Topotecan – oral

Topotecan treats new found or relapsed small cell lung cancers using inhibitory properties of the drug.

Overview

It belongs to a group of cancer medicines known as antineoplastic, inhibiting cell growth and eventual elimination of the damaged cell. Like most cancer treatments, the distinction between healthy cells and cancer cells is difficult to control and the treatments produce some unwanted effects. The duration of these effects vary from person to person. One common effect of this treatment is hair loss, which usually grows back after treatments stop.

It’s used to treat small cell cancer of the lungs as the cells become abnormal and begin forming a tumor. The cells can spread to other parts of the body. The cause of small cell cancer is associated with a chosen lifestyle and work environments. Genetics can play a role in cell mutations that can lead to abnormal cell growth.

Topotecan has been successful in treatments and is approved by the U.S. Food and Drug Administration (FDA). There are warnings that it can decrease bone marrow - lowering red and white blood counts (both play a critical role in cancer recovery).

In most cases, our healthcare providers are aware of the risks, but there are known risks, since we are each unique and will react differently to treatment.

It is important to understand your condition, the risks and the benefits of taking this medication.

Condition(s) Treated

  • Small cell cancer
  • Non-small cell cancer
  • Ovarian tumors
  • Cervical Cancer

Type of Medicine

  • Antineoplastic or cancer medicine – oral route

Side Effects

Side effects occur with any form of medical treatments. The severity depends on the stage of cancer, the duration of treatment and the individual’s health. Medical professionals can provide some insight of these side effects, along with the level of severity in response to treatment. When they occur, medical attention is needed.

Some of these side effects are more common than others. Because side effects influence metabolic processes, existing health aliments or sensitivity to medicinal compounds can increase the severity of these side effects. For this reason, it is critical that you share your medical history with your doctor. Your doctor may prescribe compatible prescriptions to help alleviate some of the side effects.

These may occur shortly after the first treatment:

  • Constipation
  • Fatigue
  • Fever
  • Abdominal pain
  • Chest Pain
  • Bone pain
  • Weakness
  • Mouth sores or ulcers
  • Sore Throat
  • Poor appetite
  • Lower back or side pain
  • Difficulty breathing

Most common side effects – if you experience any of these – contact your doctor.

  • Black stools
  • Bleeding gums
  • Blood in the urine or stools
  • Chills
  • Cough
  • Fever
  • Painful or difficult urination
  • Pale skin
  • Red spots on the skin
  • Swollen glands
  • Excessive bruising

This health condition doesn’t disappear overnight and tests to determine the proper treatment need to be done. As the treatments stop, the side effects may diminish over time. Take the time to understand what your body is going through and how the treatment can affect you. Your doctor may have suggestions on how to prevent or reduce the harshness of side effects.

Varying levels based on the frequency of treatment and your body’s reaction:

  • Diarrhea
  • Hair loss or thinning
  • Loss of strength
  • Nausea
  • Vomiting
  • Weight loss
  • Dizziness

Since each person is different, there may be other side effects not listed. If you experience more discomfort, contact your doctor.

Dosage

Cancer treatments are formidable and intense when it comes to fighting this disease. It's one reason why the side effects vary so much compared to other medical treatments. Because the compounds are so strong, the risks can be higher – your doctor's prescription may differ from start to finish. It’s also why you will notice a closer relationship and tighter monitoring of the results during your treatment.

You should take this medicine as directed by your doctor, DO NOT alter the time or the dose – it may change the outcome and cause more serious side effects. Your doctor has based the treatment on the progression of the disease. The specific medication dose is taken orally for five consecutive days or as directed by your doctor. The fifth day is referred to as a cycle completion. The cycle is repeated every 21 days, depending on patient's status.

The dose is based on:

  • Your body size
  • Medication condition
  • Health status
  • Laboratory tests
  • Response to treatment

The time allowed between doses is specific – so is the duration of treatment, depending on current illness. If you have concerns, talk with your doctor. You can take this medication with or without food, but you must swallow the entire capsule. DO NOT open, crush or chew the capsule.

