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treatment guide

All About Your Chemotherapy With Camptosar®
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What Camptosar may do for you

Camptosar is a chemotherapy drug used to treat cancers of the colon and rectum that have spread to other areas of the body. It is used when another chemotherapy drug, called fluorouracil, doesn't work or has stopped working. Camptosar has been shown to help some people with cancers of the colon and rectum live longer and feel better. If you are losing weight because of your cancer, Camptosar may slow down your weight loss. In addition, it may give you more time without cancer pain.

How the doctor will know if treatment is working

Your doctor may want to perform some tests to check the size of the tumor from time to time to see how well the treatment is working. If the tumor is the same size (has not grown after several months) or has become smaller, then the treatment is working. Some tests your doctor may perform are blood tests, X-rays, or other radiology scans such as a CT scan or an MRI.

Length of treatment

The length of your treatment depends on how your cancer responds to the chemotherapy. For example, if your tumor stays the same size or becomes smaller after each treatment cycle, you and your doctor may decide you should continue your treatments for as long as it is working. On the other hand, if your tumor does not respond to the treatment or becomes larger, you and your doctor may decide to stop your treatments.

Your First Treatment With Camptosar
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qoute I thought the first treatment cycle was hard because I didn't know what to expect. But, once I learned how to deal with the side effects, the second cycle was easier.

Overall, I just want other people to know that they can control the side effects if they know what to look for and act quickly.qoute


Joan, a 52-year old realtor recalling her
first treatment with Camptosar

You will receive Camptosar in treatment cycles. A "treatment cycle" refers to one or more doses given over several weeks. You and your doctor will discuss which treatment cycle is best for you.

How Camptosar is given

Camptosar is an IV (intravenous) chemotherapy drug. That means it is given through your vein. Each treatment with Camptosar takes about 90 minutes, but your total treatment time may take longer if you are getting additional medicines. For example, you may get other medicines to prevent nausea and vomiting before you get your chemotherapy.

What to expect DURING each treatment

You may feel one or more of these symptoms during treatment or within a few hours afterwards:

You may also start to feel queasy or vomit during the treatment.

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If you have any of the above symptoms, tell your doctor or nurse right away.

Your doctor can give you medicine to relieve or prevent these symptoms.

What to Expect After Each Treatment
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As with many cancer treatments, you may experience side effects with Camptosar - some of these can become serious. However, you can often control side effects, and feel better, by taking immediate action if and when they occur. The following side effects may appear at any time (even days or weeks) after each of your treatments with Camptosar:

Diarrhea

Diarrhea is the most common side effect. To keep it under control, be alert and act quickly. If you do not treat diarrhea right away, it can become serious.

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If you have diarrhea (more bowel movements than usual or stools that are more loose, soft or watery), start taking Imodium A-D* (loperamide HCl) right away. See The Four-Step Plan to Treat Diarrhea.

* Imodium A-D is a registered trademark of Janssen/McNeil Consumer Products. All rights reserved.

Nausea and vomiting

Your doctor can give you a medicine to help relieve any nausea and vomiting you may have. Ask about taking medicine before your next treatment to prevent nausea and vomiting.

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Call your doctor's office if nausea and vomiting lasts more than 12 hours, or still occurs even though you are already taking medicine to control it.

Low white blood cell count

White blood cells help your body fight off infection. If your doctor or nurse tells you your white blood cell count is LOW:

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If you think you may have an infection, call your doctor's office right away.

Hair loss

Hair loss varies among people who receive Camptosar. You may lose some, none, or all of your hair. The amount of hair lost does not have anything to do with how ill you are or how well your treatment is working.

Even though your hair will eventually grow back, losing hair can be an emotional experience. It's common to feel angry, sad or afraid. Writing or talking about your feelings may make it easier to cope. Also, your nurse can share useful ideas and tips from others who have dealt with hair loss.

