Topotecan

DEA Class; Rx

Common Brand Names; Hycamtin

• Antineoplastics, Topoisomerase Inhibitors; 
• Antineoplastics, Camptothecin

Indicated for SCLC sensitive disease after failure of first-line chemotherapy

Indicated for combination therapy with cisplatin for stage IV-B, recurrent or persistent cervical carcinoma which cannot be treated with surgery and/or radiation therapy

Indicated for metastatic ovarian cancer after failure of initial or subsequent chemotherapy

Hypersensitivity reactions to drug or any components

IV infusion

• Ovarian cancer

  • Neutropenia, grade 4 (80%)

  • Anemia, grade 3 or 4 (41%)

  • Thrombocytopenia, grade 4 (27%)

  • Febrile neutropenia (23%)

• Small cell lung cancer

  • Neutropenia, grade 4 (70%)

  • Anemia, grade 3 or 4 (42%)

  • Thrombocytopenia. grade 4 (29%)

• Cervical cancer (Combination therapy with cisplatin)

  • Constitutional, grade 3 or 4 (69%)

  • Pain, grade 3 or 4 (59%)

  • Neutropenia, grade 4 (48%)

  • Vomiting, grade 3 or 4 (40%)

  • Anemia, grade 3 (34%)

  • Thrombocytopenia, grade 3 (26%)

  • Neutropenia, grade 3 (26%)

Capsule

• All grades

  • Anemia (98%)

  • Sepsis (43%)

  • Nausea (33%)

  • Thrombocytopenia (29%)

  • Neutropenia (24%)

• Grade 3 or 4

  • Neutropenia (24-32%)

  • Thrombocytopenia (6-29%)

  • Anemia (7-18%)

Administer to patients with bone marrow suppression only if patient has adequate bone marrow reserves; monitor peripheral blood counts and adjust dose as needed

PO: Do NOT redose if ANC <1500/mm³; Plt 100,000<mm³; hgb=”” <9=”” g=”” dl<=”” p=””></mm³;>

Avoid use in pregnancy; can cause fetal harm; advise women of potential risk to fetus

Neutropenia: pancytopenia has been reported

Grade 4 thrombocytopenia and grade 3-4 anemia reported; withhold and reduce dose based on neutrophil counts, platelet counts and hemoglobin levels

Fatal cases of interstitial lung disease have occurred; permanently discontinue for confirmed ILD

If extravasation occurs, immediately stop administration and institute recommended management procedures; severe cases reported

PO: If patient vomits after taking capsule, do NOT repeat dose

PO: If diarrhea occurs, treat aggressively, potentially life-threatening

Monitor patients presenting with neutropenia, fever and abdominal pain; fatal typhlitis reported in patients with neutropenic enterocolitisas

Monitor patients presenting with cough, fever, dyspnea and/or hypoxia and a history of lung disease as fatalities due to interstitial lung disease have been reported

Based on animal data and its mechanism of action, therapy can cause fetal harm when administered to a pregnant woman

There are no data on presence of drug or its metabolites in human milk or their effects on breastfed infant or on milk production; lactating rats excrete high concentrations of drug in milk

Topoteca 

powder for injection

• 4mg/vial

capsule

• 0.25mg
• 1mg