8 Topotecan Side Effects You Should Know About
Side effects of topotecan (Hycamtin) may include stomach pain, nausea, and shortness of breath. See more common topotecan side effects, plus ways to manage them.
topotecan
Used for Cervical Cancer, Lung Cancer, Ovarian Cancer
Used for Cervical Cancer, Lung Cancer, Ovarian Cancer
Hycamtin (topotecan) is an anticancer treatment option used for small cell lung cancer (SCLC) that comes back (relapsed) after having been treated with first-choice chemotherapy. It’s a convenient pill taken by mouth, usually for a few days each chemotherapy cycle. This medication can raise your risk for infections and bleeds.
What is Hycamtin (topotecan)?
What is Hycamtin (topotecan) used for?
- Advanced small cell lung cancer (SCLC) that continued to spread after other chemotherapy
How Hycamtin (topotecan) works
Hycamtin (topotecan) is a type of anticancer medication called a topoisomerase I inhibitor. It prevents cancer cells from growing by damaging the cancer cells’ genetic material, which leads to cell death.
Drug facts
| Common Brands | Hycamtin |
|---|---|
| Drug Class | Topoisomerase I inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Hycamtin (topotecan)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Low blood cell counts (up to 98%)
- Nausea (27-33%)
- Diarrhea (14-22%)
- Vomiting (19-21%)
- Hair loss (10-20%)
- Tiredness (11-19%)
Less Common Side Effects
- Fever
- Lack of appetite
- Weakness
Hycamtin (topotecan) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infections: repeated fevers, chills, cough, trouble breathing, severe diarrhea, vomiting, painful or frequent urination
- Serious bleeds: bleeding or bruising that doesn’t stop or go away, large amount of bleeding, blood in the urine, throwing up blood, bloody or black and tarry stool
- Lung problems: dry cough, chest pain, trouble breathing
The following Hycamtin (topotecan) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Black, tarry stools
bleeding gums
blood in the urine or stools
body aches or pain
chills
congestion
difficult or labored breathing
dryness or soreness of the throat
hoarseness
lower back or side pain
painful or difficult urination
pale skin
pinpoint red spots on the skin
tender, swollen glands in the neck
tightness in the chest
trouble in swallowing
troubled breathing with exertion
ulcers, sores, or white spots in the mouth
unusual bleeding or bruising
unusual tiredness or weakness
voice changes
Less common
Confusion
dizziness
fainting
fast heartbeat
lightheadedness
pain or cramping in the abdomen
rapid, shallow breathing
stomach pain
vomiting
Incidence not known
Cracked lips
dizziness
large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
pale skin, pain, or redness at the site of injection
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
severe bleeding
severe itching, skin rash
severe stomach pain
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
N/A
GoodRx discount
$201.54
Pros and cons of Hycamtin (topotecan)
Pros
- Taken by mouth
- Only need to take for 5 days out of each 21-day treatment cycle
- Recommended treatment option for small cell lung cancer if your cancer comes back after initial chemotherapy (relapse)
Cons
- Slightly more nausea, vomiting, and diarrhea compared to topotecan (Hycamtin) injection
- Raises your risk for infections, bleeding, or bruising
- Not available as a generic
Pharmacist tips for Hycamtin (topotecan)
- Swallow Hycamtin (topotecan) capsules whole. Don’t open, dissolve, or chew the capsules because the medication can cause serious harm if it’s not taken properly.
- Hycamtin (topotecan) can be taken with or without food. Try to take it around the same time each day.
- If you miss a dose of Hycamtin (topotecan) or vomit after a dose, don’t take another dose on the same day. Take your next dose as scheduled on the following day.
- You’ll need to get bloodwork done regularly while receiving this medication. Hycamtin (topotecan) can lower your blood cell counts and make you more at risk of bleeding or developing a serious infection. Follow the lab schedule your provider gives you. Depend on your blood cell count, your provider might need to adjust your dose of Hycamtin (topotecan) to minimize your risk of side effects.
- Tell your care team as soon as possible if you develop a fever while receiving Hycamtin (topotecan) treatment. This medication can make it more likely for you to get sick. When you’re receiving anticancer medication, sometimes fever can be the first (or only) sign that you’re sick.
- Store Hycamtin (topotecan) capsules in the refrigerator at 36° to 46°F (2° to 8°C), in its original container. If you live with other people, make sure they're aware of where your medication is stored and don't accidentally take it or touch it. Ask your provider or pharmacist if there are any other storage safety instructions for Hycamtin (topotecan).
