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Topotecan IV is a cancer treatment drug. With the main ingredient is Topotecan hydrochloride, Topotecan is used in the treatment of ovarian, cervical, small cell lung cancer.
1. What is Topotecan?
Topotecan IV belongs to the group of anti-cancer drugs, with the main ingredient being Topotecan hydrochloride. Topotecan inhibits topoisomerase-I and causes single-strand breaks in protein-bound DNA.
Topotecan is made in the form of hard capsules with the content of 0.25mg and 1mg; lyophilized powder for solution for infusion 1mg and 4mg Topotecan.
Topotecan IV is indicated for use in the following cases:
Metastatic ovarian carcinoma, the patient has been treated with the first or second course of chemotherapy but failed; Small cell lung cancer recurred, the patient was treated with the first regimen but it was not effective. Alternatively, combine Topotecan IV with Cisplatin for the treatment of stage IV B or recurrent cervical carcinoma following radiation therapy. However, if the patient has previously taken Cisplatin, a period of discontinuation may be required for combination therapy.
2. How to use and dosage Topotecan
Dosage of Topotecan IV in the treatment of ovarian carcinoma and small cell lung cancer:
Initial dose: 1.5 mg/m2 body surface area/day, intravenous infusion over 30 minutes/day and continuous infusion for 5 days, each course is 3 weeks apart. Continue treatment until the disease improves if the patient tolerates the drug well; Subsequent dose: Continue treatment with Topotecan IV only until target neutrophil counts, platelets, and hemoglobin concentrations have not been achieved. If Topotecan is used with other drugs, it is important to reduce the dose to achieve the neutrophil count and maintain the target. Topotecan dosage in the treatment of cervical carcinoma:
Initial dose: 0.75 mg/m2 body surface area/day, intravenous infusion over 30 minutes/day and infusion on the first days, Monday Tuesday. On the first day, intravenous infusion of Cisplatin at a dose of 50 mg/m2 body surface area/day. After 21 days (3 weeks), repeat the course and treat 6 courses or the number of courses depends on the progress of the treatment; Next dose: Only continue Topotecan until the target neutrophil count, platelet count and hemoglobin concentration have not been achieved. If Topotecan is used with other drugs, it is important to reduce the dose to achieve neutrophil counts and maintain target counts. Dosage of Topotecan IV in other subjects is as follows:
Patients with renal impairment : Use only in people with moderate renal impairment. Treatment of ovarian carcinoma or small cell lung cancer with Topotecan IV monotherapy in patients with renal failure with creatinine clearance between 20 - 39 ml/min at a dose of 0.75 mg/m2 muscle surface area body/day and used for 5 consecutive days. For the treatment of cervical carcinoma with Topotecan IV in combination with Cisplatin, its use is authorized only in patients with renal impairment with a serum creatinine clearance less than 1.5 mg/dl. Patients with hepatic impairment: Topotecan should only be used in patients with liver failure with serum bilirubin levels between 1.5 and 10 mg/dl at a dose of 1.5 mg/m2 of body surface area/day for 5 days. days and each course is spaced 3 weeks apart. However, data on drug use in this population are limited. To date, Topotecan IV overdose has no specific antidote. Overdose causes symptoms similar to side effects, especially mucositis, elevated liver enzymes, and effects on bone marrow. Ideally, medication should be managed and taken as recommended.
3. Topotecan side effects
Topotecan can cause some unwanted side effects with the frequency of occurrence as follows:
Common: Anorexia, nausea, vomiting, abdominal pain, constipation, diarrhea, mucositis. Rash, alopecia areata, sepsis, neutropenia, thrombocytopenia, anemia; Uncommon: Pruritus, hyperbilirubinemia; Rarely: Topotecan IV rarely causes extravasation, angioedema, anaphylaxis, urticaria, interstitial lung disease; Frequency not known: Mucositis, gastrointestinal perforation, severe bleeding. If you see any symptoms after taking Topotecan IV, the patient should immediately notify the doctor or go to the medical facility soon to be checked.
4. Some notes when taking Topotecan
Do not use Topotecan drug in people with hypersensitivity to the ingredients of the drug, women who are breastfeeding, patients with severe bone marrow failure preparing for the first course of treatment, people with severe liver failure (serum bilirubin levels). above 10mg/dl) and severe renal impairment (creatinine clearance less than 20ml/min); Regularly check the blood count to measure drug toxicity when taking Topotecan IV; Although not listed in the side effects section, Topotecan can cause cytotoxicity and severe bone marrow depression, which can lead to sepsis and, most importantly, death; During the use of Topotecan, it should be noted whether the patient has symptoms of fever, neutropenia, leukopenia colitis or not to promptly handle and limit the risk of death due to the drug; People with a history of lung cancer, interstitial lung cancer, pulmonary fibrosis, or exposure to radiation or other toxins have a higher risk of lung side effects and a higher likelihood of death when taking Topotecan. Therefore, when the patient shows symptoms of shortness of breath, lack of oxygen, fever, cough, etc., it is necessary to stop using the drug immediately; Caution should be exercised when prescribing Hycamtin to patients receiving Topotecan IV alone or in combination with Cisplatin because of the high risk of thrombocytopenia, tumor bleeding; It is necessary to assess the status of protein S deficiency in patients to ensure the ability to respond to the drug and limit the rate of complications when using Topotecan such as fever, infection...; It is necessary to warn about the risk of effects on the fetus in pregnant women using Topotecan or taking the drug to become pregnant; Limit driving and operating and operating machinery if the use of Topotecan makes the patient tired and weak for a long time; Topotecan IV may interact with other medications and reduce tolerability. Therefore, it is necessary to reduce the dose of each drug to ensure that the patient's body tolerates the drug and achieves effective treatment; When treating Topotecan IV in combination with Cisplatin, depending on the day of use, the dose must be reduced to improve the tolerability of each drug. The use of Topotecan IV drug is to break the DNA strand associated with protein, so that the drug is used in the treatment of metastatic or recurrent cancer, including ovarian or cervical carcinoma, cancer. small cell lung. The drug can be used alone or in combination with other drugs. To ensure the safety of your health and maximize the effectiveness of treatment, you need to take the medicine exactly as directed by your doctor.
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