Drug Interaction Report

ADJUST DOSING INTERVAL: Concomitant administration of colony-stimulating factors with topotecan can prolong the duration of neutropenia. The mechanism of interaction has not been established.

MONITOR: Coadministration with colony-stimulating factors may potentiate the risk of interstitial lung disease (ILD) associated with the use of topotecan. According to the product labeling, risk factors for topotecan-induced ILD include a history of ILD, pulmonary fibrosis, lung cancer, thoracic exposure to radiation, and use of pneumotoxic drugs and/or colony-stimulating factors.

MANAGEMENT: Colony-stimulating factors should not be initiated until 24 hours after completion of a course or cycle of topotecan treatment. Patients should be monitored for pulmonary symptoms indicative of ILD such as cough, fever, dyspnea and/or hypoxia. Topotecan should be discontinued if a new diagnosis of ILD is confirmed.