Toptecan

Other Names: Hycamtin®

About this Drug

Topotecan is used to treat cancer. It is given by the vein (IV) or orally (by mouth).

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding. 
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face ,armpits, pubic area, chest and/or legs. You may also notice your hair getting thin. 
  • Fevers
  • Tiredness
  • Nausea and throwing up (vomiting)
  • Loose bowel movements (diarrhea)

Note: Each of the side effects above was reported in 10% or greater of patients treated with topotecan. Not all possible side effects are included above. Side effects may be dependent on whether you are taking topotecan by mouth or IV.

Warnings and Precautions 

  • Inflammation (swelling) of the lungs, which can rarely be life-threatening. You may have a dry cough or trouble breathing. 
  • Severe bone marrow depression.
  • Typhlitis. Swelling (inflammation) in the colon, at the same time of being severely immune compromised (low white blood cells, which raises your risk of infection) which can rarely be life-threatening - symptoms are loose bowel movements (diarrhea), pain in your abdomen, fevers and/or chills. 
  • Severe loose bowel movements (diarrhea)
  • (IV only) Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue. Injury may be rarely severe. 

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, vomit, semen, and vaginal secretions. Talk to your doctor and/or nurse about the necessary precautions to take during this time. 

How to Take Your Medication

  • For oral only: Swallow the medicine whole with or without food as instructed by your doctor. Do not chew, crush, or divide. 
  • Missed dose: If you vomit or miss a dose, take your next dose at the regular time. Do not take another dose on the same day. 
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves. 
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest, between energy-draining activities. 
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever. 
  • To decrease your risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss. 
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor. 
  • Get regular exercise. If you feel too tired to exercise vigorously, try taking a short walk. 
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from loosing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help stop or lessen these symptoms. 
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping. 
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea. 
  • To help with hair loss, wash your hair with a mild shampoo and avoid washing your hair every day. 
  • Avoid rubbing your scalp, pat your hair or scalp dry. 
  • Avoid coloring your hair.
  • Limit your use of hairspray, electric curlers, blow dryers, and curling irons. 
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the "Look Good, Feel Better" program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans, and scarves as well as makeup techniques and skin and nail care. 

Food and Drug Interactions

  • There are no known interactions of topotecan with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with topotecan. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions. 

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Pain in your chest
  • Dry cough
  • Wheezing or trouble breathing
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Nausea that stops you from eating or drinking and/or is nor relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • While you are getting this drug, please tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion
  • If you think you are pregnant or if you have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during cancer treatment and for at least 1 month after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 3 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner. 
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised November 2017