Description: Topotecan, an alkaloid, is a semi-synthetic derivative of camptothecin that prevents DNA replication and translocation.


Distribution: Widely distributed. Protein-binding: 35%. Terminal half-life: 2-3 hr.

Metabolism: Undergoes reversible hydrolysis to inactive hydroxy acid form; small amounts demethylated in the liver.

Excretion: Excreted in urine.

This medication treats small cell lung cancer by killing cancer cells or slowing their growth.

How to use topotecan

Read the Patient Information Leaflet provided by your pharmacist before you start taking topotecan and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth, usually once daily for 5 days or as directed by your doctor. Each 5-day treatment period is called a cycle. You will usually repeat this cycle every 21 days. The dosage is based on your body size, medical condition, laboratory tests, and response to treatment.

Take this medication with or without food. Swallow the capsules whole. Do not open, crush, or chew the capsules. If the capsule contents touch your skin, wash the skin immediately and completely with soap and water. If the contents get into your eyes, mouth, or nose, flush immediately with water for at least 15 minutes. Consult your doctor if you have redness/burning/swelling on the area of skin the contents touched or if the contents get into your eyes.

If you vomit after taking a dose, do not take another dose at that time. Take your next dose on your usual dosing schedule.

All people should wash their hands carefully after handling this drug. Women who are pregnant or who may become pregnant should not handle this medication.

Topotecan decreases bone marrow function which leads to a low number of blood cells such as red cells, white cells, and platelets. A low number of blood cells can cause anemia, decrease your body’s ability to fight an infection, or cause your body to bruise or bleed more easily.

Tell your doctor or pharmacist promptly if these effects persist or worsen:

  • nausea
  • vomiting
  • diarrhea
  • tiredness
  • loss of appetite
  • weakness
  • fever

Temporary hair loss may occur. However, normal hair growth should return after treatment has ended.

Tell your doctor right away if you have lung problems (such as cough, shortness of breath).

This medication may affect male and female fertility.

A very serious allergic reaction to this drug is rare.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.


  • Allergic reaction to this medication
  • Patients with medical history of blood/bone marrow disorders or kidney problems
  • This drug may make you weak or tired
  • Topotecan can make you more likely to get infections or may worsen any current infections
  • Do not have immunizations/vaccinations without the consent of your doctor
  • Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose)
  • Older adults may be more sensitive to diarrhea and decreased bone marrow
  • This medication is not recommended for use during pregnancy
  • Consult your doctor before breast-feeding

Consult your doctor regarding the precautions mentioned above.


Other medications may affect how topotecan works. Examples include:

  • azole antifungals (such as ketoconazole)
  • macrolide antibiotics (such as erythromycin)
  • cyclosporine
  • HIV protease inhibitors (such as ritonavir)


If overdose is suspected, contact a poison control center or emergency room immediately.


Do not share this medication with others.

Laboratory and/or medical tests (such as complete blood count, kidney function test) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

If you miss a dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.


Store in the refrigerator. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.


Available Brands

  • Topotel [ Fresenius Kabi ]

Also marketed as

  • Hycamtin [ GlaxoSmithKline ]

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