Chemotherapy: FOLFIRI

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.

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