FOLFIRI is the name given to a combination of chemotherapy drugs used with respect to colorectal cancer that has spread beyond the colorectum (metasticized).
The drugs which make up FOLFIRI are:
- 5-fluorouracil (5FU), (five-flure-oh-YOOR-a-sill)
- leucovorin (loo-koe-VOR-in)
- irinotecan (eye-ri-noe-TEE-kan) or Camptosar® (CAMP-toe-zar)
Diarrhea that starts after completion of a treatment (late onset diarrhea) is common with FOLFIRI (though, like all side effects of chemotherapy, it is not predictable whether any particular person will experience it).
NOTE: As a practical matter, if you experience chemotherapy related diarrhea, it is usually advisable to start with an over-the-counter medication such as Immodium rather than a stronger medication. Stronger medications can lead to constipation, which then has to be treated. This can become a back and forth seesaw making you very uncomfortable in the process. (For information about dealing with constipation, click here.)
To make life easier, patient advocates suggest that patients carry Immodium or another over-the-counter anti-diarrheal medication "just in case." The odds are that if diarrhea happens, you won't be able to immediately get to a pharmacy or other store to get anti-diarrheal medication. The sooner you start treating diarrhea, the sooner you are likely to get it under control. Uncontrolled diarrhea can leads to unnecessary complications - and feeling poorly to boot.
When taking Immodium, follow the instructions on the container. However, if the diarrhea is more like a watery liquid (not just loose bowels), experienced patient advocates have found that Immodium can be more effective if taken every two hours for 12 hours straight. It doesn't matter if the condition continues - one episode of watery diarrhea is enough to trigger the suggestion. DO NOT take this suggestion without checking with your health care team first.
Side Effects Of FOLFIRI
Common side effects of FOLFIRI include the following. As you read the list, keep in mind that there is no way to predict what side effects will show up for any individual, and with what severity. For suggestions for dealing with one of these side effects if they appear, click on the side effect.
The most common side effects (from the Camtosar) are hair loss and diarrhea.
- Hair loss: For information about preparing before hair falls out, and tips for coping during hair loss, click here.
- Diarrhea: There are two types of diarrhea that can be experienced while taking FOLFIRI treatment.
- Early onset diarrhea can literally happen while the medication is being infused. This type of diarrhea is generally controllable, giving plenty of time to get to the bathroom from the time a person starts to feel it coming on. Do not expect to soil yourself due to this type of diarrhea. There is no reason to try to control this type of diarrhea.
- Late onset diarrhea generally starts somewhere between day 1 and 4 after the infusion. This type of diarrhea should be treated with both medication and diet. Untreated diarrhea can lead to dehydration which not only makes you feel lousy, but can lead to complications such as kidney failure. To learn more about diarrhea, including how to control it, click here. (If diarrhea is watery, particularly notice the section about medications used to control diarrhea).
- Appetite loss
- Hand/foot syndrome (swelling or redness, tingling or dry, cracked skin in the hands or feet)
- Mouth sores
- Nausea/Vomiting
- Neuropathy in the hands or feet
- Risk of infection
