topotecan (Intravenous route)
Do not give topotecan hydrochloride to patients with baseline neutrophil counts of less than 1500 cells/mm(3). In order to monitor the occurrence of bone marrow suppression, primarily neutropenia, which may be severe and result in infection and death, monitor peripheral blood counts frequently on all patients receiving topotecan .
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
- Powder for Solution
Therapeutic Class: Antineoplastic Agent
Pharmacologic Class: Topoisomerase I Inhibitor
Uses For topotecan
Topotecan is used to treat patients with metastatic cancer (a cancer that has already spread) of the ovaries after other treatments have failed. topotecan is also used to treat a certain type of lung cancer called small cell lung cancer. It is also used in combination with cisplatin to treat cancer of the cervix which cannot be treated with surgery or radiation therapy.
Topotecan belongs to the group of medicines called antineoplastics. It interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal cells may also be affected by the medicine, other effects may also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may occur after treatment with topotecan has been stopped.
topotecan is available only with your doctor's prescription.
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, topotecan is used in certain patients with the following medical conditions:
- Chronic myelomonocytic leukemia (CMML).
- Myelodysplastic syndrome (MDS).
Before Using topotecan
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For topotecan, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to topotecan or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of topotecan in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of topotecan in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving topotecan.
|All Trimesters||D||Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.|
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving topotecan, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using topotecan with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Rotavirus Vaccine, Live
Using topotecan with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine Type 4, Live
- Adenovirus Vaccine Type 7, Live
- Bacillus of Calmette and Guerin Vaccine, Live
- Influenza Virus Vaccine, Live
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rubella Virus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine
- Varicella Virus Vaccine
- Yellow Fever Vaccine
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of topotecan. Make sure you tell your doctor if you have any other medical problems, especially:
- Bone marrow depression, severe—Should not be used in patients with this condition.
- Chickenpox (including recent exposure) or
- Herpes zoster (shingles)—Topotecan may cause these conditions to get worse and spread to other parts of your body.
- Infection—May decrease your body's ability to fight infection.
- Kidney disease—Higher blood levels of topotecan can occur, which increases the risk of serious side effects.
- Lung disease (e.g., interstitial lung disease), or history of or
- Neutropenia (low white blood cells)—Use with caution. May make these conditions worse.
Proper Use of topotecan
You will receive topotecan while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you topotecan. topotecan is given through a needle placed in one of your veins.
Topotecan is usually given every day for 3 to 5 days. This 3-day or 5-day treatment is given again every 21 days until your body responds to the medicine. Each treatment usually takes about 30 minutes.
Topotecan often causes nausea and vomiting. It is very important that you continue to receive the medicine even if it makes you feel ill. Ask your doctor for ways to lessen these effects.
Precautions While Using topotecan
It is very important that your doctor check your progress at regular visits to make sure that topotecan is working properly. Blood tests may be needed to check for unwanted effects.
Using topotecan while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
While you are being treated with topotecan, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Topotecan may lower your body's resistance, and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine, since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the past several months. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
Topotecan can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are needed for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, painful or difficult urination, severe diarrhea, or stomach pain.
- Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Also, check with your medical doctor before having any dental work done.
- Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injury could occur.
topotecan may cause some people to become tired or weak than they are normally. If any of these side effects occur, avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
If you develop a skin rash or any allergic reaction to topotecan, stop using the medicine and check with your doctor as soon as possible.
Stop using topotecan and check with your doctor right away if you start having breathing problems, cough, fast heartbeat, fever, shortness of breath, or wheezing. These could be symptoms of a serious lung problem.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
topotecan Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:More common
- Abdominal or stomach pain
- black, tarry stools
- blood in the urine or stools
- cough or hoarseness (accompanied by fever or chills)
- fever or chills
- lower back or side pain (accompanied by fever or chills)
- painful or difficult urination (accompanied by fever or chills)
- pinpoint red spots on the skin
- shortness of breath or troubled breathing
- unusual bleeding or bruising
- unusual tiredness or weakness
- Changes in the skin color of the face
- fast or irregular breathing
- large, hive-like swellings on the face, eyelids, mouth, lips, or tongue
- puffiness or swelling of the eyelids or around the eyes
- skin rash, hives, or itching
- tightness in the chest or wheezing
- Bleeding gums
- difficult breathing
- difficulty with swallowing
- fast heartbeat
- skin rash or itching, severe
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Burning or tingling in the hands or feet
- loss of appetite
- muscle weakness
- nausea or vomiting
- sores, ulcers, or white spots on the lips or tongue or inside the mouth
Topotecan sometimes causes bruising or redness at the place of injection. Check with your doctor or nurse if these effects are especially bothersome.
Topotecan may also cause a temporary loss of hair in some people. After treatment with topotecan has ended, normal hair growth should return.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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