- Tell your provider and pharmacist about all the medications you take, including supplements and over-the-counter medications, so they can help you check for interactions. For example, medications like cyclosporine modified (Neoral) and ketoconazole can raise Hycamtin (topotecan) levels in your body and put you at higher risk for side effects, such as nausea and diarrhea. Before starting any new medications, make sure your provider knows you're taking Hycamtin (topotecan).
- If you’re able to get pregnant, you should use birth control while receiving Hycamtin (topotecan) and for 6 months after the last dose. This medication can cause harm to an unborn baby.
- If you’re male and have a partner who can get pregnant, you should use birth control measures, such as condoms, while you’re receiving Hycamtin (topotecan) and for 3 months after your last dose. It’s possible for Hycamtin (topotecan) to cause harm to the unborn baby of your female partner if you’re taking this medication.
- Hycamtin (topotecan) might affect your ability to have a baby. If you or your partner are thinking about having a child in the future, talk to your provider about your different options before starting Hycamtin (topotecan), such as sperm banking or egg freezing.
- Ask your provider or pharmacist about the best way to handle and throw away Hycamtin (topotecan) safely. You or your caregiver should wear gloves when handling this medication. Make sure to wash hands before and after handling. Anticancer medications can be very harmful to people who handle or come into contact with them.
Risks and warnings for Hycamtin (topotecan)
Hycamtin (topotecan) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood cell count
Hycamtin (topotecan) can cause your red blood cells (RBCs), white blood cells (WBCs), and platelets counts to drop. When the number of these cells are lower than normal, you’re at risk of developing anemia, infections, and bleeding or bruising. In some cases, your blood cell counts might be low for a while. This is because your chemotherapy medications can weaken your bone marrow and affect its ability to make new blood cells like normal.
Your provider will closely check your blood cell counts through routine lab work when you’re receiving Hycamtin (topotecan). Let your provider know as soon as possible if you experience extreme tiredness, rapid breathing, fevers, chills, or bleeding and bruising that doesn’t stop or go away.
Diarrhea
Hycamtin (topotecan) can cause diarrhea. This usually happens within 5 to 9 days of treatment. In rare cases, the diarrhea can be severe enough that you might need to be hospitalized. Talk to your healthcare team if you develop diarrhea and be sure to stay well-hydrated. They can recommend antidiarrheal medications, such as loperamide (Imodium A-D) to help manage it. If your diarrhea doesn’t improve or gets worse, let your provider know right away. Your provider might need to lower your dose of Hycamtin (topotecan) or ask you to stop taking it temporarily.
Rare lung problems
- Risk factors: Lung cancer | Scarring of the lungs | Chest radiation |Taking medications that can harm the lungs or cause WBCs to grow (growth factors)
Let your provider know right away if you experience coughing or trouble breathing while receiving Hycamtin (topotecan). This medication can cause interstitial lung disease (ILD), a condition where there’s scarring on the lungs. If you develop these symptoms, your provider will need to examine you to figure out they’re caused by Hycamtin (topotecan) or an infection, and treat you accordingly. If you have ILD, your provider will likely stop this medication.
Harm to unborn baby
Based on animal studies, Hycamtin (topotecan) can harm an unborn baby. Because of this risk, regardless of your sex, you should use birth control during treatment with Hycamtin (topotecan) to prevent pregnancy. After the end of treatment, continue to use birth control for at least another 3 months (for males) or 6 months (for females). Let your provider know right away if you or your partner becomes pregnant during this time.
Hycamtin (topotecan) dosage
The average cost for 1 vial of 4mg of Hycamtin (topotecan) is $201.54 with a free GoodRx coupon.
Typical dosage for Hycamtin (topotecan)
Your provider will calculate your dose of Hycamtin (topotecan) based on your body surface area (BSA, in units of m2), which takes into account your body weight and height.
The typical dose is 2.3 mg/m2 by mouth daily for 5 days (Days 1 through 5) of each 21-day treatment cycle.
Interactions between Hycamtin (topotecan) and other drugs
Hycamtin (topotecan) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Hycamtin (topotecan). Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine, Live
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine
- Bacillus of Calmette and Guerin Vaccine, Live
- Capmatinib
- Cholera Vaccine, Live
- Darolutamide
- Dengue Tetravalent Vaccine, Live
- Enasidenib
- Influenza Virus Vaccine, Live
- Lasmiditan
- Leflunomide
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Teriflunomide
- Typhoid Vaccine, Live
- Venetoclax
- Yellow Fever Vaccine
How much does Hycamtin (topotecan) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
What are alternatives to Hycamtin (topotecan)?
There are a number of medications that your doctor can prescribe in place of Hycamtin (topotecan). Compare a few possible alternatives below.
News about Hycamtin (topotecan)
