A chemotherapy for ovarian, lung and cervical cancers
Topotecan
A chemotherapy medicine used to treat ovarian cancer, small-cell lung cancer and cervical cancer.
What is Topotecan?
Topotecan is a specialist chemotherapy used to treat ovarian cancer, small-cell lung cancer and cervical cancer. It belongs to a group called topoisomerase inhibitors, which damage the way cancer cells copy their DNA so they cannot keep dividing. It is given by a cancer team, either into a vein or, for some cancers, as a capsule. Its most important effect is a fall in blood cells, especially the white cells that fight infection, which can lead to serious infection. Diarrhoea, tiredness and nausea are also common.
Education and reference only. This is a plain-language guide to Topotecan — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Topotecan is a chemotherapy medicine used to treat several cancers, including ovarian cancer that has come back, small-cell lung cancer and cervical cancer. It belongs to a group of medicines called topoisomerase inhibitors. It is given under the close care of a cancer (oncology) team, usually as an infusion into a vein over several days in a cycle, though it can also be given as capsules for some cancers. Because it is a powerful medicine that affects the blood and other fast-growing tissues, it is always used with careful monitoring.
How it works
Cancer cells grow by copying their DNA and dividing. Topotecan blocks an enzyme called topoisomerase that cells need to unwind and copy their DNA, so the DNA strands break and the cancer cells cannot keep dividing and eventually die. Because it acts on cells that divide quickly, it also affects healthy fast-growing cells, especially those in the bone marrow that make blood cells. This is why it is given in cycles, with breaks to let the bone marrow recover, and why blood counts are checked before each dose.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist chemotherapy used in the UK to treat ovarian cancer, small-cell lung cancer and cervical cancer.
Practical use
How to take Topotecan
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by your cancer team, usually as an infusion into a vein over several days, or as capsules for some cancers.
- Contact your cancer team urgently if you develop a high temperature, shivering or feel unwell, as this may be a serious infection.
- Attend all your blood test and treatment appointments, as doses depend on your blood counts recovering.
- Tell your team about diarrhoea, sickness or mouth soreness, as there are treatments that help.
- If you take the capsules, swallow them whole and follow your team's instructions exactly; do not open or crush them.
Weighing it up
Advantages & disadvantages of Topotecan
Advantages
- An established treatment option for ovarian, small-cell lung and cervical cancers.
- Available both as a vein infusion and, for some cancers, as capsules.
- Given in cycles with monitoring, so treatment can be adjusted to how you respond and tolerate it.
Disadvantages
- Commonly causes a serious fall in white blood cells, raising the risk of infection.
- Can cause diarrhoea, nausea, tiredness and hair loss.
- Needs frequent blood tests and close specialist supervision.
Practical use
Good to know
The most important thing to understand about topotecan is its effect on the bone marrow: it commonly causes a marked fall in white blood cells (neutropenia), which lowers your ability to fight infection. A high temperature, shivering or feeling generally unwell can be a sign of a serious infection and should be treated as an emergency, with urgent contact to your cancer team day or night. It can also lower red cells and platelets, causing tiredness or easy bruising and bleeding. Diarrhoea and nausea are common, and your team will advise on managing these. Blood counts are checked before each cycle, and a dose may be delayed if your counts are low. As with all chemotherapy, it is given by a specialist team who will give you clear advice on what to watch for.
Who should not take it / use with caution
- People who have had a serious allergic reaction to topotecan should not receive it.
- It is not used in pregnancy or breastfeeding, as it can harm a developing baby.
- It is used with great care, or avoided, in people whose bone marrow is already very suppressed.
- It needs dose adjustment in people with kidney problems and should only be given under specialist supervision.
Monitoring
- Regular full blood counts before each cycle and during treatment.
- Checking kidney function, as the dose depends on it.
- Watching for signs of infection, bleeding and other side effects between cycles.
Side effects
- A fall in white blood cells (neutropenia), which raises the risk of serious infection.
- A fall in red cells and platelets, causing tiredness, breathlessness or easy bruising and bleeding.
- Diarrhoea, nausea, vomiting, mouth soreness and hair loss.
- Rarely but seriously, severe infection (sepsis) or a serious lung inflammation, which need urgent care.
Key interactions
- Other medicines or treatments that lower blood counts, such as other chemotherapy or radiotherapy, add to its effects.
- Some medicines can affect topotecan levels, so your team will review everything you take.
- Live vaccines are generally avoided during treatment because the immune system is weakened.
Available as: A solution given as an infusion into a vein, and capsules taken by mouth for some cancers.
Answers
Topotecan: frequently asked questions
What is topotecan used for?
It is a chemotherapy used to treat ovarian cancer, small-cell lung cancer and cervical cancer, working by stopping cancer cells from copying their DNA.
Why does it affect my blood?
It acts on fast-growing cells, including those in the bone marrow that make blood, so it commonly lowers white cells, red cells and platelets, which is why blood counts are checked.
What should I do if I get a temperature?
A high temperature, shivering or feeling unwell can be a sign of a serious infection while your white cells are low; contact your cancer team urgently, day or night.
How is it given?
It is usually given as an infusion into a vein over several days in a cycle, though it can also be taken as capsules for some cancers, always under specialist care.
Will it cause hair loss?
Hair loss can happen with topotecan, along with tiredness, nausea and diarrhoea; your cancer team can advise on what to expect and how to cope.
The wider class
About Cytotoxic chemotherapy (topoisomerase inhibitor)
Topotecan belongs to the cytotoxic chemotherapy (topoisomerase inhibitor) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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