toe-poe-TEE-kan 
Absorption: IV administration results in complete bioavailability.
Distribution: Unknown.
Metabolism/Excretion: 30% excreted in urine; small amounts metabolized by the liver.
Half-life: PO — 3–6 hr; IV — 2–3 hr.
Contraindicated in:
Use Cautiously in:
Derm: alopecia.
GI: abdominal pain, diarrhea, nausea, vomiting, anorexia, constipation, ↑ liver enzymes, stomatitis.
Hemat: anemia, leukopenia, thrombocytopenia.
MS: arthralgia.
Neuro: headache, fatigue, weakness.
Resp: INTERSTITIAL LUNG DISEASE, dyspnea.
Drug-Drug:
Renal Impairment
Renal Impairment
1.5 mg/dL. Do not administer if serum creatinine >1.5 mg/dL.Grade 1, resume with dose decreased by 0.4 mg/m2/day for subsequent coursesIV Administration:
(Generic available)
1500 cells/mm3 and platelet count of 100,000 cells/mm3 are required before first dose. The nadir of neutropenia occurs in 11 days, with a duration of 7 days. The nadir of thrombocytopenia occurs in 15 days, with a duration of 5 days. The nadir of anemia occurs in 15 days. Subsequent doses should not be administered until neutrophils recover to >1000 cells/mm3, platelets recover to >100,000 cells/mm3, and hemoglobin levels recover to 9.0 mg/dL. When topotecan used as a single-agent,↓ dose to 1.25 mg/m2 if neutrophil <500 cells/mm3, or administer granulocyte-colony stimulating factor (G-CSF) starting no sooner than 24 hrs following the last dose or platelet counts less than 25,000 cells/mm3 during previous cycle. When topotecan used with cisplatin,↓dose to 0.60 mg/m2 (and to 0.45 mg/m2 if necessary) for febrile neutropenia (neutrophil counts <1,000 cells/mm3 with temperature of 38°C (100.4°F)), or administer G-CSF starting no sooner than 24 hrs following the last dose or platelet counts less than 25,000 cells/mm3 during previous cycle.
NDC Code*