Topotecan

(Topotecan) This medication is used to treat small cell lung cancer. It works by killing cancer cells or slowing their growth.

Read the Patient Information Leaflet provided by your pharmacist before you start taking topotecan and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Take this medication by mouth, usually once daily for 5 days or as directed by your doctor. Each 5-day treatment period is called a cycle. You will usually repeat this cycle every 21 days. The dosage is based on your body size, medical condition, laboratory tests, and response to treatment. Take this medication with or without food. Swallow the capsules whole. Do not open, crush, or chew the capsules. If the capsule contents touch your skin, wash the skin right away and completely with soap and water. If the contents get into your eyes, mouth, or nose, flush right away with water for at least 15 minutes. Consult your doctor if you have redness/burning/swelling on the area of skin the contents touched or if the contents get into your eyes. If you vomit after taking a dose, do not take another dose at that time. Take your next dose on your usual dosing schedule. All people should wash their hands carefully after handling this drug. Women who are pregnant or who may become pregnant should not handle this medication.

Before using topotecan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems. This drug may make you feel weak or tired. Alcohol or marijuana (cannabis) can make you more tired. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis). Topotecan can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details. Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose). To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports. Older adults may be more sensitive to the effects of this drug, especially diarrhea and decreased bone marrow function. This medication can affect fertility in both males and females. Ask your doctor for more details. Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using topotecan. Topotecan may harm an unborn baby. Ask your doctor about reliable forms of birth control. Females should use birth control during treatment and for 6 months after stopping this drug. Males should use birth control during treatment and for 3 months after stopping this drug. If you or your partner become pregnant, talk to your doctor right away about the risks and benefits of this medication. It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding is not recommended while using this drug and for 1 week after stopping this drug. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Other medications can affect the removal of topotecan from your body, which may affect how topotecan works. Examples include azole antifungals (such as ketoconazole), cyclosporine, macrolide antibiotics (such as erythromycin), HIV protease inhibitors (such as ritonavir), among others.

Topotecan decreases bone marrow function. This effect may lead to a low number of blood cells such as red cells, white cells, and platelets. A low number of blood cells can cause anemia, decrease your body's ability to fight an infection, or cause your body to bruise or bleed more easily. Tell your doctor right away if you develop any of the following symptoms: unusual tiredness, pale skin, signs of infection (such as sore throat that doesn't go away, fever, chills), easy bruising/bleeding. Your doctor will order frequent blood tests to monitor your bone marrow function while you are taking this medication. Keep all medical and laboratory appointments.

If you miss a dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

See also Warning section. Nausea, vomiting, diarrhea, tiredness, loss of appetite, weakness, and fever may occur. If these effects persist or worsen, tell your doctor or pharmacist promptly. Nausea and vomiting can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. Diarrhea can also be severe and may require treatment in a hospital. Tell your doctor right away if you have any diarrhea with fever, diarrhea with stomach pain, or diarrhea 3 or more times a day. Temporary hair loss may occur. However, normal hair growth should return after treatment has ended. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: lung problems (such as cough, shortness of breath). A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Store in the refrigerator. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.