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Topotecan Disease Interactions

There are 6 disease interactions with topotecan:

Major

Antineoplastics (applies to topotecan) infections

Major Potential Hazard, High plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  5. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  6. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  7. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  8. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  9. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  10. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  11. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  12. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  13. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
  14. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  15. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  16. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  17. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  18. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  19. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  20. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  21. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  22. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  23. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  24. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  25. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  26. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  27. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  28. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  29. "Product Information. Nipent (pentostatin)." Hospira Inc, Lake Forest, IL.
  30. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  31. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.
View all 31 references
Major

Topotecan (applies to topotecan) bleeding disorders

Major Potential Hazard, High plausibility.

Topotecan induces myelosuppression. Severe thrombocytopenia (< 25,000/mm3) has been reported during topotecan therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bleeding such as petechiae, purpura, hematuria, or melena. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until platelet counts exceed 100,000/mm3.

References

  1. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
Major

Topotecan (applies to topotecan) myelosuppression

Major Potential Hazard, High plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts, Fever

Topotecan induces myelosuppression. Severe neutropenia (< 500/mm3), severe thrombocytopenia (< 25,000/mm3), and severe anemia (< 8 g/dl) have been reported frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with neutrophil counts < 1500/mm3 and/or platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until neutrophil counts exceed 1000/mm3, platelet counts exceed 100,000/mm3, and/or hemoglobin levels are at least 9 g/dl.

References

  1. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
Major

Topotecan (applies to topotecan) renal dysfunction

Major Potential Hazard, High plausibility.

Topotecan is partially eliminated by the kidney. Approximately 30% of topotecan is excreted in the urine. Plasma clearance of topotecan was reduced 33% in patients with mild renal impairment (creatinine clearance of 40 to 60 mL/min) and 66% in patients with moderate renal impairment (creatinine clearance of 20 to 40 mL/min). Therapy with topotecan should be administered cautiously and at a reduced dosage in patients with moderate to severe renal dysfunction.

References

  1. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
Moderate

Topotecan (applies to topotecan) diarrhea

Moderate Potential Hazard, Moderate plausibility.

Topotecan capsules can cause severe and life-threatening diarrhea that may require hospitalization. It is recommended to withhold treatment for severe diarrhea. Manage diarrhea caused by topotecan aggressively and do no administer topotecan capsules to patients with Grade 3 or 4 diarrhea. Reduce the dose of therapy after recovery to Grade 1 or less. Close monitoring is recommended.

Moderate

Topotecan (applies to topotecan) interstitial lung disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Impairment

Fatal cases of interstitial lung disease (ILD) have occurred with the use of topotecan. Risk factors include a history of ILD, pulmonary fibrosis, lung cancer, thoracic radiation, and use of pneumotoxic drugs and/or colony stimulating factors. It is recommended to monitor patients for pulmonary symptoms indicative of ILD and permanently discontinue treatment for confirmed ILD.

Topotecan drug interactions

There are 322 drug interactions with topotecan

Topotecan alcohol/food interactions

There is 1 alcohol/food interaction with topotecan

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.