Controlling Diarrhea Before It Controls You
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Diarrhea may occur at any time after each of your treatments with Camptosar, including several days or weeks later. Although diarrhea is the most common side effect of Camptosar, it can often be controlled if you recognize it early and treat it right away.

Recognizing diarrhea early

While on therapy with Camptosar, "diarrhea" is defined as any one of the following changes:

You may already have soft or loose stools because of your condition, so it may seem like it will be hard to know if Camptosar is causing diarrhea. The only way to really recognize diarrhea early is to compare your bowel habits each day with your usual bowel habits just before you started Camptosar.

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Complete Step 1 in The Four-Step Plan to Treat Diarrhea before you have your first treatment. Throughout your treatment, use this description to track any changes in your bowel habits.

Treating diarrhea right away

If you develop diarrhea, you must start taking Imodium A-D right away. If you delay taking Imodium A-D, your diarrhea may become severe. Severe diarrhea can lead to dehydration and may require you to be hospitalized.

Imodium A-D is also called loperamide. It comes in 2 mg caplets. You can either buy loperamide yourself as an over-the-counter medicine, or your doctor can give you a prescription for it. Imodium A-D is only used to stop diarrhea - NOT to prevent it.

Important information about Imodium A-D

Only follow the special dosage directions for Imodium A-D as explained to you by your doctor or nurse. You may also receive a special label with these dosage instructions.

These special directions recommend a higher dosage of Imodium A-D than the original dosage printed on the Imodium A-D package. Do not use the original directions. Studies have shown that people receiving treatment with Camptosar need to take higher doses of Imodium A-D to keep their diarrhea under control.

The Four-Step Plan to Treat Diarrhea
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Follow this plan to stop diarrhea before it gets serious.

Make sure you have Imodium A-D at home before your first chemotherapy treatment. Imodium A-D is also called loperamide and comes in 2 mg caplets. If you are not sure what to buy, ask your doctor, nurse or pharmacist.

Step 1.

Before you have your first chemotherapy treatment, describe your usual bowel habits as they are now:

describe habits

I usually have ________ bowel movements every day or________ every week.

My stools usually appear:

boxHard

boxFormed

boxSoft


boxLoose

boxWatery



Step 2.

Start taking Imodium A-D at the first sign of diarrhea (diarrhea is any change in your usual bowel movements including an increase in the number of stools, OR stools that are more loose, soft or watery). Do not delay taking your first dose of Imodium A-D.

take Immodium

Step 3.

Follow these Imodium A-D dosing directions exactly.
Do not skip doses. Do not delay doses.

First Dose:

During the Day:

During the Night:

first sun moon

Take 2 caplets (4 mg) of Imodium A-D.

Take 1 caplet (2 mg) every 2 hours.

Take 2 caplets (4 mg) at bedtime and 2 caplets every 4 hours until morning. You must set your alarm clock to wake up during the night to take your Imodium A-D.

Step 4.

Stop taking Imodium A-D when you have not had any bowel movements for 12 hours.

stop

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Call your doctor or nurse right away if:

  • You have taken Imodium A-D for 24 hours and still have diarrhea.
  • You also have a fever or are vomiting.
  • You have questions or concerns.


Other Important Tips to Control Diarrhea
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fluids Replenish your body fluids

Diarrhea causes your body to lose fluids and can lead to dehydration.

DO:

Drink 6 to 8 glasses of clear, mild liquids every day to replenish the fluids you are losing. These may include water, clear broths, sodas such as ginger ale and seltzer, apple juice, herbal tea, and Gatorade®.

DON'T:

Do not drink milk or beverages that contain alcohol or caffeine (coffee, tea, colas). Do not drink prune juice. These liquids can make your diarrhea worse.

Stay away from medicines that can make diarrhea worse

Make sure you talk to your doctor about all the medicines you take - including over-the-counter medicines - so you will know which to avoid.

