Topotecan interactions
Full monograph for TopotecanCheck it against another medicine
Medicines
194 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Adalimumab | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| Baricitinib | Major | Synergy | Coadministration of baricitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies… | 4 sources — open the full entry |
| Carboplatin | Major | Synergy | Topotecan combined with a platinum agent may produce synergistic cytotoxicity against some germ cell cancers. However, myelosuppression may also be more severe. | 3 sources — open the full entry |
| Cisplatin | Major | Synergy | Topotecan combined with a platinum agent may produce synergistic cytotoxicity against some germ cell cancers. However, myelosuppression may also be more severe. | 3 sources — open the full entry |
| Clozapine | Major | Synergy | Coadministration of clozapine with other agents that can cause neutropenia or agranulocytosis may increase the risk and/or severity of hematologic toxicity. | 9 sources — open the full entry |
| Deferiprone | Major | Synergy | Coadministration of deferiprone and other drugs that can cause neutropenia or agranulocytosis may increase the risk and/or severity of hematologic toxicity… | 5 sources — open the full entry |
| Etanercept | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| Golimumab | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| Infliximab | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| Leflunomide | Major | Synergy | The use of leflunomide with other immunosuppressive or myelosuppressive agents may increase the risk of infections. The risk is thought to extend to… | 2 sources — open the full entry |
| Oxaliplatin | Major | Synergy | Topotecan combined with a platinum agent may produce synergistic cytotoxicity against some germ cell cancers. However, myelosuppression may also be more severe. | 3 sources — open the full entry |
| Rotavirus Vaccine | Major | Others | The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of… | 9 sources — open the full entry |
| Thalidomide | Major | Synergy | Coadministration of thalidomide with glucocorticoids and/or antineoplastic agents in the treatment of malignancy may potentiate the risk of thromboembolism… | 20 sources — open the full entry |
| Tofacitinib | Major | Others | Coadministration of tofacitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies… | 1 sources — open the full entry |
| Upadacitinib | Major | Others | Coadministration of upadacitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies. | 1 sources — open the full entry |
| Yellow Fever Vaccine | Major | Others | The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of…2 documented mechanisms | 19 sources — open the full entry |
| Abemaciclib | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Acalabrutinib | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Aflibercept | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Alpelisib | Moderate | Excretion | Coadministration with alpelisib may theoretically increase the plasma concentrations of drugs that are substrates of organic anion transporter (OAT3)… | 5 sources — open the full entry |
| Apalutamide | Moderate | Absorption · Metabolism | Coadministration with apalutamide may decrease the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 3A4, 2C9, 2C19, breast… | 5 sources — open the full entry |
| Asciminib | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. | 1 sources — open the full entry |
| Azacitidine | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Azathioprine | Moderate | Synergy | The use of azathioprine with other immunosuppressive or myelosuppressive agents may result in additive hematologic toxicities and increased risk of infections… | 3 sources — open the full entry |
| Beclomethasone Dipropionate + Chloramphenicol + Clotrimazole + Lidocaine | Moderate | Synergy | Coadministration of chloramphenicol with other agents that can cause bone marrow depression or aplastic anemia may increase the risk and/or severity of… | 8 sources — open the full entry |
| Bendamustine | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Beta carotene + Vitamin C + Vitamin E | Moderate | Others | The potential effects of vitamin E on cancer chemotherapy and radiation have not been established. Because vitamin E is an antioxidant, pharmacologic doses… | 9 sources — open the full entry |
| Bevacizumab | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Bleomycin Sulfate | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Bortezomib | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Brigatinib | Moderate | Excretion | Coadministration with brigatinib may increase the plasma concentrations and risk of adverse effects of drugs that are substrates of P-glycoprotein (P-gp)… | 4 sources — open the full entry |
| Cabazitaxel | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Cabozantinib | Moderate | Others | Based on in vitro inhibition data, coadministration with cabozantinib may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein… | 2 sources — open the full entry |
| Capecitabine | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Capmatinib Hydrochloride | Moderate | Absorption | Coadministration with capmatinib may increase the plasma concentrations and risk of adverse effects of drugs that are substrates of P-glycoprotein (P-gp)… | 1 sources — open the full entry |
| Carfilzomib | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Carmustine | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Ceritinib | Moderate | Excretion | Coadministration with ceritinib may increase the plasma concentrations and the risk of adverse effects of orally administered drugs that are substrates of the… | 2 sources — open the full entry |
| Chlorambucil | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Chloramphenicol (Ophthalmic) | Moderate | Synergy | Coadministration of chloramphenicol with other agents that can cause bone marrow depression or aplastic anemia may increase the risk and/or severity of… | 8 sources — open the full entry |
| Chloramphenicol (Oral) | Moderate | Synergy | Coadministration of chloramphenicol with other agents that can cause bone marrow depression or aplastic anemia may increase the risk and/or severity of… | 8 sources — open the full entry |
| Chloramphenicol + Lidocaine Hydrochloride | Moderate | Synergy | Coadministration of chloramphenicol with other agents that can cause bone marrow depression or aplastic anemia may increase the risk and/or severity of… | 8 sources — open the full entry |
| Crizotinib | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Cyclophosphamide | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Cytarabine | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Dacarbazine | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
| Daclatasvir | Moderate | Excretion | Coadministration with daclatasvir may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Daclatasvir + Sofosbuvir | Moderate | Excretion | Coadministration with daclatasvir may increase the plasma concentrations of drugs that are substrates of the P-glycoprotein (P-gp) transporter. The proposed… | 2 sources — open the full entry |
| Darolutamide | Moderate | Metabolism | Coadministration with darolutamide may increase the plasma concentrations of drugs that are substrates of the breast cancer resistance protein (BCRP)… | 3 sources — open the full entry |
| Dasatinib | Moderate | Synergy | The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe… | 1 sources — open the full entry |
Conditions
Conditions in which Topotecan needs care, as documented in this source.
