Irinotecan side effect of diarrhea

[Patience]

Quick question: What recommendations do you have for the diarrhea that can occur after irinotecan?
Thanks.

[Rheaeliza]

Immodium, which works for some pretty well, but for me it didn't work well and I got prescribed lomotil which works much better for me. Also make sure the day of infusion they are giving you atropine injections.

[cptmac]

I had two shots of Atropine before my chemo. Regular bm's for me after that.

[gep]

my husband liked the chewable immodium with multi symptom relief. The multi symptom relief (gas, etc.) was a biggie for him.
Gloria

[Guinevere]

Lomotil worked best for me on those rare times I had the big D. It's the pill form of atropine.

[secriswell]

Questran can help as well. It's a cholesteroll-lowering powder you mix with water (or in my wife's case Gatorade), but it has an effect on bile salts that help with diarrhea. On bad days, we're finding two to four immodium, followed by a lomotil, and a Questran chaser seems to do the trick.
I did read recently that for chemo-induced diarrhea, the maximum dosage on the box of immodium usually isn't enough. And the article recommended continuing with immodium every four hours for 12 hour after the diarrhea stops. But ask your onc about maximum dosage.

[jeanette57]

wish I could find something that works. 3 months of GI blues. No relief yet,

[Kathryn in MN]

I have been on Irinotecan for 2 years now. (with some breaks) I used to get hit hard with the early onset diarrhea, but Atropine prior to infusion stopped that at infusion time. The antiemetics stop me up for the first couple days, then it hits. And the second week I get the late onset diarrhea, which is harder to stop.

In the beginning I didn't follow the oncology directions for Imodium, and it didn't work for me. If you get the bad diarrhea, you have to follow those - NOT the instructions on the box. For chemo-induced diarrhea you can take a LOT more Imodium than the package says. At the very first episode, take 2 pills. Then take one pill every 2 hours. You are even supposed to set the alarm to get up once in the middle of the night to take 2 pills (sleep 4 hours, then take 2). Once the diarrhea stops, keep taking them for 24 hours, and then stop. I found that I also had to take one before each meal for the next day or two.

Also, try the B.R.A.T. (banana, rice, applesauce & toast) diet. Remember to stick to WHITE for the rice and toast. You can also add peanutbutter (creamy - no nuts) and marshmallows to that list. When trying to transition to other foods, make sure to peel and de-seed all fruits and vegetables, and avoid whole grains and fried food.

A while ago Imodium stopped working completely for me. I switched to Lomotil and it worked for a bit. But this last cycle it didn't work either - nothing stopped it. I tried not eating all day long to give my system a rest, and then tried very mild, diarrhea safe foods - no luck. I was up in the bathroom all night long for several days and wearing out. I was worried I'd end up in the hospital if it didn't stop, and didn't know how I'd get chemo again on Monday if it didn't stop. I got tincture of opium and just ONE dose stopped it! That was Wednesday afternoon. Unfortunately I couldn't go yesterday at all, or today... But I finally went a little tonight.

For anyone not having any luck with Imodium or Lomotil, even with dietary changes, ask for tincture of Opium

[jeanette57]

'''for tincture of Opium'' what is it?" prescription or not.
I just found out that Walgreens will check all my medications against my chemo drugs and give me the side effect for free. Seems 3 of my non-chemo drugs interact with diarrhea, so no wonder they didn't work. I have to take the information to doc. scary to read. The only great thing about the diarrhea is that I have bag, so no painful butt like in the past. My stoma isn't to happy but still it does not hurt like the old way.

maybe the sleep time tea is working, feel tired now or was it the sandwich at 4 am, yum

[secriswell]

Kathryn,
What you describe about immodium dosage is what I read online. Wish I could find the page again. Thanks for the two hour dosage directions.
On that same site I remember reading something about glutamine helping with chemo-induced diarrhea. Anyone tried it?
My wife is getting hit pretty hard with the irinotecan diarrhea, but it seems to be directly related to her increased appetite and her eating more--which is a blessing. I'm not sure if I can convince her to go on the BRAT diet now that she has gotten a taste for almond milk ice cream sandwiches.
S.

[jeanette57]

Anyone have any clue what electrolytes one should take when having such diarrhea? I am trying to drink smart water, eat bananas and jars of beets and artichokes (magnesium) but still feel washed out from months of extreme diarrhea.

[Patience]

Thanks for the tips, my husband has some Questran (Cholestyramine) on hand so I'll keep that in mind. And Imodium.

jeanette57, hopefully someone will chime in with an answer to your question.