CAMPTOSAR Injection should be administered only under the
supervision of a physician who is experienced in the use of cancer
chemotherapeutic agents. Appropriate management of complications is
possible only when adequate diagnostic and treatment facilities are
readily available. CAMPTOSAR can induce both early and late forms of
diarrhea that appear to be mediated by different mechanisms. Both
forms of diarrhea may be severe. Early diarrhea (occurring during or
shortly after infusion of CAMPTOSAR) may be accompanied by
cholinergic symptoms of rhinitis, increased salivation, miosis,
lacrimation, diaphoresis, flushing, and intestinal hyperperistalsis
that can cause abdominal cramping. Early diarrhea and other
cholinergic symptoms may be prevented or ameliorated by atropine (see
PRECAUTIONS, General). Late diarrhea (generally occurring more than
24 hours after administration of CAMPTOSAR) can be life threatening
since it may be prolonged and may lead to dehydration, electrolyte
imbalance, or sepsis. Late diarrhea should be treated promptly with
loperamide. Patients with diarrhea should be carefully monitored and
given fluid and electrolyte replacement if they become dehydrated or
antibiotic therapy if they develop ileus, fever, or severe
neutropenia (see WARNINGS). Administration of CAMPTOSAR should be
interrupted and subsequent doses reduced if severe diarrhea occurs
(see DOSAGE AND ADMINISTRATION).
Severe myelosuppression may occur (see WARNINGS).