Iriten

Iriten is an alkaloid, a plant medicine with antitumor properties. Its active ingredient is irinotecan. Camptothecin is used as a base in the production of the substance.

The drug slows down the activity of the enzyme topoisomerase I (this is a monomeric protein that can affect DNA topology). Reviews from doctors specializing in this field show that the active element affects neoplasms that have high cellular resistance to modern treatment methods. [ 1 ]

Indications Iriten

It is used for the treatment of locally advanced or metastaticcolorectal carcinoma ( as a second-line treatment drug).

Release form

The drug is released in the form of a concentrate for the manufacture of infusion fluid, inside vials of 2, 5 or 15 ml; there are 5 or 10 such vials inside a box.

Pharmacodynamics

Iriten is an antitumor drug whose principle of action is associated with slowing the activity of the cellular enzyme topoisomerase I, a participant in DNA binding processes. The drug has an immunosuppressive effect and slows the action of acetylcholinesterase. [ 2 ]

Pharmacokinetics

After intravenous infusion, the drug is involved in metabolic processes with the formation of the active breakdown product SN-38. Metabolic processes mainly develop inside the liver. The average excretion rates of irinotecan in urine over a 24-hour period are 19.9%, and the breakdown product SN-38 is 0.25%. [ 3 ]

The pharmacokinetics of the drug does not depend on the dosage size.

Dosing and administration

The infusion should be administered within 30-90 minutes.

In case of malignant neoplasm in the area of the appendix and colon, monotherapy is used, 0.35 g of the substance over a period of 20 days.

When combined with 5-fluorouracil or calcium folinate, a dose of 80 mg/m2 should be administered weekly.

A regimen with a single administration of 0.18 g at 2-week intervals is allowed.

When additionally using bolus infusions with Ca folinate and 5-fluorouracil, 0.125 g/m2 should be used weekly.

Iriten should be used until diarrhea and vomiting attacks stop completely; in addition, the neutrophil count should not exceed 1500 cells. In case of severe hematopoiesis disorders, severe diarrhea, concomitant infections and abnormal levels of leukocytes with platelets, it is necessary to use reduced doses of the drug. It is also necessary to reduce the dosage of 5-fluorouracil to 15-20%.

• Application for children

Since there is no information on the safety of using the drug in pediatrics, it cannot be used for this age group.

Use Iriten during pregnancy

The medication should not be prescribed to pregnant or breastfeeding women.

Persons of childbearing age should use reliable contraception during therapy and for 3 months after its completion.

Contraindications

Main contraindications:

• chronic inflammatory intestinal pathologies;
• intestinal obstructions;
• an increase in blood bilirubin levels to a level exceeding the ULN by more than 1.5 times;
• severe myelodepression;
• history of severe intolerance to irinotecan.

Side effects Iriten

Side effects include:

• problems with hematopoietic function: thrombocyto- or neutropenia (curable), as well as anemia;
• Gastrointestinal disorders: nausea, diarrhea and vomiting. Constipation, abdominal pain or stomatitis may develop.
• dermatological symptoms: curable alopecia may occur;
• manifestations of allergy: epidermal rashes occasionally occur;
• others: convulsions, asthenia, dyspnea, paresthesia, involuntary muscle contractions and fever (provided there is no infection or severe neutropenia) may occur.
• The appearance of cholinergic syndrome in an active form is possible (hyperhidrosis, decreased blood pressure, vasodilation, chills, asthenia, early diarrhea, abdominal pain, visual disturbances, runny nose and conjunctivitis, as well as increased salivation or lacrimation).

Overdose

In case of poisoning with the drug, intestinal upset (diarrhea) and agranulocytosis with granulocytopenia may occur due to a decrease in blood neutrophil levels.

Symptomatic procedures are carried out (in hospital, since it is easier to monitor the patient's condition). If the dose of the medicine is exceeded twice, dangerous complications may develop, sometimes with a fatal outcome.

Interactions with other drugs

It is prohibited to mix the drug with other substances in the same bottle.

The drug slows down the activity of cholinesterase, which excites the activity of the nervous system, which is why when combined with suxamethonium, neuromuscular blockade can be prolonged. The opposite effect is observed in the case of combining the drug with muscle relaxants that have a non-depolarizing effect.

Storage conditions

Iriten should be stored in a place protected from sunlight, at a temperature of no more than 25°C.

Shelf life

Iriten can be used within a 2-year period from the date of manufacture of the pharmaceutical product.