  • Wash your skin if you come in contact with the capsule’s contents – use soap and water.
  • Avoid contact with your eyes, mouth or nose – if it happens, flush the area with water for 15 minutes and contact your doctor at once.
  • Look for allergy reactions from skin contact – redness, burning sensation or swelling.

Be careful with this drug – if you experience vomiting after taking a dose, DO NOT take another dose. Contact your doctor or pharmacist. You need to keep the cycle schedule if possible. Your doctor may adjust the dose to help lessen the effects of nausea and vomiting for you.

  • If you are a caretaker and pregnant, DO NOT handle this medication.

Follow your doctor’s instructions – if your doctor changes the dose be sure to maintain the schedule. Because this medicine is concentrated, it is important that you DO NOT change the dose or schedule without your doctor’s approval.

Small cell lung cancer dose:

  • Adults – 2.3 milligrams per square meter of the body surface – once a day for five days.
  • Children – the attending physician prescribes the precise dose.

Interactions

There are several interactions with this medicine – the most predominate is its extent of bone marrow suppression or what the industry terms as myelosuppression. Here's the nonprofessional’s explanation:

  • Interruption of the bone marrow activity reduces the production of red and white blood cells and platelets.

The concern is when bone marrow fails - it triggers aplastic anemia, an autoimmune disease where the body mistakenly attacks and destroys healthy body tissue. The interactions are visible as symptoms begin appearing with the change in red and white blood cells and platelets:

  • Easy bruising
  • Nose, gums or mouth bleeding
  • Red spots on the skin
  • Fever and chills
  • Rash or diarrhea
  • Fatigue
  • Change in skin, lips and nailbed pigments

The second major interaction concern has to do with infectious diseases. Individuals with existing disorders being treated with this medicine may experience a life-threatening situation. The signs include:

  • Fever
  • Sore throat
  • Local infection during treatment

In this case, your doctor will need to monitor the status closely. In some situations, this medicine may not be the best treatment with existing health disorders. Other interactions involve allergies to the certain foods, dyes or preservatives – your sensitivities to these items may prompt a similar reaction to this medicine.

Family History

The full effect of using Topotecan with pediatric patients is still unknown – proceed with caution. Geriatric studies have limited results for using this medicine in the elderly – industry knowledge believes diarrhea, age and kidney problems may be precautionary issues for this age group. Nursing mothers are advised to notify your doctor, regarding passing on the chemical effects to the infant.

Drug Interactions

Over 290 brand and generic names are known to interact with Topotecan.

  • 35 major interactions
  • 211 moderate interactions
  • 46 minor interactions

Individuals undergoing treatment, currently participating in other health routines or taking prescriptions to support or correct additional ailments should use caution. Studies report differences in the interactions between drugs – although it does happen and the severity is not exact, there are still precautions when choosing to be treated with this medicine.

  • It is important that you talk to your doctor and that you understand the full extent of the interactions you are about to experience.

Listed below are vaccines that are not recommended when being treated with Topotecan.

  • Adenovirus Vaccine
  • Bacillus of Calmette and Guerin Vaccine
  • Cholera Vaccine
  • Influenza Virus Vaccine
  • Measles Virus Vaccine
  • Mumps Virus Vaccine
  • Poliovirus Vaccine
  • Rotavirus Vaccine
  • Rubella Virus Vaccine
  • Smallpox Vaccine
  • Varicella Virus Vaccine
  • Yellow Fever Vaccine

Additionally, these medicines may be required in some cases, yet they are not recommended for use when being treated with Topotecan due to the potential side effects. If the two medicines are prescribed, your doctor may need to adjust the dose or the frequency of the treatment cycle for one or both medicines.

  • Abiraterone
  • Amiodarone
  • Azithromycin
  • Captopril
  • Carboplatin
  • Carvedilol
  • Cisplatin
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Cyclosporine
  • Diltiazem
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Eliglustat
  • Eltrombopag
  • Erythromycin
  • Felodipine
  • Filgrastim
  • Itraconazole
  • Ivacaftor
  • Ketoconazole
  • Lomitapide
  • Lopinavir
  • Nilotinib
  • Quercetin
  • Quinidine
  • Ranolazine
  • Ritonavir
  • Simeprevir
  • Sofosbuvir
  • Sunitinib
  • Telaprevir
  • Ticagrelor
  • Tocophersolan
  • Typhoid Vaccine
  • Velpatasvir
  • Verapamil

Lifestyle Interactions

Medicines contain chemical elements that do affect the performance and outcome for many health disorders. At the same time, how we choose to live our lives can have similar effects when we are treated with Topotecan.

