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topotecan

Generic Hycamtin
Used for Lung Cancer, Ovarian Cancer, Cervical Cancer
Used for Lung Cancer, Ovarian Cancer, Cervical Cancer

Topotecan (Hycamtin) is an anticancer treatment option used for certain types of ovarian cancer, cervical cancer, and small cell lung cancer (SCLC). It can be used by itself or in combination with other anticancer medications. Topotecan (Hycamtin) is given as an infusion through the vein by a healthcare provider. It’s a recommended treatment option for certain cancers in adults, but can raise your risk for serious infections and bleeding.

Reviewed by:
reviewer
Jenny Zhang, PharmD, BCOP
reviewer
Connie Zheng, PharmD
Last reviewed on June 25, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesLatest newsReferencesPricesMedicare
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What is Topotecan (Hycamtin)?

What is Topotecan (Hycamtin) used for?

  • Metastatic ovarian cancer that continued to spread after other chemotherapy

  • Platinum-sensitive small cell lung cancer (SCLC) that continued to spread after other chemotherapy

  • Advanced cervical cancer, along with cisplatin (Platinol)

How Topotecan (Hycamtin) works

Topotecan (Hycamtin) is a type of anticancer medication called a topoisomerase I inhibitor. It prevents cancer cells from growing and damages the cancer cells’ genetic material, which leads to cell death.

Are you looking for information on Hycamtin (topotecan) capsules instead?

Drug Facts

Common BrandsHycamtin
Drug ClassTopoisomerase I inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the side effects of Topotecan (Hycamtin)?

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 (70-80%)
  • Fever (23-28%)
  • Nausea (8-10%)
  • Vomiting (10%)
Please note: These side effects were reported by people who took topotecan (Hycamtin) alone in clinical studies. The side effects you experience might differ if you’re receiving it along with other anticancer medications.

Other Side Effects

  • Difficulty breathing
  • Tiredness or weakness
  • Diarrhea or constipation
  • Stomach pain
  • Blockage in the intestine
  • Pain
  • Infections

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

Source: DailyMed

The following 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

chest pain

chills

congestion

cough

difficult or labored breathing

dryness or soreness of the throat

fever

hoarseness

lower back or side pain

painful or difficult urination

pale skin

pinpoint red spots on the skin

runny nose

sneezing

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

diarrhea

dizziness

fainting

fast heartbeat

lightheadedness

nausea

pain or cramping in the abdomen

rapid, shallow breathing

stomach pain

vomiting

Incidence not known

Cracked lips

dizziness

hives, itching, skin rash

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:

Less common

Bone or back pain

constipation

lack or loss of strength

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.

pros-and-cons

Pros and cons of Topotecan (Hycamtin)

thumbs-up

Pros

Recommended treatment option for certain types of ovarian cancer, cervical cancer, and small cell lung cancer

Less risk of diarrhea compared to oral Hycamtin (topotecan) capsules

Very low risk of hair loss

thumbs-down

Cons

Can raise your risk for infections, bleeding, or bruising

Can make you feel dizzy or weak

Can affect your ability to have children in the future

pharmacist-tips

Pharmacist tips for Topotecan (Hycamtin)

pharmacist

  • You’ll need to get bloodwork done regularly while receiving this medication. Topotecan (Hycamtin) can lower your blood cell counts and make you more at risk of bleeding or developing an infection. Follow the lab schedule your provider gives you. Tell your care team if you develop a fever.

    • You might feel more tired or weak while receiving treatment with topotecan (Hycamtin). Avoid activities that require you to be alert (like driving) until you know how this medication affects you.

      • If you’re able to become pregnant, you should use birth control while receiving topotecan (Hycamtin) 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 topotecan (Hycamtin) and for 3 months after your last dose. It’s possible for topotecan (Hycamtin) to cause harm to the unborn baby of your female partner if you’re taking this medication.