DON'T:

Do not use laxatives such as Phillips'® Milk of Magnesia, Dulcolax®, Metamucil®, or
Peri-Colace®, or medicines that contain magnesium such as Maalox®, Mylanta®, or Ascriptin® A/D. They can make your diarrhea worse.

Phillips' Milk of Magnesia is a registered trademark of Bayer Corporation; Ascriptin A/D and Maalox are registered trademarks of Rhone-Poulenc Rorer; Dulcolax is a registered trademark of CIBA Consumer; Mylanta is a registered trademark of Johnson & Johnson Merck; Metamucil is a registered trademark of Procter and Gamble; Peri-Colace is a registered trademark of Mead Johnson; Gatorade is a registered trademark of the Gatorade Company.

 

foods

Eat foods that will help reduce diarrhea

Choosing bland foods to eat can help reduce diarrhea.

DO:

Eat bland foods such as:
boxplain rice, noodles, white bread, and cereals
boxchicken, turkey, beef, fish, cottage cheese, yogurt, and smooth peanut butter
boxripe bananas, pureed vegetables, and canned or cooked fruits such as applesauce

DON'T:

Do not eat these foods. They can make diarrhea worse:
boxhigh-fiber cereals containing bran
boxcooked, gas-forming vegetables such as broccoli, cauliflower, cabbage, and beans
boxnuts, raw fruits, and raw vegetables
box greasy, fatty or fried foods
box spicy foods (curry, hot pepper)
boxchocolate or foods with chocolate (cake, brownies)

When to Call the Doctor's Office
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Call your doctor or nurse if:

boxYou have taken Imodium A-D for 24 hours and still have diarrhea.
boxYou have a fever (temperature over 100.4°F) or chills.
boxYour vomiting lasts more than 12 hours or still occurs even though you are taking medicine to control it.
boxYou have symptoms of dehydration such as feeling faint, light-headed or dizzy.
boxYou have questions for your doctor or nurse.
boxOther reasons:

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Resources for More Information
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American Cancer Society
1-800-ACS-2354 (1-800-227-2345)
www.cancer.org

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Cancer Care
1-800-813-HOPE (1-800-813-4673) www.cancercareinc.org

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Cancer News
www.cancernews.com/colon.html

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Cancer News
www.cancernews.com/colon.html

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Medicine OnLine: Colon Cancer Information Center
www.meds.com/colon/colon.html

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National Cancer Institute (NCI), CancerNet
1-800-4-CANCER (1-800-4-CANCER (1-800-422-6237)
cancernet.nci.nih.gov/

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National Caoaltion for Cancer Survivorship
1-888-YES NCCS (1-888-937-6227
www.cansearch.com

Camptosar can cause Diarrhea. If you develop diarrhea, follow these directions.
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Start taking Immodium A-D at the first sign of diarrhea (diarrhea is any change in your usual bowel movements including an increase in the number of stools, OR stools that are more loose, soft or watery).

First
Dose:

pill
pill

Take 2 caplets (4 mg) of Imodium A-D

During
the Day:

pill

Take 1 caplet ( 2 mg) every 2 hours

During
the Night

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pill

Take 2 caplets (4 mg) at bedtime and 2 caplets (4 mg) every 4 hours until morning. You must set an alarm clock to wake up during the night to take your Imodium A-D.

Stop

Stop taking Imodium A-D when you have not had a bowel movement for at least 12 hours.

box

Follow these dosing directions or those explained by your doctor or nurse exactly. Do not skip doses. Do not delay doses.

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This dosage is recommended by your doctor and is higher than the original dosage directions printed on the Imodium A-D package.

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Call your doctor or nurse if you have questions or if you have taken Imodium A-D for 24 hours and still have diarrhea.

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Drink 6-8 glasses of clear, mild liquids (water, clear broths or apple juice) every day.

 

Camptosar


Pharmacia & Upjohn Yakult Daiichi

© 1999 Pharmacia & Upjohn Company


USX 2290.00 December 1998

 

Full Prescribing Information

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