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What is topotecan?

Topotecan (also called Hycamtin®) is an anticancer medicine. It is available as a 0.25 mg capsule, a 1 mg capsule, and a liquid taken by mouth. It is also available as a light-yellow liquid given by vein (IV).

Topotecan can pose a health hazard to caregivers. All caregivers should take safety precautions while giving this drug. For 48 hours after this drug is given, the patient’s body fluids can contain the drug. During that 48-hour period, caregivers should follow safety guidelines when handling the patient’s vomit, blood, urine, and bowel movements, including diapers. These guidelines include wearing gloves when cleaning up body fluids. For a complete list of safety precautions, see “Do you know… Protecting caregivers from drug hazards.”

Possible side effects of topotecan


  • Nausea and vomiting
  • Flu-like symptoms (muscle aches, fatigue, headache, fever)
  • Rash

Later (usually more than a day after treatment starts)

  • Low blood counts
  • Mouth sores (rare)
  • Hair loss
  • Temporary changes in liver function
  • Diarrhea (can occur within first 24 hours of treatment)

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for topotecan

  • If you have diarrhea after taking topotecan, tell your doctor or nurse right away. A medicine may be prescribed to help control the diarrhea.
  • The staff may take blood samples to check topotecan levels in the blood and to check for changes in blood counts and liver function.
  • Topotecan should be taken on an empty stomach. If you have problems taking this medicine on an empty stomach, talk with your doctor or pharmacist.
  • If the liquid form is used, each dose will be measured in advance by the pharmacy and put in an oral syringe. Each oral syringe holds one (1) dose. Report any doses wasted or vomited to your doctor or nurse.
  • You can mix the liquid with juice or flavored syrup right before it is taken.
  • Store the liquid medicine in the refrigerator. Do not use past the expiration date written on the label.
  • Swallow the capsules whole. Do not crush, chew or cut capsules. Store the capsules in the refrigerator.
  • Because topotecan may cause birth defects, do not take this medicine if you are pregnant. Both men and women who are taking topotecan should use effective birth control methods.
  • It is not known whether topotecan passes into breast milk. Because this medicine might cause serious harm to a nursing infant, women who are taking topotecan should not breast-feed a baby.
  • Keep this and all medicine out of the reach of children and pets.

Safe handling of topotecan

All chemotherapy drugs taken by mouth can post a health hazard to caregivers and patients. You should be careful when handling this medicine and try to keep the drug from touching the skin. Taking precautions will ensure that both the patient and the caregiver are protected as well as possible.

  • Prepare a clean area where the drug can be handled safely (away from areas where food is prepared, out of the reach of children, and out from under any air vents or fans).
  • We suggest you or the caregiver wear gloves while handling this medicine. Wash your hands right away if your skin comes in contact with the medicine.
  • Completely clean up any spills in the area where the medicine is prepared.
  • For the liquid, use each oral syringe only one (1) time and then discard it in the trash. Do not try to wash and reuse the syringes.


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1  (الهاتف النصي: 1040-595-901-1).