​Early side effects (within days after receiving Topotecan injection)

• Mild nausea, vomiting or appetite loss
• Take small, frequent meals throughout the day.
• Take the medications for nausea or vomiting as instructed by your doctor if any.

Delayed side effects (within days to weeks after receiving Topotecan injection)

• Feeling tired and lack of energy
• Do not drive or operate machinery when you feel tired.
• Decreased white blood cells, red blood cells and platelets
• This may put you at higher risk of infections, bleeding or bruising and feeling tired.
• To reduce your risk of infection:
• Avoid crowds and people who are sick. Wear a face mask when you are going out.
• Wash your hands after using the toilet and before handling food.
• Eat food that is fresh and completely cooked, and avoid raw or half-cooked food.
• To reduce your risk of bleeding problems:
• Be careful when using sharp objects such as knives.
• Try not to bruise, cut or knock yourself.
• Brush your teeth gently as your gums may bleed more easily.
• Apply direct pressure to any cuts or wounds to help stop bleeding
• Diarrhea or constipation
• To manage diarrhea:
• Drink plenty of clear fluids to replace those lost (2 litres everyday).
• Avoid oily or spicy food and milk or dairy products.
• To manage constipation:
• Drink more water or clear fluids (if you do not have a limit on the amount that you can take each day).
• Add more fibre to your diet by eating more fruits and vegetables
• Temporary hair loss

Please see your healthcare professional immediately if any of the following occurs:

• Fever of 38° C and above, especially with chills, pain or difficulty in passing urine
• Unusual bleeding, bruising or black sticky stools
• Very bad diarrhea (e.g. more than 4 times a day) that does not improve even after taking medications used to stop diarrhea
• Shortness of breath, dry cough that does not go away or worsens

​Inform your healthcare professional if:

• You are allergic to this medication
• You or your partner becomes pregnant, or is planning for pregnancy
• You should use effective birth control during treatment and for a period of time after you finish treatment.
• Topotecan may affect your ability to have children in the future. You may wish to discuss this with your doctor before starting treatment.
• You are breastfeeding
• Do not breastfeed during treatment.
• You are taking or intend to take any other medication, supplements, traditional medications or herbal remedies

​Topotecan is an injection that is given into your vein (intravenous).

​If you forget to receive a dose of Topotecan injection, reschedule an appointment with your hospital as soon as possible.

You may refer to the following website if you need more information: https://www.macmillan.org.uk/