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Topotecan Dosage

Medically reviewed by Drugs.com. Last updated on Apr 5, 2023.

Applies to the following strengths: 4 mg; 0.25 mg; 1 mg; 1 mg/mL

Usual Adult Dose for Ovarian Cancer

1.5 mg/m(2) IV over 30 minutes once a day for 5 consecutive days, starting on day 1 of a 21 day course

Comments:


Use: Metastatic carcinoma of the ovary after failure of initial or subsequent chemotherapy.

Usual Adult Dose for Cervical Cancer

0.75 mg/m(2) IV over 30 minutes on days 1, 2, and 3 of each 21 day cycle

Comments:


Use: In combination with cisplatin, treatment of stage IVB, recurrent or persistent carcinoma of the cervix which is not amenable to curative treatment with surgery and/or radiation therapy.

Usual Adult Dose for Small Cell Lung Cancer

IV formulation: 1.5 mg/m(2) IV over 30 minutes once a day for 5 consecutive days, starting on day 1 of a 21 day course
Oral capsules: 2.3 mg/m(2) orally once a day for 5 consecutive days, starting on day 1 of a 21 day course (round dose to nearest 0.25 mg)

Duration of therapy: Until disease progression

Comments:


Uses:
IV formulation: Small cell lung cancer sensitive disease after failure of first-line chemotherapy. Sensitive disease was defined as disease responding to chemotherapy but subsequently progressing at least 60 to 90 days after chemotherapy.
Capsule formulation: Treatment of relapsed small cell lung cancer in patients with a prior complete or partial response and who are at least 45 days from the end of first-line chemotherapy.

Renal Dose Adjustments

Small cell lung cancer or Ovarian cancer, IV formulation:


Small cell lung cancer, oral capsules:

Cervical cancer:

Liver Dose Adjustments

Data not available

Dose Adjustments

All cancer types:
On day 1 of first cycle, delay therapy initiation until hematologic or renal recovery IF:


On day 1 of subsequent cycles, delay treatment cycle until hematologic or renal recovery IF:
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Small cell lung cancer or Ovarian cancer:
IV formulation:
Severe neutropenia [less than 500 cells/mm(3)] in preceding cycle:

Platelet count below 25,000 cells/mm(3): Reduce dose to 1.25 mg/m(2) for subsequent courses .

Oral capsules (Small cell lung cancer only):
Permanently reduce dose by 0.4 mg/m(2) for subsequent courses for:
Do not give oral formulation to patients with Grade 3 or 4 diarrhea
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Cervical cancer:
First occurrence of febrile neutropenia [less than 1,000 neutrophils/mm(3) with fever of 38 C/100.4F or higher] in preceding cycle:

Re-occurrence of febrile neutropenia in preceding cycle despite use of G-CSF:

Platelet nadir less than 25,000 cells/mm(3) in preceding cycle:

Serum creatinine greater than 1.5 mg/dL in subsequent cycles:

Precautions

US BOXED WARNING:
BONE MARROW SUPPRESSION


Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:


Reconstitution/preparation techniques:

Further information

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