Tecan

Indications

Topotecan is a chemotherapy medicine used to treat certain cancers, including small cell lung cancer that has come back, ovarian cancer that has come back after first treatment, and, together with Cisplatin, some advanced or recurrent cervical cancers.

How It Works

Topotecan is a topoisomerase I inhibitor. Topoisomerase I is an enzyme that untwists DNA so cells can copy it before dividing. Topotecan traps this enzyme on the DNA, causing breaks that the fast-dividing cancer cells cannot repair, so they die.

Dosage and Administration

Topotecan is given under the care of a cancer specialist. The injection is given by a doctor or nurse as an infusion into a vein, usually on several days in a row in repeating cycles; capsules, where used, are taken exactly as prescribed. The dose depends on body size, blood counts and kidney function and is set by the specialist, as prescribed.

Interactions

Other chemotherapy, especially Cisplatin, can increase effects on the bone marrow. Ciclosporin and some other medicines can raise Topotecan levels from capsules. Live vaccines must be avoided during treatment. Tell the team about every medicine and supplement you take.

Contraindications

• Allergy to Topotecan.
• Severe bone marrow suppression (very low blood counts) before starting a cycle.
• Pregnancy and breastfeeding.

Side Effects

The main side effect is low blood counts: low white cells (risk of infection), low platelets (bleeding or bruising) and anaemia (tiredness). Nausea, vomiting, diarrhoea, hair loss, mouth sores, loss of appetite and tiredness are also common. Rarely, lung inflammation occurs.

Get urgent medical help for fever of 38°C or above, chills or other signs of infection, unusual bleeding or bruising, severe diarrhoea, new or worsening cough or shortness of breath, or severe weakness.

Pregnancy and Lactation

Topotecan can harm an unborn baby. Women and men must use effective contraception during treatment and for some months afterwards, as advised by the specialist. Do not breastfeed during treatment.

Precautions and Warnings

Blood counts are checked before each dose and regularly during treatment. Doses are lowered in kidney disease. Avoid contact with people who have infections, and keep good mouth hygiene. Caregivers should handle the medicine and body fluids with care.

Overdose

Overdose mainly causes severe bone marrow suppression and mouth sores. It is treated in hospital with close monitoring and supportive care.

Therapeutic Class

Antineoplastic, topoisomerase I inhibitor (camptothecin derivative).

Storage

Hospital product: store as directed on the pack, below 30°C, away from light and out of the reach of children. Capsules may need refrigeration at 2 to 8°C if stated on the pack.