{"id":4424,"date":"2025-03-31T18:12:07","date_gmt":"2025-03-31T18:12:07","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/topotecan-txt\/"},"modified":"2025-03-31T18:12:07","modified_gmt":"2025-03-31T18:12:07","slug":"topotecan-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/topotecan-txt\/","title":{"rendered":"Topotecan.txt"},"content":{"rendered":"

CLINICAL USE <\/H3> Treatment of metastatic ovarian cancer

DOSE IN NORMAL RENAL FUNCTION <\/H3> 1.5 mg\/m2 for 5 days, repeated every 3 weeks

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 457.9 (as hydrochloride) <\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 35 <\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 51 <\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp : 132 litres +\/\u2013 57 <\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp : 2\u20133\/4.9 (in moderate renal failure)

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4> 40\u201359 Dose as in normal renal function. See \u2018Other Information\u2019 20\u201339 0.75 mg\/m2\/day. <20 Use with caution.

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Unknown dialysability. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp : Dialysed. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp: Unknown dialysability. 0.5\u20130.75 mg\/m2\/day and monitor closely

    IMPORTANT DRUG INTERACTIONS <\/H3> Potentially hazardous interactions with other drugs\n
  • None known

    ADMINISTRATION <\/H3>

    Reconstition<\/H4> Add 4 mL of water for injection to each 4 mg vial

    Route <\/H4>

    IV infusion <\/H4>

    Rate of Administration <\/H4> Over 30 minutes

    Comments<\/H4> Dilute further in sodium chloride 0.9% or glucose 5% to obtain a concentration of 25\u201350 mcg\/mL Once reconstituted use within 12 hours if stored at room temperature, and 24 hours if stored at 2\u20138\u00b0C if made under aseptic conditions

    OTHER INFORMATION <\/H4> Undergoes reversible, pH-dependent hydrolysis of the active lactone moiety to the inactive hydroxyacid (carboxylate) form. A relatively small amount of topotecan is metabolised by hepatic microsomal enzymes to an active metabolite, N-demethyltopotecan; the clinical significance of this metabolite is not known. Excretion is via biliary and renal routes with 20\u201360% excreted in the urine as topotecan or the open ring form If the patient has received extensive prior therapy it has been suggested that 1 mg\/m2\/day can be used in mild renal impairment and 0.5 mg\/m2\/day in moderate renal impairment. (Ormrod D, Spencer CM. Topotecan: a review of its efficacy in small cell lung cancer. Drugs. 1999, Sep; 58(3): 533\u201351.) In renal failure there is an increased risk of haematological toxicity (even at low doses, e.g. 0.5 mg\/m2\/day), therefore if it is to be used in severe renal failure, start at doses less than 0.5 mg\/m2\/day and monitor closely An alternative dosing schedule (Kintzel PE, Dorr RT. Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev. 1995; 21: 33\u201364): CrCl 60 mL\/min: 80% of dose \u2014 CrCl 45 mL\/min: 75% of dose \u2014 CrCl 30 mL\/min: 70% of dose \u2014 Bennett suggests: GFR>50 mL\/min: 75% of dose \u2014 GFR=10\u201350 mL\/min: 50% of dose \u2014 GFR <10 mL\/min: 25% of dose \u2014 .
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Treatment of metastatic ovarian cancer DOSE IN NORMAL<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4424","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4424","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4424"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4424\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4424"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4424"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4424"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}