Irenotecan and Diarrhea Help

westie66
westie66 Member Posts: 642
Hi: I am on both Irenotecan and Oxaliplatin. Right now the irenotecan has kicked in with constant liquid diarrhea. I am taking as directed Imodium every 2 hrs during day and 2 pills every 4 hrs at night. I am eating "white" food like white bread, white bagels, bland fruit, Ensure. Any other hints? I seem to be getting quite weak with this. Thanks!
Cheryl
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Comments

  • smokeyjoe
    smokeyjoe Member Posts: 1,425
    Ask your doctor, but I've
    Ask your doctor, but I've had to take much more than two every couple of hours. Leena
  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    Cheryl:)
    Are they giving you ATROPINE as part of your pre-meds package? This really helps.

    And you can ask your onc about LOMOTIL by Rx. It works better than Immodium, cuts down the spasms, the peristalis I believe it's called.

    -Craig
  • thxmiker
    thxmiker Member Posts: 1,278
    Speak with your Doc
    Speak with your Doc about the correct use of imodium with Cancer Diarhea. I was taking significantly more imodium then you are describing. I liked lomotil better. It did not dry out my eyes and mouth as bad. (Drying of the mouth will also have a much higher risk of cavities.)

    The two other things I did to makes things less bad. Nothing is going to make this go away just less severe. Try a Low residue diet. Very easy to find on the internet and easy to follow. Try liquid probiotics. They can be from $11 a liter to $100 a liter. The more expensive ones were no better then the less expensive ones, if you read the labels. Not all are the same. Probiotics help restore the good flora. It made me less gassy and have less cramps.

    Baby wipes and good TP are a must.

    My thoughts and prayers are with you!
    Best Always, mike
  • idlehunters
    idlehunters Member Posts: 1,787
    thxmiker said:

    Speak with your Doc
    Speak with your Doc about the correct use of imodium with Cancer Diarhea. I was taking significantly more imodium then you are describing. I liked lomotil better. It did not dry out my eyes and mouth as bad. (Drying of the mouth will also have a much higher risk of cavities.)

    The two other things I did to makes things less bad. Nothing is going to make this go away just less severe. Try a Low residue diet. Very easy to find on the internet and easy to follow. Try liquid probiotics. They can be from $11 a liter to $100 a liter. The more expensive ones were no better then the less expensive ones, if you read the labels. Not all are the same. Probiotics help restore the good flora. It made me less gassy and have less cramps.

    Baby wipes and good TP are a must.

    My thoughts and prayers are with you!
    Best Always, mike

    Sandostatin
    Your Onc can give you a shot of this med and it will help A LOT in drying you up. Don't get dehydrated!!! This happens faster than you think. Take care.

    Jennie
  • plh4gail
    plh4gail Member Posts: 1,238
    Sorry for your discomforts.
    Sorry for your discomforts. I used white toast, white rice, bananas, and Benefiber ( hoping to bulk things up) when I had the diarrhea from chemo. Good luck and I hope it gets better soon. Oh....I also used Northern ultra and the disposible toilet wipes. No cutting corners on cost in this department!! lol

    Love, Gail
  • doura
    doura Member Posts: 5
    atropine
    hi
    my mom went through this so atropine was a magic just ask your doc about it & u have to have complete tests so as to keep hydrated u might need iv fluids
    hope u get better
    doura
  • thingy45
    thingy45 Member Posts: 632
    diarhea
    I had a bout with that and Imodium did not help, but LOMOTIL did, however I live in Canada do not know if it is available in USA.
    Hugs Marjan
  • westie66
    westie66 Member Posts: 642
    thingy45 said:

    diarhea
    I had a bout with that and Imodium did not help, but LOMOTIL did, however I live in Canada do not know if it is available in USA.
    Hugs Marjan

    Irenotecan and Diarrhea
    Hi: Thanks for all the fabulous advice. It is also so good to know one is not alone in this as the oncologist certainly doesn't talk about it (although the dietician does). I did get the injection just before the irenotecan and nausea pills but didn't get nausea thankfully. I live in Canada and will ask about Lomatil as Imodium didn't do much at all at least at the dosage I was given. I got the softest tissue possible and those wipe things - boy did that help! I have reverted to just plain jello (lots) and clear broth and that has slackened it but now to get the energy back without getting it all again. Luckily I got my dog to a safe place with friends for awhile. But I've leaned on my friends too much right at the beginning - I'm going to be better prepared next time (less than a week!). Lots to look forward to - neuropathy with the one (I'm giving L-glutamine a go) and diarrhea with the other (lots of options there).
    It was our long weekend here in Canada (Victoria day) - yours (many of you anyways) is next weekend right? Lots of firecrackers!
    Cheryl
  • plh4gail
    plh4gail Member Posts: 1,238
    westie66 said:

