Drug Interaction Report

MONITOR: The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe neutropenia and neutropenic sepsis resulting in death were reported with topotecan and cisplatin.

MANAGEMENT: Caution is advised if topotecan is used with other cytotoxic agents. Dosage reductions may be required, and bone marrow function should be closely monitored. Patients should be advised to contact their physician if they develop signs and symptoms of myelosuppression such as pallor, dizziness, fatigue, lethargy, fainting, easy bruising or bleeding, or signs of infection such as fever, chills, sore throat, body aches, and other influenza-like symptoms.

The recommended maximum number of medicines in the 'DNA topoisomerase I inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'DNA topoisomerase I inhibitors' category:

• Onivyde (irinotecan liposomal)
• topotecan

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.