Irinotecan measure

Possible Measures to Predict Patients at High Risk of Toxicity after Irinotecan... 

The main PK parameters for irinotecan are summarized in Table 14.5. The PK parameters for irinotecan at week 1 were similar to those at week 4, suggesting the absence of a PK interaction with cetuximab. For the metabolite SN-38 the measured concentrations were in good agreement with those cited in the literature [27] however, the number of samples with quantifiable concentrations was not sufficient to allow a meaningful analysis. 

Additive renal toxic effects may occur with immunosuppressants (e.g. azathioprine, ciclosporin, tacrolimus), ACE inhibitors, penicillamine, irinotecan and aminoglycoside antibiotics. A deterioration of renal function may even occur after the topical use of NSAIDs. Guidelines are variable for the use of NSAIDs with differing degrees of renal function, as assessed by creatinine clearance measurements. 

There is increasing evidence that the extent and severity of gastrointestinal toxicity correlates with concentrations of the active compound SN-38 in the plasma and bowel. The role of plasma pharmacokinetics in predicting the severity of irinotecan-induced diarrhea has been highlighted by the introduction of a biliary index, which is the product of the relative area ratio of SN-38 to SN-38 glucuronide and the total AUC. According to preUminary evidence, preventive measures should be considered when the biliary index exceeds 3.484 hours.micrograms/ ml (107,108). 

Shimizu M, Kukizaki M, NakashimaT, Alvarez-Nakase AM. 2002a. Leakage of inclosed irinotecan hydrochloride and remedial measures taken during production of the W/O type oral medicine. In Proceedings of the 38th Int. SPG Forum Membrane and Particle Science and Technology in Food and Medical Care , Industrial Technology Center, Miyazaki. 

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