    Irenotecan and Diarrhea
    Hi: Thanks for all the fabulous advice. It is also so good to know one is not alone in this as the oncologist certainly doesn't talk about it (although the dietician does). I did get the injection just before the irenotecan and nausea pills but didn't get nausea thankfully. I live in Canada and will ask about Lomatil as Imodium didn't do much at all at least at the dosage I was given. I got the softest tissue possible and those wipe things - boy did that help! I have reverted to just plain jello (lots) and clear broth and that has slackened it but now to get the energy back without getting it all again. Luckily I got my dog to a safe place with friends for awhile. But I've leaned on my friends too much right at the beginning - I'm going to be better prepared next time (less than a week!). Lots to look forward to - neuropathy with the one (I'm giving L-glutamine a go) and diarrhea with the other (lots of options there).
    It was our long weekend here in Canada (Victoria day) - yours (many of you anyways) is next weekend right? Lots of firecrackers!
    Cheryl

    Cheryl
    For me with the Irinotecan, Immodium doesn't touch the problem. It takes Lomotil. I take 2 the first diarrhea then one each next time and stops after about 4. Good luck :) And bananas, white rice, and white toast while having the issue.

    Love and hugs, Gail
  • luvmum
    luvmum Member Posts: 457
    Hi Cheryl
    I know the frustration of diarrhea... saw my mum going to toilet 14 times a day! She also takes lomotil to stop it.

    I hope your diarrhea will be under control soon!
    Dora
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900
    hi cheryl
    sorry to hear about the diarrhea.

    I had a bag and was on folfox, and managing diarrhea while on chemo was a fulltime job.

    I went to 6 naturopaths and ended up finding a naturpath who survived colon cancer.

    I was put on a good probiotic, digestive enzymes and gut relief powder and a special anti diarreal mix.

    just get the best care and advice you have access to. I decided to look outside the medical system when I got desperate and I realised the harm the side effect drugs were having.

    I just added the gut relief product details, its got so many good things in it. ask your onc. the curcumin may enhance folfox effectiness, the l-glutamine may enhance minimising neuropathy. the rest definitely helped with my diarrhea, the goal being to repair your gut each fortnight. These maybe are based on limited studies and clinical practice but they serve as a basis for discussion with your onc.

    goodluck and if you end up trying this I would like to know the results as well as your onc opinion.

    hugs,

    Pete


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  • westie66
    westie66 Member Posts: 642
    luvmum said:

    Hi Cheryl
    I know the frustration of diarrhea... saw my mum going to toilet 14 times a day! She also takes lomotil to stop it.

    I hope your diarrhea will be under control soon!
    Dora

    The frustration of Diarrhea
    That's for sure. I'm going to ask the oncologist for lomotil next time. I'll start the BRAT (bananas, white rice, etc.) tomorrow. I just noticed the jello has asparatame in it. I'm missing my pup. Thanks all.
    Cheryl
  • geotina
    geotina Member Posts: 2,111
    Cheryl;
    I tried to send you a pm regarding this but your settings are set so you don't receive pm's. George was just in the hospital for the diarrhea, it was quite bad so be careful, it can get critical pretty fast. He did end up with 3 days of fluids, potassium and 2 units of blood. Things have really turned around and he is doing so much better.

    Anyway, make sure you incorporate the BRAT diet (bananas, rice, applesauce and toast) with your meals. It really binds things.

    Make sure the Immodium you take is Immodium AD. Generic is fine as long as it has the same ingridients as the name brand and the cost is significantly less, I get it at Costco or Walmart. I checked this with the onc and nurse and they both said generic is fine.

    Take care and hope things improve for you -

    Tina
  • menright
    menright Member Posts: 256
    Opium
    I once had serious diarrhea and Opium extract was prescribed and fix it. It is a closely controlled dtug and tastes nasty but it worked.

    Good luck,

    Mike
  • westie66
    westie66 Member Posts: 642
    menright said:

    Opium
    I once had serious diarrhea and Opium extract was prescribed and fix it. It is a closely controlled dtug and tastes nasty but it worked.

