Topotecan

What is topotecan?

Topotecan is a medicine used to kill cancer cells.

You may hear topotecan called by its brand name, Hycamtin. Topotecan comes in an injection form.

Before giving topotecan to your child

Tell your child's doctor if your child has ever reacted badly to topotecan or any other drugs.

Talk with your child's doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child:

• has low blood counts
  
• has an infection or recent exposure to infection, such as chickenpox
  
• has kidney or liver problems
  
• is pregnant

How will your child get topotecan?

Topotecan is a clear light yellow-coloured liquid that a nurse will give by needle into your child's vein. Usually your child will get this medicine in the hospital clinic or on the nursing unit.

What are the possible side effects of topotecan?

Your child may have some of these side effects while they take topotecan. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or they bother your child:

• upset stomach or throwing up
  
• watery bowel movements (diarrhea)
  
• trouble having a bowel movement (constipation)
  
• stomach cramps
  
• tiredness
  
• cough

Most of the following side effects are not common, but they may be a sign of a serious problem. Let your child's doctor or nurse know as soon as possible if your child has any of these side effects:

• cough or hoarse voice
  
• dark urine or yellow skin or eyes
  
• rash
  
• headache

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• signs of infection such as a fever, chills, or a sore throat
  
• unusual bleeding or bruising
  
• blood in the urine or stools
  
• pain when urinating
  
• feeling extremely tired or weak
  
• severe nausea or vomiting or stomach pain

What safety measures should you take when your child is using topotecan?

Topotecan can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:

• Avoid people with infections, such as a cold or the flu.
  
• Avoid places that are very crowded with large groups of people.
  
• Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
  
• You and your child should not touch your child's eyes or inside the nose without washing hands first.
  
• Your child's nurse will review with you what to do in case of fever.

Topotecan can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:

• Be careful not to cut your child when using fingernail scissors or toenail clippers.
  
• Be careful when shaving or waxing.
  
• Your child should avoid contact sports where bruising or injury could occur.
  
• Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking topotecan.

Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) vaccine and chickenpox vaccine.

Your child may lose their hair. It will grow back once your child is no longer receiving topotecan. Its colour and texture may change. Use a gentle shampoo and a soft brush.

There is a chance that topotecan may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active it is best that they use birth control while receiving topotecan. Tell the doctor right away if your child may be pregnant.

What other important information should you know about topotecan?

• Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).
• Keep a list of all medications your child is on to show the doctor or pharmacist.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep topotecan out of your child’s sight and reach and locked up in a safe place. If your child takes too much topotecan, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.