Bone Marrow Failure Disorders
MajorTopotecan induces myelosuppression. Severe neutropenia (< 500/mm3), severe thrombocytopenia (< 25,000/mm3), and severe anemia (< 8 g/dl) have been reported frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with neutrophil counts < 1500/mm3 and/or platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until neutrophil counts exceed 1000/mm3, platelet counts exceed 100,000/mm3, and/or hemoglobin levels are at least 9 g/dl.
1 source
- "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
Hemorrhagic Disorders
MajorTopotecan induces myelosuppression. Severe thrombocytopenia (< 25,000/mm3) has been reported during topotecan therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bleeding such as petechiae, purpura, hematuria, or melena. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until platelet counts exceed 100,000/mm3.
1 source
- "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
Infections
MajorBecause of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.
39 sources
- Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
- "Product Information. Methotrexate (methotrexate)." Lederle Laboratories (2002):
- "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb (2001):
- "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb (2001):
- "Product Information. Novantrone (mitoxantrone)." Immunex Corporation (2001):
- "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb (2001):
- "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb (2001):
- "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation) (2001):
Show all 39 sourcesShow fewer sources
- Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
- Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
- Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
- Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
- "Product Information. Fludara (fludarabine)." Berlex Laboratories (2001):
- "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn (2001):
- "Product Information. Matulane (procarbazine)." Roche Laboratories (2001):
- "Product Information. DTIC-Dome (dacarbazine)." Bayer (2001):
- "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn (2001):
- "Product Information. Leustatin (cladribine)." Ortho Biotech Inc (2001):
- "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company (2001):
- "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
- "Product Information. Taxotere (docetaxel)." Rhone Poulenc Rorer (2001):
- "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb (2001):
- "Product Information. Nipent (pentostatin)." Hospira Inc (2001):
- "Product Information. Tabloid (thioguanine)." Prasco Laboratories (2001):
- "Product Information. Xeloda (capecitabine)." Roche Laboratories (2001):
- "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):
- "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome (2001):
- "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
- "Product Information. Doxil (doxorubicin liposomal)." Sequus Pharmaceuticals Inc (2001):
- "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn (2001):
- "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation (2001):
- "Product Information. Jevtana (cabazitaxel)." sanofi-aventis (2010):
- "Product Information. Halaven (eribulin)." Eisai Inc (2010):
- "Product Information. Keytruda (pembrolizumab)." Merck & Co., Inc (2014):
- "Product Information. Blincyto (blinatumomab)." Amgen USA (2014):
- "Product Information. Opdivo (nivolumab)." Bristol-Myers Squibb (2014):
- "Product Information. Unituxin (dinutuximab)." United Therapeutics Corporation (2015):
- "Product Information. Empliciti (elotuzumab)." Bristol-Myers Squibb (2015):
- "Product Information. Pepaxto (melphalan flufenamide)." Oncopeptides Inc. (2021):
Kidney Diseases
MajorTopotecan is partially eliminated by the kidney. Approximately 30% of topotecan is excreted in the urine. Plasma clearance of topotecan was reduced 33% in patients with mild renal impairment (creatinine clearance of 40 to 60 mL/min) and 66% in patients with moderate renal impairment (creatinine clearance of 20 to 40 mL/min). Therapy with topotecan should be administered cautiously and at a reduced dosage in patients with moderate to severe renal dysfunction.
1 source
- "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
Diarrhea
ModerateTopotecan capsules can cause severe and life-threatening diarrhea that may require hospitalization. It is recommended to withhold treatment for severe diarrhea. Manage diarrhea caused by topotecan aggressively and do no administer topotecan capsules to patients with Grade 3 or 4 diarrhea. Reduce the dose of therapy after recovery to Grade 1 or less. Close monitoring is recommended.
1 source
- "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
Lung Diseases, Interstitial
ModerateFatal cases of interstitial lung disease (ILD) have occurred with the use of topotecan. Risk factors include a history of ILD, pulmonary fibrosis, lung cancer, thoracic radiation, and use of pneumotoxic drugs and/or colony stimulating factors. It is recommended to monitor patients for pulmonary symptoms indicative of ILD and permanently discontinue treatment for confirmed ILD.
1 source
- "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):