    Good luck,

    Mike

    Irenotecan and Diarrhea
    Hi and thanks : My nurse came over this morning and checked to make sure I'm not getting dehydrated (ended up in the hospital last year with same thing but with cisplatin - they reduced dosage and I was fine after that). So far, so good. I'm drinking gallons of gatorade and apple juice. I have now had all of the items on the BRAT (oh the rice was so so so delicious!) and so far not worse, but not better. The oncologist has prescribed lomotil (here in Canada it is viewed as a "special" prescription, kind of narcotic like so may not get it delivered until tomorrow) to see if that works better. HOpe so as treatment is coming up on Tuesday and I'd like one shot at a delicious meal before I do this all again! I get the Imodium (loparomi....) as a prescription to save money from the cancer centre.
    Did any one you have to have a dosage reduction with irenotecan because of the diarrhea or did they just manage it?
    Cheryl
  • westie66
    westie66 Member Posts: 642
    geotina said:

    Cheryl;
    I tried to send you a pm regarding this but your settings are set so you don't receive pm's. George was just in the hospital for the diarrhea, it was quite bad so be careful, it can get critical pretty fast. He did end up with 3 days of fluids, potassium and 2 units of blood. Things have really turned around and he is doing so much better.

    Anyway, make sure you incorporate the BRAT diet (bananas, rice, applesauce and toast) with your meals. It really binds things.

    Make sure the Immodium you take is Immodium AD. Generic is fine as long as it has the same ingridients as the name brand and the cost is significantly less, I get it at Costco or Walmart. I checked this with the onc and nurse and they both said generic is fine.

    Take care and hope things improve for you -

    Tina

    PM
    Hi: Now here is a dumb message - what is a "pm" - personal message? Maybe I can undo the setting.
    See my message at the end of this thread.
    Thanks!
    Cheryl
  • westie66
    westie66 Member Posts: 642
    westie66 said:

    PM
    Hi: Now here is a dumb message - what is a "pm" - personal message? Maybe I can undo the setting.
    See my message at the end of this thread.
    Thanks!
    Cheryl

    Personal Messages
    Hi Tina: I do have my email entered to receive personal messages. Not sure why it wouldn't let you. Technology!
    Cheryl
  • plh4gail
    plh4gail Member Posts: 1,238
    westie66 said:

    Irenotecan and Diarrhea
    Hi and thanks : My nurse came over this morning and checked to make sure I'm not getting dehydrated (ended up in the hospital last year with same thing but with cisplatin - they reduced dosage and I was fine after that). So far, so good. I'm drinking gallons of gatorade and apple juice. I have now had all of the items on the BRAT (oh the rice was so so so delicious!) and so far not worse, but not better. The oncologist has prescribed lomotil (here in Canada it is viewed as a "special" prescription, kind of narcotic like so may not get it delivered until tomorrow) to see if that works better. HOpe so as treatment is coming up on Tuesday and I'd like one shot at a delicious meal before I do this all again! I get the Imodium (loparomi....) as a prescription to save money from the cancer centre.
    Did any one you have to have a dosage reduction with irenotecan because of the diarrhea or did they just manage it?
    Cheryl

    Do they give you Atropine IV
    Do they give you Atropine IV as a pre med when you get your chemo? That helps a lot I think.

    Gail
  • Livingbyfaith
    Livingbyfaith Member Posts: 55
    CPT-11
    My husband ended up in the hospital twice from this drug, very bad diarreah and vomitting. They are switching him back to folfox which he tolerated better. Rough stuff, ask them if they can reduce dose or change chemo. Nothing helped my husband meds wise.
  • westie66
    westie66 Member Posts: 642

    CPT-11
    My husband ended up in the hospital twice from this drug, very bad diarreah and vomitting. They are switching him back to folfox which he tolerated better. Rough stuff, ask them if they can reduce dose or change chemo. Nothing helped my husband meds wise.

    Irenotecan and Diarrhea
    Hi Gail and Living by Faith: Luckily I didn't get the vomiting. I am on both Irenotecan and Oxaliplatin so folfoxfiri????. Anyways, many people on this discussion board recommended Lomotil rather than Imodium and halleluia that worked! The nurse was here yesterday, ordered it, pills came, took one, and that worked. Not that I want to take a pill this strong for very long but it worked. I complemented it with the BRAT diet and hopefully I'll know what to do next time - manage it before it happens, not after like I tried to do. I'll talk to the oncologist about changing the dose. I had to do that last year when I too ended up in the hospital for 10 days (with cisplatin).

    Gail - yes, they give you an injection just before they IV in the irenotecan. Obviously didn't work well with me! But if I start preparing the day before foodwise ...

    One question I have is about taking cal/mag for the neuropathy (I'm taking L-glutamine). They do give it with the chemo IV if you ask for it here. But doesn't that contribute to diarrhea? I was taking large doses before chemo started but have stopped for that reason. I have low bone density so should have the calcium as I don't drink milk.

    Thanks!

    Cheryl