Find out what FOLFIRI is, how you have it and other important information about having FOLFIRI.
FOLFIRI is a combination of chemotherapy drugs and is also known as irinotecan de Gramont or Irinotecan modified de Gramont. It is a treatment for bowel cancer.
It’s made up of:
- folinic acid (also called leucovorin, calcium folinate or FA)
- fluorouracil (also called 5FU)
How it works
These cancer drugs destroy quickly dividing cells, such as cancer cells.
How you have it
You have folinic acid, 5FU and irinotecan into your bloodstream (intravenously).
You have the drugs through a long line - a central line, a PICC line or a portacath. These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.
You have the 5FU through a small pump which slowly puts the fluid into your bloodstream (infusion). You can keep the pump in a small bag or attached to a belt. When the 5FU infusion finishes, the nurse blocks the end of the central line with a plastic cap until the start of your next treatment. A district nurse or chemotherapy nurse may be able to do this at home.
When you have it
You have FOLFIRI chemotherapy as cycles of treatment. Each cycle of treatment lasts 2 weeks (14 days). Depending on your needs, you may have up to 12 cycles, taking up to 6 months in total.
- You have irinotecan through a drip into the bloodstream over 60 to 90 minutes
- You have folinic acid through a drip into the bloodstream over 2 hours
- You have an injection of fluorouracil into the bloodstream over 5 minutes
- You have an infusion of 5FU through a drip or pump into the bloodstream for 46 hours
- You continue to have the 5FU infusion
- You have no treatment
Then you start the cycle again.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Other medicines, food drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.
Don’t breastfeed during this treatment because the drugs may come through in your breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
- be in contact with other people who have had live vaccines as injections
Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.
This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.
You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened.
Around 5 out of 100 people (5%) have low levels of an enzyme called DPD in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from fluorouracil. It doesn’t cause symptoms so you won’t know if you have a deficiency. Contact your doctor if your side effects are severe.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.