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Topotecan (Hycamtin)

Warning: There are several severe side effects that can occur during or as a result of the use of this medication. Specifically, it can affect the bone marrow and cause a sharp decrease in various types of blood cells including red blood cells, white blood cells, and platelets. This may cause anemia, easy bruising or bleeding, or a decreased ability to fight infection. Throughout your treatment, you will undergo routine testing in order to monitor your blood and the effects that the medication may be having. If you experience symptoms of infection, seek medical help immediately. Also, contact your doctor if you find that you are unusually tired, bleeding or bruising more easily, or if your heart is pounding or racing.

Indications: Topotecan is the drug whose brand name is Hycamtin. It is prescribed for the treatment of several different kinds of cancer, the most common being ovarian cancer and lung cancer. It is also used in combination with cisplatin, another medication, in order to treat cervical cancer. 

Topotecan may also be prescribed for other medical conditions besides ovarian and small cell lung cancer; talk to your doctor or pharmacist for more information on Topotecan. 

Dosage: Topotecan can be taken in one of two ways. For most types of cancer, it is given intravenously as part of chemotherapy treatment. It should be administered by a health care professional and under the supervision of a doctor. The specific dosage may vary somewhat depending on your body size and type, the condition that it is being used to treat, laboratory tests, and your body’s ongoing response to treatment.

This medication is also given in order to treat small cell lung cancer. It is enclosed in caplets and should be taken once a day for five days in a row. Several cycles are usually prescribed, with each cycle lasting 21 days. This medicine can be taken with or without food and should be swallowed whole – never opened, crushed, or chewed. There are capsules available in different strengths in order to accommodate the specific needs of the patient. Your doctor will determine the appropriate dosage for you, based on your body and medical condition.

Overdose: Topotecan overdose can cause decreased levels of white blood cells in the blood, which can be dangerous in fragile patients. Although rare, an overdose of Topotecan may also lead to kidney problems. If you think you have been given an overdose or you experience abnormal symptoms, contact your doctor immediately.

Missing dose: the fact that Topotecan is administered in hospital, missing dose is basically difficult if you respect your doctor’s appointments. Therefore, If for some reasons you cannot go to the hospital for the treatment, contact your oncologist before the date you are scheduled for the injection. Do not stay home because you are experience side effects; Topotecan cause side effects in most patients. Missing a session of the therapy can affect the entire treatment.  

Contraindication: The medication is not recommended in the following conditions: 

  • low number of white blood cells
  • inadequate production of platelets
  • severe kidney failure
  • allergy to Topotecan or any of its ingredients
  • pregnancy or breastfeeding
  • severe liver failure.

Mechanism of action (MOA): Topotecan belongs to the class of chemotherapeutic drugs known as topoisomerase type 1 inhibitor. Normally, before a cell divides into two, its DNA is copied and each daughter cell receives a copy. Topotecan slows or stops growth of cancer cells by interfering with their DNA material needed for reproduction.

Interactions: When you are prescribed this and any other medication, it is important that you disclose to your doctor all of the other medicines, supplements, and vitamins that you are taking or that you plan to take during the course of your treatment, even if they are over the counter or if they were prescribed by another physician.

Topotecan has been shown to interact with phenytoin. While undergoing treatment, avoid eating foods that contain turmeric (curcumen), as it can inhibit the effectiveness of this medication. There are also several medications that can influence the way medicines are removed from the body. You may wish to discuss this and other concerns with your physician.

Side Effects: When attacking cancer cells, Topotecan also affects healthy cells, which lead to, in certain patients, the following side effects:

  • constipation  
  • diarrhea  
  • difficulty sleeping  
  • skin rash  
  • mouth sores  
  • stomach or back pain
  • depression (rarely)
    decreased appetite
    • temporary hair loss
    • nausea and vomiting
    • runny nose
    • nail changes
    • fatigue or weakness
    • Unusual fever or chills accompanied by cough or hoarseness 

    If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms:

    • unusual bleeding or bruising
    • extreme tiredness
    • shortness of breath
    • chest pain
    • persistent coughing
    • fast or irregular heartbeat
    • numbness, tingling, or burning sensation in the hands or feet
    • skin problems: hives, rash, itching, etc.
    • difficulty breathing or swallowing
    • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.