Precautions and Warnings With Topotecan

Prior to taking topotecan, make sure your healthcare provider is aware of any other medical conditions you have, such as a history of lung problems, any kind of infection, or any bleeding. Other precautions and warnings with topotecan involve potential drug interactions, an increased risk of potentially serious (and even life-threatening) side effects, and the danger of using this medication while pregnant or breastfeeding.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking topotecan (Hycamtin®) if you have:
 
  • Any infection
  • Kidney disease, such as kidney failure (renal failure)
  • Any bleeding
  • A history of interstitial lung disease (ILD)
  • Pulmonary fibrosis
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Topotecan Warnings and Precautions

Some warnings and precautions to be aware of prior to taking this medicine include the following:
 
  • Topotecan can decrease the bone marrow's ability to produce blood cells. This can result in anemia and other serious conditions. Because your immune system depends on certain blood cells, you may be more susceptible to infections while taking topotecan (see Chemotherapy and Infections). You may also be at a higher risk for bleeding (see Blood Clotting Problems and Chemotherapy). You will need regular blood tests to make sure your blood counts are not too low.
     
  • There have been reports of interstitial lung disease (ILD) in people taking topotecan. The risk appears to be greater in people with pulmonary fibrosis, lung cancer, radiation to the chest, or a history of ILD. Other medications or conditions that cause lung damage might also increase the risk of this problem with topotecan. Let your healthcare provider know if you develop any signs or symptoms of ILD, such as:
     
    • Coughing
    • Fever
    • Shortness of breath.
 
  • Let your healthcare provider know if you experience any diarrhea (even if minor) while taking this medication. Catching this problem early can help avoid serious and possibly life-threatening complications.
     
  • Like most chemotherapy medications, topotecan often causes nausea and vomiting. Your healthcare provider should consider giving you medications before and after your topotecan dose, in order to prevent and treat nausea and vomiting (see Chemotherapy and Nausea).
     
  • Topotecan can interact with other medications (see Drug Interactions With Topotecan).
     
  • Topotecan is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug during pregnancy (see Topotecan and Pregnancy).
     
  • It is unknown if topotecan passes through breast milk in humans. It is usually recommended that women should not breastfeed while receiving topotecan treatment (see Topotecan and Breastfeeding).
     
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Topotecan Chemotherapy Information

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