibitor.

Its main use is in colon cancer, particularly in combination with other chemotherapy agents. This includes the regimen FOLFIRI which consists of infusional 5-fluorouracil, leucovorin, and irinotecan.

Irinotecan is marketed by Pfizer as Camptosar®. It is also known as CPT-11.

Mechanism

Irinotecan is activated by hydrolysis to SN-38, an inhibitor of topoisomerase I. This is then inactivated by glucuronidation by uridine diphosphate glucoronosyltransferase 1A1 (UGT1A1).

Side effects

Irinotecan is associated with severe diarrhea, sometimes leading to hospitalization for dehydration. This side effect is managed with the aggressive use of antidiarrheals such as loperamide or Lomotil with the first loose bowel movement.

See also

• Camptothecin
• Topotecan (Hycamtin®)