Indications & Dose: COLORECTAL METASTATIC CARCINOMA Combination therapy/First-line therapy IV Adult 6wk (42 days) cycle: 125mg/m2 as inf over 90min with leucovorin (20mg/m2 administered as rapid IV inj immediately following irinotecan) & fluorouracil (500mg/m2 administered as rapid IV inj immediately following leucovorin) on days 1, 8, 15 & 22 followed by a 2wk rest, the next cycle is initiated on day 43 | Mono therapy IV Adult 6wk (42 days) cycle: 125mg/m2 as inf over 90min weekly for 4wk, followed by a 2wk rest period or 350mg/m2 over 90min q3wk as long as tolerable. Adjust dosage in increments based on tolerance and age

Precautions: Renal/hepatic impairment, pelvic/abdominal radiation recipients, elderly

ADR: Serious: Vasodilation, cholinergic toxicity, blood disorders, thromboembolic events, bilirubin, alkaline phosphatase increased, Others: neutropenic fever, alopecia, rash, dehydration, fever, dizziness, insomnia, headache, chills, diarrhea, abdominal pain, nausea, vomiting, anorexia, constipation, mucositis, weight loss, stomatitis, flatulence, weakness, somnolence, infect, dyspepsia, edema, confusion

DDI: Serious Ciclosporin decreases drug clearance, Sorafenib increases both levels, Phenobarbital/Carbamazepine/Phenytoin increases drug clearance, HIV protease inhibitors/Azoles increases drug levels

Monitor: CBC, platelet count, Hb, bilirubin, electrolytes, bowel movements & hydration status, infusion site for signs of inflammation