          • Topotecan (Hycamtin) 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 topotecan (Hycamtin), such as sperm banking or egg freezing.

            faqs

            Frequently asked questions about Topotecan (Hycamtin)

            Is topotecan (Hycamtin) a recommended treatment option for my cancer?
            Topotecan (Hycamtin) is a recommended treatment option for certain types of ovarian cancer, cervical cancer, and small cell lung cancer (SCLC). Usually, topotecan (Hycamtin) can be used after your cancer stops responding to, spreads, or comes back, after treatment with a first-choice chemotherapy option for these types of cancers. But topotecan (Hycamtin) is considered a first-choice option for treating cervical cancer in combination with other chemotherapy. Your provider will choose the most appropriate option for you depending on many factors, including your age, kidney and liver health, potential side effects, and how well you’ll tolerate chemotherapy. Talk with your provider if you have any questions about the benefits and risks with any of the treatment options.
            How can I prevent an infection while receiving topotecan (Hycamtin)?
            There are many ways you can lower your chances of developing an infection while you’re receiving topotecan (Hycamtin). For example, wash your hands often with soap, especially before eating, after using the bathroom, or after touching things like door knobs. If you can, avoid crowded places and people who are sick. But if you need to be around crowds, it’s best to wear a mask. To avoid food-borne illnesses, make sure to wash raw fruits and vegetables before eating, and cook foods thoroughly. It’s important to follow these tips during topotecan (Hycamtin) treatment because the medication weakens your immune system, and makes you more likely to develop a serious infection. Let your provider know right away if you have any signs of an infection, such as fever, tiredness, or chills.
            Can topotecan (Hycamtin) cause hair loss?
            Topotecan (Hycamtin) can cause hair loss and hair thinning because it damages your hair follicles. But not everyone will experience this side effect. According to clinical studies, 10-20% of people who took topotecan (Hycamtin) reported hair loss, but most of the time it was mild. For people who did experience hair loss, it typically starts 3 to 4 weeks after the first dose. This side effect is usually temporary and hair typically grows back after you’re done with the treatment. If you’re concerned about hair loss from topotecan (Hycamtin), talk with your provider about how to minimize this side effect. They might recommend that you try a cooling cap, or give you tips on proper hair care during chemotherapy.
            Is topotecan (Hycamtin) safe if I have kidney problems?
            If you have kidney problems, you might be at higher risk for side effects from topotecan (Hycamtin). Typically, the kidneys help get rid of topotecan (Hycamtin) from the body through urine. But if you have kidney problems, your body will have a hard time getting rid of the medication. This can lead to higher levels of the medication in your body and higher risk of side effects, such as risk of infection, nausea, vomiting, and diarrhea. Let your provider know if you have problems with your kidneys, as you’ll need to be monitored more closely and might need a lower dose of topotecan (Hycamtin).
            Is topotecan (Hycamtin) safe while breastfeeding?
            You shouldn’t breastfeed while receiving topotecan (Hycamtin) and for one week after the last dose. It’s unclear whether this medication passes into human breast milk. But if it does, it can cause serious harm to nursing babies. Talk to your provider if you have any questions about other ways to feed your baby while receiving topotecan (Hycamtin).
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            What are the risks and warnings for Topotecan (Hycamtin)?

            Topotecan (Hycamtin) 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.

            risk-warning

            Low blood cell counts

            Topotecan (Hycamtin) can cause your red blood cell (RBC) count, white blood cell (WBC) count, and platelet counts to drop. When the number of these cells are lower than normal, you’re at risk of developing anemia, serious infections, and bleeding or bruising. This is because your chemotherapy medications can weaken your bone marrow and affect its ability to make new blood cells like normal. Drops in blood cell count are most common during the first treatment cycle, but can happen at any time.

