topotecan

Posted on December 4th, 2008 by

Class: Chemotherapy

Generic Name: Topotecan (toe-poe-TEE-kan)
Trade Name: Hycamtin®

How is this drug used? Topotecan is FDA approved for the treatment of ovarian cancer and small-cell lung cancer, both of which have stopped responding to prior therapies. Topotecan is also approved for the treatment of cervical cancer in combination with Platinol® (cisplatin) in patients who have received at least one prior therapy. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Topotecan is classified as a topoisomerase inhibitor. Topotecan produces its anti-cancer effects by inhibiting an enzyme, topoisomerase, which is responsible for maintaining structural function and integrity of DNA. By inhibiting the normal activity of topoisomerase, topotecan ultimately causes cellular death.

How is topotecan given (administered)? Topotecan is administered into a vein (intravenous), and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used, and the overall health of the patient.

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with topotecan.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.

What are the common (occur in 30% or more of patients) side effects of treatment with topotecan?

• Low levels of white blood cells – increases risk of infection
• Low levels of red blood cells – increases risk of anemia
• Low levels of platelets – increases risk of bleeding
• Hair loss
• Nausea and vomiting
• Diarrhea

What are the less common (occur in 10% to 29% of patients) side effects of treatment with topotecan?

• Constipation
• Fatigue or weakness
• Fever
• Abdominal pain
• Bone pain
• Back pain
• Mouth sores
• Poor appetite
• Rash
• Shortness of breath
• Cough
• Headache

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, patients should avoid large crowds or persons who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
• Eat small meals frequently to help alleviate nausea.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Patients should use caution when driving or completing tasks that require mental alertness until effects of the drug are known

When should patients notify their physician?

• Severe abdominal pain
• Flu or cold-like symptoms - fever, chills, sore throat, cough
• Signs of infection – redness, swelling, pus, tenderness, painful urination
• Unexplained or excessive bleeding (nosebleeds, bruising, black tarry stools, blood in the urine, etc.)
• Persistent or severe fatigue
• Shortness of breath
• Persistent or extreme nausea or vomiting
• Persistent or extreme diarrhea
• Mouth sores
• Constipation
• Pain, swelling or redness at infusion site
• Skin rash, itching
• Allergic reaction

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2016 CancerConnect Last updated 07/10.

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Tags: Chemotherapy, Drug Dictionary, T

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