Combination causes greater myelosuppression than topotecan alone with sequence-dependent interaction. Dose reduction of both agents required, particularly when coadministered on day 1 versus day 5 of topotecan dosing.
Source: NLP:topotecan
Topotecan Interactions
Brand names: Topotecan
Topoisomerase Inhibitor · Topoisomerase Inhibitors
Route: Intravenous
FDA Black Box Warning
WARNING: BONE MARROW SUPPRESSION Do not give Topotecan Injection to patients with baseline neutrophil counts less than 1,500 cells/mm 3 . In order to monitor the occurrence of bone marrow suppression, primarily neutropenia, which may be severe and result in infection and death, monitor peripheral blood counts frequently on all patients receiving Topotecan Injection . [see Warnings and Precautions ( 5.1 ) ] WARNING: BONE MARROW SUPPRESSION See full prescribing information for complete boxed warning Do not give Topotecan to patients with baseline neutrophil counts less than 1,500 cells/mm 3 . In order to monitor the occurrence of bone marrow suppression, primarily neutropenia, which may be severe and result in infection and death, monitor peripheral blood cell counts frequently on all patients receiving Topotecan Injection. ( 5.1 )
Contraindications
4 CONTRAINDICATIONS Topotecan Injection is contraindicated in patients who have a history of severe hypersensitivity reactions (e.g., anaphylactoid reactions) to topotecan or to any of its ingredients. Topotecan Injection should not be used in patients with severe bone marrow depression. History of severe hypersensitivity reactions (e.g., anaphylactoid reactions) to topotecan or any of its ingredients ( 4 ) Severe bone marrow depression ( 4 )
Pregnancy & Breastfeeding
8.1 Pregnancy Pregnancy Category D [see Warnings and Precautions ( 5.4 ) ]. Topotecan Injection can cause fetal harm when administered to a pregnant woman. In rabbits, a dose of 0.1 mg/kg/day (about equal to the clinical dose of 1.5 mg/m 2 ) given on days 6 through 20 of gestation caused maternal toxicity, embryolethality, and reduced fetal body weight. In the rat, a dose of 0.23 mg/kg/day (about equal to the clinical dose of 1.5 mg/m 2 ) given for 14 days before mating through gestation day 6 caused fetal resorption, microphthalmia, pre-implant loss, and mild maternal toxicity. A dose of 0.1 mg/kg/day (about half the clinical dose of 1.5 mg/m 2 ) given to rats on days 6 through 17 of gestation caused an increase in post-implantation mortality. This dose also caused an increase in total fetal malformations. The most frequent malformations were of the eye (microphthalmia, anophthalmia, rosette formation of the retina, coloboma of the retina, ectopic orbit), brain (dilated lateral and third ventricles), skull, and vertebrae. There are no adequate and well controlled studies of Topotecan Injection in pregnant women. If this drug is used during pregnancy, or if a patient becomes pregnant while receiving Topotecan Injection, the patient should be apprised of the potential hazard to the fetus. [see Warnings and Precautions ( 5.4 ) ]
7 interactions on record
Combination causes severe myelosuppression with sequence-dependent interaction. At 1.25 mg/m² topotecan with 50 mg/m² cisplatin, severe neutropenia and neutropenic sepsis were reported. Dose reduction required.
Source: NLP:topotecan
Topotecan + G-CsfMajor
Concomitant administration can prolong the duration of neutropenia. Do not initiate G-CSF until day 6 of topotecan therapy or 24 hours after completion of treatment.
Source: NLP:topotecan
Topotecan + EltrombopagModerate
BCRP substrate; eltrombopag may increase exposure. Monitor closely for signs of excessive exposure.
Source: NLP:eltrombopag
Topotecan + Eltrombopag OlamineModerate
BCRP substrate; monitor for excessive exposure and consider dose reduction if appropriate.
Source: NLP:eltrombopag olamine
Topotecan + RolapitantModerate
Increased plasma concentrations may result in potential adverse reactions. Monitor for adverse reactions if use cannot be avoided.
Source: NLP:rolapitant
Topotecan + Tedizolid PhosphateModerate
Tedizolid inhibits BCRP, increasing plasma concentrations of orally administered topotecan. Monitor for adverse reactions; consider interrupting topotecan during tedizolid treatment due to narrow therapeutic index.
Source: NLP:tedizolid phosphate