For example, cert foods or specific times of consumption can affect the absorption of the medicine, delay the biological process or completely change how our metabolic functions respond. Consuming alcohol or partaking in tobacco with certain medicines will also alter the intended results.

  • Be sure to ask your doctor about the consequences should you decide to continue any of these lifestyle choices while undergoing treatment.

Existing Medical Problems

Our lives are filled with medical and health situations, each one may be affected for better or worse when combined with treatments and multiple medicines. Major concerns and the development of serious health disorders subjected to consequences when taking Topotecan include:

  • Interstitial lung disease
  • Kidney disease

Warnings

Topotecan has very specific effects for all individuals taking this medication as treatment:

  • Temporarily lowers white and red blood cell count – lowering your ability to fight infection.
  • Reducing the number of platelets – stopping the natural process of blood clotting.

You need to be careful with your surroundings – you’ll want to avoid other individuals with infections, since your body’s ability to fight is much weaker than usual. You want to avoid injuring yourself, group activities or sports. Pay attention - accidentally bumping into things can cause unnecessary bleeding.

  • Check with your doctor if you notice bruises that don’t go away.
  • If you find yourself with fevers, coughs or pain – you may have the beginnings of an infection.

Some medications have adverse effects during and after treatment – they also affect other aspects of our lives, from fertility, pregnancy and nursing infants. If you are pregnant, talk with your doctor – Topotecan can harm your unborn baby. If you become pregnant during treatment, notify your doctor at once.

Daily Routines

Simple tasks like brushing your teeth can cause abnormal bleeding of your gums. Be careful when using a toothpick and dental floss. Talk with your dentist – they can make recommendations of safer methods for cleaning your teeth and gums.

  • Be sure to advise your doctor of any health procedures when undergoing treatment. They may have an adverse effect on your health.

Personal Hygiene

While taking Topotecan, you need to take extra precaution – always wash your hands. Germs can travel ad multiple easy when our body’s defense is low. Ordinary habits like wiping your nose with a sneeze or rubbing your eyes can transfer germs quickly.

  • No shop manicures, be careful shaving or even clipping fingernails – seems easy enough, yet these actions can heighten the possibilities of getting an infection.

Metabolic Processes

Topotecan causes diarrhea, it may vary in some patients, but it is more common to be severe – dehydrating your body quickly. DO NOT take any form of medication, home remedy or supplements to sooth this condition. The methods may only make the situation worse - contact your doctor, they may have suggestions of other medications or over-the-counter remedies that work with Topotecan.

It is also known to cause severe fatigue, most likely due to the abnormal chemical reactions that hinder metabolic processes. Your goal is to stay as healthy as possible throughout treatments for small cell cancer.

Storage

All medications should be stored out of reach of children and pets. To keep the medicine operative it should be stored in the container at room temperature, away from heat, moisture and light. Topotecan has a sensitivity when coming in contact with the skin – it should be handled with care when dispensing.

  • DO NOT open, crush or chew the capsule. Have a full glass of water ready to swallow the capsule in a single gulp of water.

All medications have expiration dates – DO NOT keep outdated medicine or medicines no longer needed. DO NOT flush medications – simply ask your doctor, pharmacist or hospital to dispose of the medication properly for you.

Summary

At some point in all of our lives, medications become necessary to make us feel better, eliminating pain and the symptoms that come with health disorders. Each medication has proven to provide the elements needed to fight against disease – yet they also carry risks that can be dangerous to our overall health. For some, the risks of Topotecan are as simple as an upset stomach, while other risks cause us to review the benefits.

In order to minimize the risks of Topotecan we rely on several sources for information – our doctor, health organizations like the FDA and our pharmacist. They offer valuable information that not only protects our health; they help with making decisions before we start treatment and throughout the cycle.

Resources
Last Reviewed:
December 25, 2017
Last Updated:
December 22, 2017
Content Source: