topotecan hydrochloride at a glance
Medicine class
Topoisomerase I inhibitor; cytotoxic chemotherapy.
Available forms
A concentrate diluted for intravenous infusion and hard capsules taken by mouth.
Key safety issue
Suppression of blood-cell production can increase infection, anaemia and bleeding risks.
Food
Capsules may be taken with or without food and must be swallowed whole.
What is topotecan hydrochloride used for?
Selected products are licensed for:
Intravenous monotherapy for metastatic ovarian cancer after failure of earlier treatment.
Intravenous or oral monotherapy for relapsed small-cell lung cancer when repeating the initial regimen is not considered appropriate; capsules are licensed for adults.
Intravenous topotecan with cisplatin for cervical cancer that has recurred after radiotherapy or is Stage IVB; previous cisplatin exposure requires an adequate treatment-free interval.
How does topotecan hydrochloride work?
Topotecan stabilises the temporary complex formed between topoisomerase I and cut DNA, preventing normal resealing. The resulting DNA damage particularly affects actively replicating cells and can lead to cancer-cell death.
topotecan hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 4 mg/4 mL
Capsule
Route: Oral
Strengths: 0.25 mg, 1 mg
How to take topotecan hydrochloride
Treatment must be prescribed and supervised by an experienced chemotherapy team.
The infusion concentrate is diluted and given into a vein in a specialist unit.
Swallow capsules whole; do not open, crush, chew or divide them.
Capsules may be taken with or without food.
Return damaged capsules or unused cytotoxic medicine according to the cancer centre or pharmacy's instructions.
topotecan hydrochloride side effects
Common or expected effects
- Reduced white cells, red cells or platelets, with infection, tiredness or bruising risk
- Nausea, vomiting or diarrhoea
- Constipation, abdominal discomfort or a sore mouth
- Reduced appetite
- Hair loss
- Fatigue, weakness or fever
Get urgent medical advice
- Fever, chills or other infection symptoms, which may indicate neutropenia or sepsis
- Unexpected or severe bleeding
- Severe diarrhoea, dehydration, or fever with abdominal pain
- New cough, breathlessness or low oxygen levels
- Severe allergic reaction with swelling or breathing difficulty
topotecan hydrochloride in pregnancy
Topotecan can harm a developing baby and pregnancy should be avoided during treatment. Effective contraception is required; the selected infusion product advises continuing this for six months after treatment for women and three months for men. Anyone who is pregnant, becomes pregnant or is planning a pregnancy should promptly discuss this with the specialist team.
topotecan hydrochloride while breastfeeding
Breastfeeding is contraindicated and should stop when treatment begins. Discuss feeding alternatives with the oncology and maternity teams.
topotecan hydrochloride interactions
The oncology team should review all prescribed, over-the-counter and complementary products before treatment.
Cyclosporin and other ABCB1 or ABCG2 transporter inhibitors
These can substantially increase exposure to oral topotecan, requiring close monitoring for toxicity.
Other cytotoxic chemotherapy
Combined treatment can increase toxicity, particularly bone-marrow suppression, and must be specialist managed.
Cisplatin or carboplatin
Tolerability depends partly on treatment sequence, so the combination must follow the specialist protocol.
Common questions about topotecan hydrochloride
Answers are fully visible for fast scanning and source review.
Is topotecan hydrochloride chemotherapy?
Yes. It is a cytotoxic chemotherapy and topoisomerase I inhibitor.
Which cancers is topotecan hydrochloride licensed to treat?
Selected products cover specified relapsed or advanced ovarian, small-cell lung and cervical cancers; the exact indication depends on the formulation.
Can topotecan hydrochloride be taken as capsules?
Yes. Capsules are licensed for adults with relapsed small-cell lung cancer when repeating first-line treatment is inappropriate.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.