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 if you develop any of the following symptoms: unusual tiredness, pale skin, signs of infection (such as fever, chills, persistent sore throat), 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.Who should not take topotecan?
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 immediately and completely with soap and water. If the contents get into your eyes, mouth, or nose, flush immediately 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.
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.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: 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 -
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: blood/bone marrow disorders, kidney problems.
This drug may make you weak or tired. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
Topotecan can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. 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 the polio vaccine taken by mouth or 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 is not recommended for use during pregnancy. It may harm an unborn baby. Discuss reliable forms of birth control with your doctor. If you become pregnant or think you may be pregnant, tell your doctor immediately. Female patients should use reliable forms of birth control during and for 1 month after treatment with topotecan. Male patients and their female partner should use reliable forms of birth control during and for 3 months after treatment with topotecan since this medication may damage sperm.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
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.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Do not share this medication with others.
Laboratory and/or medical tests (such as complete blood count, kidney function test) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
If you miss a dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Store in the refrigerator between 36-46 degrees F (2-8 degrees C). Keep all medicines 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 for more details about how to safely discard your product.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised August 2014. Copyright(c) 2014 First Databank, Inc.
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