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Irinotecan

Irinotecan Side Effects

Julia Lee, PharmD, BCOPCydnee Ng, PharmD
Reviewed by Julia Lee, PharmD, BCOP, Cydnee Ng, PharmD
Last reviewed on October 8, 2025

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Low blood cell counts (up to 97%)
  • Late diarrhea (more than 24 hours after the - infusion, 85%)
  • Nausea (79%)
  • Feeling very weak (70%)
  • Stomach pain (63%)
  • Vomiting (60%)
  • Early diarrhea (within 24 hours of the infusion, 46%)
  • Hair loss (43%)
  • Fever (42%)
  • Constipation (41%)
  • Loss of appetite (34%)
  • Mouth sores, inflammation, or pain (32%)
  • General pain (31%)

Less Common Side Effects

  • Dizziness
  • Shortness of breath
  • Cough
  • Infection
  • Rash
  • Mouth sores
  • Sleepiness
  • Confusion
  • Low blood pressure

Note: Side effects and percentages were reported in people taking [[EDITOR|DRUG_DISPLAY_NAME]] with 5-fluorouracil and leucovorin.

Irinotecan serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Any diarrhea, but especially severe diarrhea: diarrhea that doesn’t go away, having 4 or more bowel movements than usual per day, dehydration (feeling dizzy or lightheaded)
  • Low blood cell counts: unusual bleeding or bruising, tiredness, fever, chills
  • Lung problems: having trouble catching your breath, fever, new cough, worsening cough, wheezing
  • Serious allergic reactions: swelling of the face, lips, or tongue; trouble breathing or swallowing; rash; itching
When do Irinotecan possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Diarrhea
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following Irinotecan side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Anxiety

black, tarry stools

blood in the urine or stools

blurred vision

changes in skin color

chest pain or discomfort

chest tightness or heaviness

chills

clay colored stools

cold hands and feet

confusion

constricted pupils

cough or hoarseness

dark urine

diarrhea with or without stomach cramps or sweating

dizziness

fainting

fast, slow, or irregular heartbeat

fever

full or bloated feeling or pressure in the stomach

headache

increased production of saliva

increased tear production

itching or skin rash

lightheadedness when getting up suddenly from a lying or sitting position

loss of appetite

low blood pressure or pulse

lower back or side pain

nausea or vomiting

numbness or tingling in the face, arms, or legs

pain

pain in the chest, groin, or legs, especially calves of the legs

pain in the shoulders, arms, jaw, or neck

painful or difficult urination

pale skin

pinpoint red spots on the skin

redness or swelling of the leg

runny nose

severe headache of sudden onset

slow breathing

slurred speech

sore throat

stomach pain

stopping of the heart

sudden and severe weakness in the arm or leg on one side of the body

sudden loss of coordination

sudden vision changes

sweating

swelling

swelling of the abdomen or stomach area

temporary blindness

tenderness, pain, or swelling of the arm, foot, or leg

troubled breathing

trouble with speaking or walking

ulcers, sores, or white spots on the lips or in the mouth

unconsciousness

unpleasant breath odor

unusual bleeding or bruising

unusual tiredness or weakness

vomiting of blood

warm, red feeling over the body

yellow eyes or skin

Less common

Bleeding gums

coughing up blood

decreased urination

difficulty with swallowing

dryness of the mouth

increased menstrual flow or vaginal bleeding

increased thirst

nosebleeds

paralysis

prolonged bleeding from cuts

sneezing

wrinkled skin

Rare

Decreased amount of urine

decreased frequency of urination

fast, irregular, or troubled breathing

hives

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

rapid weight gain

Incidence not known

Abdominal or stomach pain and tenderness

agitation

bloated or full feeling

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

coma

constipation

depression

heartburn or indigestion

hostility

irritability

lethargy

muscle pain and cramps

muscle twitching

pain in the stomach, side, or abdomen, possibly radiating to the back

pain or discomfort in the arms, jaw, back, or neck

rectal bleeding

severe abdominal or stomach cramping or burning

severe and continuing nausea

stupor

swelling of the face, lower legs, ankles, fingers, or hands

tightness in the chest

unusual tiredness or weakness

vomiting of material that looks like coffee grounds

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Acid or sour stomach

belching

blistering, peeling, redness, or swelling of the palms of hands or bottoms of the feet

cracked lips

excess air or gas in the stomach or intestines

feeling of constant movement of self or surroundings

numbness, pain, tingling, or unusual sensations in the palms of the hands or bottoms of feet

passing gas

right upper abdominal or stomach pain and fullness

sensation of spinning

sleepiness or unusual drowsiness

stomach discomfort, upset, or pain

trouble sleeping

weight loss

Incidence not known

Hiccups

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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