            Your provider will closely check your blood cell counts through routine lab work when you’re receiving topotecan (Hycamtin). If your levels are too low, they might need to lower your dose or pause the treatment. 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.

            risk-warning

            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 topotecan (Hycamtin). 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 topotecan (Hycamtin) or an infection, and treat you accordingly. If you have ILD, your provider will likely stop this medication.

              risk-warning

              Skin or tissue injury

              If topotecan (Hycamtin) leaks out of the veins while you receive your infusion, it can irritate and cause damage to the surrounding tissue, muscle, or skin. Usually, this can be avoided by proper administration of the medication. However, there is still a small risk of this happening. Let your provider or nurse know right away if you feel pain, swelling, or burning around the IV site.

              risk-warning

              Harm to unborn baby

              Based on animal studies, topotecan (Hycamtin) can harm an unborn baby. Because of this risk, if you or your partner can become pregnant, you should use birth control during treatment with topotecan (Hycamtin) to prevent pregnancy. After treatment, continue to use birth control for 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.

              dosage

              Topotecan (Hycamtin) dosage forms

              Typical dosing for Topotecan (Hycamtin)

              Topotecan (Hycamtin) is an injection into a vein (intravenous, IV) that’s given by a healthcare provider. Your provider will calculate your dose of topotecan (Hycamtin) using your body surface area (BSA, in units of m2), which takes into account your body weight and height.

              • Ovarian cancer and SCLC: The typical dose is 1.5 mg/m2 daily for 5 days (Days 1 through 5) of each 21-day treatment cycle.

              • Cervical cancer: The typical dose is 0.75 mg/m2 daily for 3 days (Days 1 through 3) of each 21-day treatment cycle.

              interactions

              Interactions between Topotecan (Hycamtin) and other drugs

              Topotecan (Hycamtin) 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 Topotecan (Hycamtin). 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.

              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.

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              alternatives

              What are alternatives to Topotecan (Hycamtin)?

              There are a number of medications that your doctor can prescribe in place of Topotecan (Hycamtin). Compare a few possible alternatives below.
              Topotecan (Hycamtin)
              Used for:

              • Metastatic ovarian cancer that continued to spread after other chemotherapy

              • Platinum-sensitive small cell lung cancer (SCLC) that continued to spread after other chemotherapy

              • Advanced cervical cancer, along with cisplatin (Platinol)

              $51.50 Lowest GoodRx priceView Prices
              Hycamtin (topotecan)
              Used for:

              • Advanced small cell lung cancer (SCLC) that continued to spread after other chemotherapy

              $51.50 Lowest GoodRx priceView Prices

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              References

              Best studies we found

              Accord Healthcare, Inc. (2022). Topotecan hydrochloride injection, powder, lyophilized, for solution [package insert]. DailyMed.

              American Cancer Society. (2018). What is ovarian cancer?

              American Cancer Society. (2019). Low red blood cell counts (anemia).

              View All References (14)

              American Cancer Society. (2020). Low platelet count (bleeding).

              American Cancer Society. (2020). Preserving fertility in males with cancer.

              American Cancer Society. (2022). Cooling caps (scalp hypothermia) to reduce hair loss.

              American Cancer Society. (2023). If you have small cell lung cancer.

              American Cancer Society. (2023). Low white blood cell counts (neutropenia).

              American Cancer Society. (2023). Watching for and preventing infections.

              American Cancer Society. (2023). What is cervical cancer?

              Centers for Disease Control and Prevention. (2020). Preventing infections in cancer patients.

              Ewesuedo, R. B., et al. (1997). Topoisomerase I inhibitors. The Oncologist.

              Markman, M., et al. (2000). Second-line treatment of ovarian cancer. The Oncologist.

              National Cancer Institute. (n.d.). Extravasation.

              National Comprehensive Cancer Network. (2022). Small cell lung cancer.

              Pommier, Y. (2009). DNA topoisomerase I inhibitors: Chemistry, biology, and interfacial inhibition. Chemical Reviews.

              Robati, M., et al. (2008). A review of topotecan in combination chemotherapy for advanced cervical cancer. Therapeutics and Clinical Risk Management.

              GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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