Not to be used in patients w/ severe bone marrow failure; ECOG performance status 3 or 4. Patients w/ reduced UGT1A1 activity; late diarrhea; nausea & vomiting; gastric cancer. Crigler-Najjar (types 1 & 2) & Gilbert's syndrome. Discontinue temporarily if neutropenic fever occurs or if absolute neutrophil count <1,000/mm3
. Consider administration of atropine in patients experiencing cholinergic symptoms. Monitor infusion site for signs of inflammation; resp symptoms; liver function; hematologic toxicities. Increased risk of hematotoxicity in patients w/ hyperbilirubinemia. Avoid concomitant administration of live or live attenuated vaccines. Treatment must not be initiated until resolution of bowel obstruction. Increased risk of myelosuppression in patients who previously received pelvic/abdominal irradiation following administration. Hereditary fructose intolerance. May affect ability to drive or operate machinery. Women of childbearing potential should avoid becoming pregnant. Elderly ≥65 yr.