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topotecan

Generic Name: topotecan (TOE poe TEE kan)
Brand Name: Hycamtin

What is topotecan?

Topotecan is a cancer medicine that interferes with the growth and spread of cancer cells in the body.

Topotecan is used to treat ovarian cancer, small cell lung cancer, and certain types of cervical cancer. This medicine is sometimes given after other treatments have failed.

Topotecan may also be used for purposes not listed in this medication guide.

Important Information

Topotecan can weaken your immune system, and you may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, cough, diarrhea, stomach cramps, pain or burning when you urinate).

You should not use topotecan if you are pregnant. Avoid getting pregnant for at least 1 month after you stop using this medicine.

Before taking this medicine

You should not use topotecan if you are allergic to it.

To make sure topotecan is safe for you, tell your doctor if you have:

  • kidney disease;

  • lung disease or lung cancer; or

  • if you have had a chest X-ray or radiation treatment of your chest area.

Do not use topotecan if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 1 month after your last dose.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because topotecan may harm the baby if a pregnancy does occur.

It is not known whether topotecan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using topotecan.

How should I use topotecan?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Topotecan capsules are taken by mouth. You may need to take two different colored capsules at one time. Make sure you know the difference between capsules because one contains 4 times as much topotecan as the other, even though they may look the same in size.

Take the capsules with a full glass (8 ounces) of water. You may take the medicine with or without food.

If you vomit after taking a topotecan capsule, do not take another dose that same day.

Do not crush or break a topotecan capsule, or use a capsule that has been accidentally broken. The medicine from a broken capsule can be dangerous if it gets in your eyes or on your skin. If this occurs, wash your skin with soap and water or rinse the eyes for at least 15 minutes with plain water. Ask your doctor or pharmacist how to safely handle and dispose of a broken tablet or capsule.

Store topotecan capsules in the refrigerator and protect them from light.

Topotecan injection is given into a vein through an IV. A healthcare provider will give you this injection once daily for 3 to 5 days in a row. This treatment is then repeated every 21 days. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when topotecan is injected.

Also tell your doctor right away if any of this medicine gets on your skin during the injection. Exposed skin should be rinsed thoroughly with soap and warm water.

Topotecan can lower blood cells that help your body fight infections and help your blood to clot. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often.

Your doctor will determine how long to treat you with topotecan capsules or injection.

What happens if I miss a dose?

Call your doctor for instructions if you miss any of your topotecan doses.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using topotecan?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Topotecan side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • new or worsening cough, fever, trouble breathing;

  • diarrhea with fever and stomach cramps;

  • pain or burning when you urinate; or

  • low blood cell counts--fever, chills, flu-like symptoms, mouth sores, skin sores, pale skin, cold hands and feet, bruising or bleeding, feeling light-headed.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Topotecan dosing information

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:
-In the absence of tumor progression, a minimum of 4 courses is recommended because tumor response may be delayed.
-The median time to response was 9 to 12 weeks.
-Recommended dosage should generally not exceed 4 mg.

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:
-Administer cisplatin 50 mg/m(2) IV on day 1 of each 21 day cycle.
-Consult cisplatin manufacturer product information for administration and hydration guidelines, and for dose adjustments.
-Recommended dosage should generally not exceed 4 mg.

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:
-In the absence of tumor progression, a minimum of 4 courses is recommended because tumor response may be delayed.
-The median time to response was 5 to 7 weeks.
-Recommended IV dosage should generally not exceed 4 mg.
-Do not prescribe a replacement oral capsule dose for emesis.

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.

What other drugs will affect topotecan?

You should not receive a "colony stimulating factor" medicine within 24 hours after your last dose of topotecan. This includes:

Other drugs may interact with topotecan, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about topotecan.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.01.

Date modified: February 01, 2018
Last reviewed: September 28, 2017

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