Search
topotecan (Hycamtin, SKF-104864A, Topo, TPT)
Tradename: Hycamtin.
Indications:
- treatment of metastatic ovarian cancer
- after failure of initial therapy
- treatment of recurrent & stage IVB cervical cancer in combination with cisplatin
- ONLY if patient has NOT previously received cisplatin (NGC NICE)
- relapsed small-cell lung cancer
- oral topotecan, IV not recommmended
- Ewing sarcoma [2]
- osteosarcoma [2]
Contraindications:
1) pregnant or breast-feeding women
2) severe bone marrow suppression Lyophilized powder:
1) store at room temperature & protect from light
2) reconstitute with 4 mL sterile water for injection (SWI)
3) further dilute in 100 mL D5W
4) 2.5 mg/mL + 50 mg of mannitol, pH = 3.5 when reconstituted with 2 mL sterile water for injection (SWI)
5) 4 mg base/vial (as HCl)
Monitor:
1) complete blood count (CBC)
2) renal function tests
Adverse effects:
1) common (> 10%)
- headache, alopecia (reversible), nausea/vomiting, diarrhea, myelosuppression
2) less common (1-10%)
- paresthesia, dyspnea
3) uncommon (< 1%)
- mild erythema & bruising
4) other
- emetic potential is moderately low (10-30%)
- myelosuppression
- dose-limiting toxicity
- WBC mild to severe, platelets mild at low doses
- nadir 8-11 days
- recovery 14-21 days
- may cause permanent sterility
Drug interactions:
1) increased toxicity with filgastim (G-CSF)
2) coadministration with other antineoplastic agents is associated with increased morbidity & mortality (i.e. cisplatin)
Laboratory:
- topotecan in serum/plasma
Mechanism of action:
- inhibits topoisomerase-1
General
topoisomerase-1 inhibitor
Properties
MISC-INFO: pregnancy-category D
Database Correlations
PUBCHEM correlations
References
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998 Health and Clinical Excellence (NICE)
ngc-guideline: 15543
- Deprecated Reference