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What is Topotecan
Topotecan is a semi-synthetic, water-soluble derivative of camptothecin, a cytotoxic plant alkaloid isolated from the Chinese tree Camptotheca acuminata.
It is a topoisomerase I inhibitor that is FDA approved in capsule form as monotherapy for the treatment of small cell lung cancer (SCLC), and as an intravenous therapy for the treatment of ovarian cancer, cervical cancer, and SCLC.
Topotecan can cause severe myelosuppression; closely monitor complete blood counts (CBC). An interruption of therapy or dose adjustment may be necessary for patients with neutropenia, thrombocytopenia, or anemia.
Brand Name
Hycamtin
Indications
- cervical cancer
- non-small cell lung cancer (NSCLC)
- ovarian cancer
- rhabdomyosarcoma
- small cell lung cancer (SCLC)
For the treatment of patients with metastatic ovarian cancer with disease progression on or after initial or subsequent chemotherapy
Side Effects
- abdominal pain
- acute respiratory distress syndrome (ARDS)
- alopecia
- alopecia
- anaphylactoid reactions
- anemia
- anemia
- angioedema
- anorexia
- anorexia
- arthralgia
- asthenia
- asthenia
- back pain
- bleeding
- bone marrow suppression
- bone pain
- cardiac arrest
- chest pain (unspecified)
- chills
- constipation
- cough
- diarrhea
- diarrhea
- dysmenorrhea
- dyspareunia
- dyspnea
- elevated hepatic enzymes
- enterocolitis
- fatigue
- fatigue
- fever
- fever
- GI obstruction
- GI perforation
- headache
- hyperbilirubinemia
- hyperhidrosis
- hypoxia
- infection
- infection
- injection site reaction
- lethargy
- malaise
- myalgia
- nausea
- nausea
- neuropathic pain
- neutropenia
- neutropenia
- pelvic pain
- pharyngitis
- pleural effusion
- pneumonitis
- pruritus
- pulmonary embolism
- stomatitis
- thrombocytopenia
- thrombocytopenia
- typhlitis
- vomiting
- vomiting
- weight gain
- weight loss
Monitoring Parameters
- CBC with differential
- pregnancy testing
- serum creatinine/BUN
Contraindications
- abdominal pain
- anemia
- bone marrow suppression
- breast-feeding
- chronic lung disease (CLD)
- colitis
- contraception requirements
- diarrhea
- extravasation
- fever
- herpes infection
- infection
- infertility
- lung cancer
- male-mediated teratogenicity
- neutropenia
- pneumonitis
- pregnancy
- pregnancy testing
- pulmonary disease
- pulmonary fibrosis
- radiation therapy
- reproductive risk
- serious hypersensitivity reactions or anaphylaxis
- thrombocytopenia
- varicella
- viral infection
Interactions
- Acalabrutinib
- Amiodarone
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Atazanavir; Cobicistat
- Brigatinib
- Cabozantinib
- Capmatinib
- Clarithromycin
- Cobicistat
- Conivaptan
- Cyclosporine
- Daclatasvir
- Darolutamide
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dextromethorphan; Quinidine
- Dronedarone
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Eltrombopag
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Erythromycin
- Erythromycin; Sulfisoxazole
- Etravirine
- Flibanserin
- Fostamatinib
- Glecaprevir; Pibrentasvir
- grapefruit juice
- Ibrutinib
- Isavuconazonium
- Istradefylline
- Itraconazole
- Ivacaftor
- Ketoconazole
- Lapatinib
- Ledipasvir; Sofosbuvir
- Leflunomide
- Lomitapide
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Mefloquine
- Mifepristone
- Nelfinavir
- Neratinib
- Ombitasvir; Paritaprevir; Ritonavir
- Osimertinib
- Palifermin
- Penicillamine
- Ponatinib
- Posaconazole
- Propafenone
- Quinidine
- Quinine
- Ranolazine
- Regorafenib
- Ritonavir
- Rolapitant
- Safinamide
- Sapropterin
- Saquinavir
- Sarecycline
- Simeprevir
- Sirolimus
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sorafenib
- Sulfasalazine
- Tacrolimus
- Tafamidis
- Tedizolid
- Temsirolimus
- Teriflunomide
- Tezacaftor; Ivacaftor
- Ticagrelor
- Tolvaptan
- Trandolapril; Verapamil
- Tuberculin Purified Protein Derivative, PPD
- Tucatinib
- Ulipristal
- Vemurafenib
- Venetoclax
- Verapamil
- Zonisamide
