More common side effects that do not require medical attention unless bothersome:

• appetite loss
• burning or tingling in the hands or feet
• constipation
• diarrhea
• fatigue
• headache
• nausea and vomiting
• redness or bruising at site of the injection
• temporary hair loss
• weakness

Contact your doctor if any of the following side effects occur:

• abdominal or stomach pain
• sores or white spots on the lips, tongue, or inside the mouth
• unusual fatigue or weakness

The following side effects could indicate serious complications. Seek immediate medical attention if any of the following occur:

• black or tarry stools or blood in urine
• cough or hoarseness with fever or chills
• fever or chills
• irregular or fast breathing
• large welts on the face, eyelids, mouth, lips, or tongue
• lower back or side pain with fever or chills
• painful or difficult urination with fever or chills
• pinpoint red spots on skin
• puffiness or swelling of the eyelids or around the eyes
• shortness of breath
• unusual bleeding or bruising
• wheezing or tightness in chest

Topotecan belongs to the group of cancer-fighting medications known as antineoplastics. It kills cancer cells by interfering with the genetic material DNA, which is necessary for their growth and reproduction.

Do not take topotecan if:

• you have severe kidney disease.
• you have severe bone marrow depression

For both men and women: Do not conceive a child (get pregnant) while taking topotecan. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

Drug interactions: There may be an interaction between topotecan and any of the following:

• amiodarone
• atorvastatin
• carvedilol
• cisplatin
• clarithromycin
• clozapine
• cobicistat
• cyclosporine
• denosumab
• dipyridamole
• echinacea
• erythromycin
• filgrastim
• gefitinib
• grapefruit juice
• imatimib
• itraconazole
• ketoconazole
• leflunomide
• live vaccines (e.g., yellow fever, BCG, measles - mumps - rubella [MMR])
• mefloquine
• natalizumab
• pantoprazole
• phenytoin
• pimecrolimus or tacrolimus
• progesterone
• propranolol
• protease inhibitors (e.g., atazanavir, indinavir, nelfinavir, ritonavir)
• quinine and quinidine
• roflumilast
• tamoxifen
• verapamil

Use in pregnancy:  There is a possibility of birth defects with topotecan. Effective birth control should be practiced while using this medication. 

Use in breastfeeding: It is not known if topotecan passes into breast milk. At this time, breastfeeding is not recommended.