topotecan
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.
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.
Drug facts
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.
Less Common Side Effects
- Difficulty breathing
- Tiredness or weakness
- Diarrhea or constipation
- Stomach pain
- Blockage in the intestine
- Pain
- Infections
Topotecan (Hycamtin) 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 Topotecan (Hycamtin) 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
Pros and cons of Topotecan (Hycamtin)
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
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 for Topotecan (Hycamtin)
- 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.
Common questions about Topotecan (Hycamtin)
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.
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.
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.
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).
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).
How to save using GoodRx
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.
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.
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.
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.
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.
Topotecan (Hycamtin) dosage
Typical dosage 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 between Topotecan (Hycamtin) and other drugs
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 Topotecan (Hycamtin) cost?
What are alternatives to Topotecan (Hycamtin)?
