topotecan (oral/injection)

What is the most important information I should know about topotecan?

What is topotecan?

Topotecan is used to treat ovarian cancer, small cell lung cancer, and certain types of cervical cancer.

Topotecan is usually given after other treatments have failed.

Topotecan may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using topotecan?

Tell your doctor if you have ever had:

• severe diarrhea;
• kidney disease;
• lung problems; or
• a chest X-ray or radiation treatment of your chest area.

• If you are a woman, do not use topotecan if you are pregnant. You may need to have a negative pregnancy test before starting this treatment. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose.
• If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.
• Tell your doctor right away if a pregnancy occurs while either the mother or the father is using topotecan.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because topotecan may harm the baby if a pregnancy does occur.

How should I use topotecan?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Topotecan capsules are taken by mouth, with or without food. You may need to take two different colored capsules at one time. Make sure you know the difference between capsules because one contains 4 times as much topotecan as the other, even though they may look the same in size.

If you vomit after taking a topotecan capsule, do not take another dose that same day.

Topotecan injection is given as an infusion into a vein. A healthcare provider will give you this injection. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when topotecan is injected.

Topotecan can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

Your doctor will determine how long to treat you with topotecan.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include skin rash or other irritation, nausea, vomiting, diarrhea, or mouth sores.

What should I avoid while using topotecan?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

What are the possible side effects of topotecan?

• new or worsening cough, fever, trouble breathing;
• diarrhea with fever and stomach cramps;
• pain or burning when you urinate;
• signs of pneumonia --fever, chills, cough with mucus, chest pain, feeling short of breath; or
• low blood cell counts --fever, chills, flu-like symptoms, mouth sores, skin sores, pale skin, cold hands and feet, bruising or bleeding, feeling light-headed.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects may include:

• low blood cell counts;
• trouble breathing, pneumonia
• nausea, diarrhea, vomiting, stomach pain;
• loss of appetite;
• hair loss; or
• feeling weak or tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect topotecan?

• filgrastim (Neupogen, Granix, Zarxio);
• pegfilgrastim (Neulasta); or
• sargramostim (Leukine).

Other drugs may affect topotecan, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your doctor or pharmacist can provide more information about topotecan.