Onivyde

— THERAPEUTIC CATEGORIES —
  • Pancreatic, thyroid, and other endocrine cancers

Onivyde Generic Name & Formulations

General Description

Irinotecan 43mg/10mL; liposomal dispersion for IV infusion after dilution.

Pharmacological Class

Topoisomerase inhibitor.

How Supplied

Single-dose vial—1

Generic Availability

NO

Onivyde Indications

Indications

In combination with fluorouracil and leucovorin, for treatment of metastatic adenocarcincoma of the pancreas after disease progression following gemcitabine-based therapy.

Limitations of Use

As a single agent, not for the treatment of metastatic adenocarcinoma of the pancreas.

Onivyde Dosage and Administration

Adult

Do not substitute for other irinotecan HCl-containing drugs. Give by IV infusion over 90 mins prior to fluorouracil and leucovorin. 70mg/m2 every 2 weeks. If homozygous UGT1A1*28 allele: initially 50mg/m2; may increase to 70mg/m2 as tolerated in subsequent cycles. If serum bilirubin >ULN: no dose recommended. Premedicate with corticosteroid and antiemetic 30 mins prior to infusion. Dose modifications: see full labeling.

Children

Not established.

Onivyde Contraindications

Not Applicable

Onivyde Boxed Warnings

Boxed Warning

Severe neutropenia. Severe diarrhea.

Onivyde Warnings/Precautions

Warnings/Precautions

Severe and life-threatening neutropenia, neutropenic sepsis, diarrhea can occur. Monitor CBCs on Days 1 and 8 of every cycle and more frequently if indicated; withhold if ANC <1500/mm3 or neutropenic fever occurs; reduce dose in subsequent cycles for Grade 3–4 neutropenia or neutropenic fever after recovery. Bowel obstruction: do not administer. Withhold for Grade 2–4 diarrhea; initiate loperamide if late onset or atropine IV/SC (unless contraindicated) if early onset; resume at reduced dose after recovery to Grade 1. Withhold if new or progressive dyspnea, cough, and fever occurs, pending evaluation; discontinue if interstitial lung disease confirmed. Permanently discontinue if severe hypersensitivity reaction occurs. Females of reproductive potential should use effective contraception during therapy and for 1 month after final dose; males should use condoms during and for 4 months after final dose. Pregnancy. Nursing mothers: not recommended (during therapy and for 1 month after final dose).

Onivyde Pharmacokinetics

See Literature

Onivyde Interactions

Interactions

Avoid concomitant strong CYP3A4 inducers (eg, rifampin, phenytoin, carbamazepine, rifabutin, rifapentine, phenobarbital, St. John’s wort) if possible; substitute non-enzyme inducing therapies at least 2 weeks before initiating irinotecan. Avoid concomitant strong CYP3A4 (eg, clarithromycin, indinavir, itraconazole, lopinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telaprevir, voriconazole) or UGT1A1 inhibitors (eg, atazanavir, gemfibrozil, indinavir) if possible; discontinue CYP3A inhibitors at least 1 week before initiating irinotecan.

Onivyde Adverse Reactions

Adverse Reactions

Diarrhea, fatigue/asthenia, vomiting, nausea, decreased appetite, stomatitis, pyrexia; neutropenic fever or sepsis, dehydration, septic shock, pneumonia, acute renal failure, thrombocytopenia.

Onivyde Clinical Trials

See Literature

Onivyde Note

Not Applicable

Onivyde Patient Counseling

See Literature

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