Camptosar

Does this vial of the new anticancer agent Camptosar Injection (irinotecan HCI injection) contain 20 mg or 100 mg?

If you said 20 mg, then you were as confused by the labeling as other health care providers have been. This drug's labeling has been linked to several accidental overdoses, including at least two deaths, since the drug's launch late last July. In three cases, patients received fivefold overdoses.

Confusion stems from the prominently displayed "20 mg/mL" pictured above on the product label. Health care providers have mistaken this amount for the entire vial contents. But the vial actually contains 100 mg-not 20 mg.

If you look at the upper right corner of the label, you'll see the hardly noticeable "5 mL Vial" in small print, indicating that the vial's contents are 5 ml. The amount of Camptosar is 20 mg/ml-or 100 mg per 5-ml vial.

Pharmacia & Upjohn Co., the manufacturer of Camptosar, is working with the FDA to improve this label. In the meantime, take these precautions when administering Camptosar:

Alert your colleagues about the potential for this serious error.

Ask your pharmacist to place auxiliary labels on containers of Camptosar, indicating that the vial contains 100 mg of Camptosar.

As with most injectable drugs, be suspicious if you need more than two vials to administer a dose-it's likely that the dosage is incorrect.

As always, double-check dosage calculations of Camptosar and have a colleague independently check them as well.

This column describes medication errors and discusses how they could have been avoided. The author is president of the Institute for Safe Medication Practices (ISMPI, a nonprofit organization that derives its reports from the USP Medication Errors Reporting Program (USPMERP). To report medication errors, call the USP at 1-800-23-ERROR (233-7767). You can reach the ISMP at (215) 956-9181 or via E-mail at (usmpinfo@ismp.org.

Copyright Springhouse Corporation Jan 1997
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