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Topotecan PhaRes is indicated for:
Pharmacology
Topotecan works in the same way as irinotecan. It is believed to damage cells mainly during the S-phase of DNA synthesis. Topoisomerase I eases the torsional strain in DNA by making reversible single strand breaks. Topotecan binds to the topoisomerase I-DNA complex and stops these single strand breaks from being religated.
The resulting ternary complex gets in the way of the moving replication fork. This leads to replication arrest and to lethal double-stranded breaks in DNA. Mammalian cells can't repair these double strand breaks efficiently, so the formation of the ternary complex eventually leads to apoptosis (programmed cell death).
Topotecan mimics a DNA base pair and binds at the site of DNA cleavage, where it intercalates between the upstream (-1) and downstream (+1) base pairs. This intercalation displaces the downstream DNA, so the cleaved strand can't be religated. Because Topotecan binds specifically to the enzyme-substrate complex, it acts as an uncompetitive inhibitor.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Check the dose against the patient's body surface area before dispensing Topotecan. The dose should generally not exceed 4 mg intravenously.
For ovarian cancer, the recommended dose is 1.5 mg/m² by intravenous infusion over 30 minutes, given daily for 5 consecutive days, starting on Day 1 of a 21-day course. Small cell lung cancer has the same dose of 1.5 mg/m² by intravenous infusion over 30 minutes daily for 5 consecutive days, starting on Day 1 of a 21-day course.
For cervical cancer, the recommended dose of Topotecan is 0.75 mg/m² by intravenous infusion over 30 minutes daily on Days 1, 2 and 3. It is given in combination with cisplatin 50 mg/m² on Day 1, and the course is repeated every 21 days.
Side Effects
Topotecan can cause neutropenia, with the lowest white cell count about 9 to 12 days after administration. Thrombocytopenia and anaemia can also occur. Other effects are GI upset, total alopecia, headache and dyspnoea. Some people feel fatigue, weakness or malaise, and pruritus and hyperbilirubinaemia are also seen.
Cautions & Contraindications
Warnings & Precautions
Take care with Topotecan if the person already has bone marrow depression. Blood cell counts in the peripheral blood need to be checked often during treatment. Don't start the next course until neutrophils have recovered to above 1000 cells/mm3, platelets to above 100,000 cells/mm3, and haemoglobin to 9.0 g/dl (with a transfusion if needed). Topotecan may also affect the ability to drive or operate machinery.
Contraindications
Topotecan must not be used in severe bone marrow depression, for example a baseline neutrophil count below 1500 cells/mm3 or a platelet count below 100,000/mm3. It is also contraindicated in pregnancy, in breastfeeding, and in severe renal or hepatic impairment.
Pregnancy & Breastfeeding
Topotecan is in pregnancy category D. This means there is positive evidence of risk to the human foetus. Even so, a pregnant woman may still receive it if the benefit is acceptable despite that risk, for example when the medicine is needed in a life-threatening situation, or for a serious disease where safer drugs cannot be used or don't work.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Renal Impairment
For ovarian carcinoma and small cell lung cancer, when CrCl is 20 to 30, start Topotecan at 0.75 mg/m2. For cervical cancer, begin treatment only if serum creatinine is ≤1.5 mg/dl.
Hepatic Impairment
Avoid Topotecan.
Storage
Keep unopened Topotecan vials at 20-25°C and protect them from light. Once the solution has been reconstituted, it stays stable for 24 hr at 20-25°C in ambient light.
Drug Interactions
Common questions about Topotecan PhaRes 4 mg/4 ml
What is Topotecan PhaRes 4 mg/4 ml Injection?
Topotecan PhaRes 4 mg/4 ml Injection is a medicine that contains Topotecan. It is made by ZAS Corporation. It belongs to the Cytotoxic Chemotherapy group of medicines.
What is Topotecan PhaRes used for?
Topotecan PhaRes is used for: Cancer.
What are the side effects of Topotecan PhaRes?
Topotecan can cause neutropenia, with the lowest white cell count about 9 to 12 days after administration. Thrombocytopenia and anaemia can also occur.
Can I take Topotecan PhaRes during pregnancy or while breastfeeding?
Topotecan is in pregnancy category D. This means there is positive evidence of risk to the human foetus. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Topotecan PhaRes?
Keep unopened Topotecan vials at 20-25°C and protect them from light. Once the solution has been reconstituted, it stays stable for 24 hr at 20-25°C in ambient light.
Can I take other medicines with Topotecan PhaRes?
Some medicines can interact with Topotecan, for example: Cisplatin, Phenytoin. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Topotecan PhaRes?
Topotecan PhaRes is a prescription (Rx) medicine. Take it as your doctor advises.