Uses

A topoisomerase I inhibitor indicated for the treatment of small cell lung cancer after failure of first-line chemotherapy, and in combination with cisplatin for stage IV-B, recurrent, or persistent cervical carcinoma.

Do not use if

Contraindicated in patients with severe hypersensitivity to topotecan or any ingredient. Should not be used in patients with severe bone marrow depression prior to treatment.

Side effects

Most common hematologic toxicities are neutropenia, leukopenia, anemia, and thrombocytopenia. Common non-hematologic effects include nausea, alopecia, vomiting, diarrhea, constipation, fatigue, and sepsis. Bone marrow suppression is the dose-limiting toxicity.

Warnings

Do not administer if baseline neutrophil count is below 1,500 cells/mm³. Monitor blood counts regularly. Topotecan is embryotoxic and teratogenic; effective contraception is required during treatment.

How it works

Topotecan binds to the topoisomerase I-DNA complex and prevents religation of single-strand DNA breaks, causing double-strand breaks during DNA replication that lead to cell death.

Storage

Store refrigerated at 2°C to 8°C, protected from light. Multi-dose vials may be stored for a limited time after opening per manufacturer guidance.