Topotecan is used to treat small cell lung cancer (a type of cancer that begins in the lungs) that was successfully treated with a different chemotherapy medication but has returned no sooner than 45 days after the last dose of the first chemotherapy medication was taken.

Topotecan is in a class of medications called topoisomerase I inhibitors. It works by killing cancer cells.

Side Effects Of Topotecan

Topotecan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • vomiting
  • diarrhea
  • loss of appetite
  • hair loss

Some side effects can be serious. If you experience any of these symptoms or those listed in the WARNINGS AND PRECAUTIONS sections, call your doctor immediately:

Topotecan may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Warnings & Precautions

Before taking topotecan:

  • tell your doctor and pharmacist if you are allergic to topotecan, any other medications, or any of the ingredients in topotecan capsules. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: cyclosporine (Gengraf, Neoral, Sandimmune); ketoconazole (Nizoral); ritonavir (Norvir, in Kaletra); or saquinavir (Fortovase, Invirase). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had kidney disease.
  • tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while you are taking topotecan. Talk to your doctor about birth control methods that you can use during your treatment. If you become pregnant while taking topotecan, call your doctor immediately. Topotecan may harm the fetus.
  • tell your doctor if you are breast-feeding. You should not breast-feed while you are taking topotecan.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking topotecan.
  • you should know that topotecan may make you drowsy, tired, or weak. Do not drive a car, use heavy tools, or operate machinery until you know how this medication affects you.
  • you should know that topotecan can cause severe diarrhea that may need to be treated in a hospital. Talk to your doctor about how to prevent and treat diarrhea. Call your doctor right away if you have any of the following symptoms: diarrhea with fever, diarrhea 3 or more times a day, or diarrhea with stomach pain or cramps.

Topotecan Dosage

Topotecan comes as a capsule to take by mouth. It may be taken with or without food. It is usually taken once a day for 5 days in a row every 21 days. Your doctor will decide how many times you should repeat this cycle. Take topotecan at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take topotecan exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole with water; do not open, chew, or crush them.

Topotecan capsules come in two different strengths. Your doctor may want you to take a combination of both strengths of capsules to make up your full dose. Be sure that you know what each type of capsule looks like and how many you are to take of each. Ask your doctor or pharmacist if you have any questions.

If any of the capsules are broken or leaking, do not touch them with your bare hands. Carefully dispose of the broken capsules without touching them directly and then wash your hands well with soap and water. If the capsule contents do touch your skin, wash the area well with soap and water right away. If any capsule contents get in your eyes, wash your eyes right away with gently flowing water for at least 15 minutes. Call your doctor if you have any skin reaction or if the medication gets in your eyes.

You may vomit after you take the medication. If this happens, let your doctor know right away. Do not take another dose of topotecan on the same day.

Your doctor may need to delay your treatment or adjust your dose if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with topotecan.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.


Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.