Topotecan Injection   

This product is manufactured by Sandoz Canada Inc. using the ingredient topotecan.

This product is taken via intravenous injection.

Why is it prescribed?

Topotecan is used to treat sensitive small cell lung cancer after failure of first-line chemotherapy (defined as recurrence at least 60 days after first-line chemotherapy).

  • a temporary reduction in the amount of new blood cells produced by your body, particularly of a type of white blood cell which is important for your body to prevent and fight off an infection. In approximately 1 in 20 patients a serious infection is caught during treatment which can be fatal. If at any time during treatment you feel unwell or develop a temperature you should contact your doctor immediately.
  • you may become temporarily anemic and tired or take longer for a minor injury to stop bleeding. The reduction in the amount of blood cells (lasts for only a few days), starting from approximately day 8 of each treatment cycle and lasting for about a week. In most cases the level of blood cells return to normal in time for the next cycle of treatment.
  • Gastrointestinal perforations  have been reported with this medication. Your doctor will monitor you for the possibility of GI perforation if you experience symptoms of severe stomach pain, nausea, vomiting and/or bloody stool and will discontinue the medication if you have an intestinal perforation



See other products used in the treatment of •small cell lung cancer •

The dose is based on body size (surface area) and the results of blood tests carried out before treatment.
The recommended dose of topotecan is 1.5 mg/m2 (although this may vary) by intravenous infusion over 30 minutes daily for 5 consecutive days followed by 16 days without medication. This cycle is then repeated at least 3 more times.


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.

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


  • 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.





Page Last Updated: 05/10/2016