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Topoisomerase I inhibitor

Topotecan (Specialist drug)

Brand names: Hycamtin

Topotecan is a topoisomerase I inhibitor cytotoxic agent used in the treatment of relapsed ovarian cancer, small-cell lung cancer and cervical cancer. It is a specialist drug given under oncology supervision.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits topoisomerase I, stabilising the enzyme-DNA complex and causing DNA strand breaks that are lethal to dividing cells.

Prescribing in practice

  • It causes severe, dose-limiting myelosuppression, particularly neutropenia, so blood counts must be checked before each course and treatment withheld until adequate recovery.
  • Diarrhoea, fatigue and mucositis are common, and the dose requires reduction in renal impairment.
  • It is teratogenic and must be handled using cytotoxic precautions, with effective contraception advised.

Monitoring

Monitor full blood count before and during each cycle, together with renal function.

Counselling the patient

  • Report fever, sore throat, bruising or bleeding straight away as your white cell count may drop.
  • Tell your team about diarrhoea, mouth ulcers or extreme tiredness.
  • Use reliable contraception during treatment.

Evidence & guidelines

Use is guided by the manufacturer's SPC and NICE guidance on topotecan in relevant gynaecological and lung cancers.

Reference: NICE TA183; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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