Cancer drugs A to Z list
Topotecan is a drug. You pronounce it as toh-poh-tee-kan. It is also known as Hycamtin. Hycamtin is only available as capsules.
Topotecan is a treatment for:
small cell lung cancer that has come back
cervical cancer that has come back after or has spread
Topotecan is a type of chemotherapy drug called a topoisomerase 1 inhibitor. It works by blocking a chemical called topoisomerase 1.
This chemical helps to separate and repair the in cells when they divide. Cancer cells need to make and repair DNA in order to grow and multiply. Blocking the action of this enzyme damages the DNA and so the cells die.
Read more about how chemotherapy works
You take topotecan as capsules. Or you have it as a drip into your bloodstream (intravenously).
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug or if you miss a dose.
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
central line
PICC line
portacath
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.
When you are having this treatment through a cannula it could damage the tissue if it leaks out of the vein. This is called extravasation. This can happen anywhere along the vein that the drug is going into. It doesn’t happen very often. Tell your nurse straight away if you notice any changes such as swelling, redness, pain, burning, or a stinging feeling.
Your nurse will stop the drug treatment. And they will treat the area to relieve symptoms and reduce tissue damage. Contact your healthcare team if you develop any of these symptoms when you are at home.
Read more about having chemotherapy into your vein (intravenous chemotherapy)
You have topotecan as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover.
You take topotecan for 5 days every 3 weeks as capsules.
You usually take topotecan for as long as it is working and you are not experiencing any side effects.
You have topotecan once a day for 3 days. You have it as a drip over half an hour. You have it with another chemotherapy drug called cisplatin on the first day. This treatment cycle is repeated every 3 weeks.
You usually have 6 treatment cycles. Your doctor will talk to you about how long you will have treatment for.
You have blood tests before and during your treatment. They check your levels of and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV. This is called a viral screen.
It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your and can cause the virus to become active again (reactivation).
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in . Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs. This is known as petechiae.
You might be breathless and look pale due to a drop in . This is called anaemia.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
You may have some hair loss or hair thinning. This can be upsetting. Your hair might grow back once treatment has finished.
Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
Contact your advice line straight away if you have abdominal pain. Tummy pain can be a sign of inflammation of your large bowel (colon). This is called colitis. Other symptoms of colitis include diarrhoea, a high temperature, loss of appetite, feeling very tired, bloating and feeling like you need to poo. You might also have blood or mucus in your poo.
Your healthcare team can check what is causing the pain. You may need treatment in hospital.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a if needed.
Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep your mouth moist. Tell your doctor or nurse if you have ulcers.
You may have inflammation of other areas of the digestive tract such as the stomach or bowel. Symptoms include pain, feeling or being sick, and diarrhoea.
You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
sepsis - a serious reaction to an infection. Signs can include feeling very unwell, not peeing, a very high or very low temperature, shivering, slurred speech, confusion, breathlessness, mottled or discoloured skin or muscle pain. Call 999 or go to accident and emergency (A&E) immediately if you have any of these symptoms
an allergic reaction that can cause a rash or itchy skin. Rarely you may develop hives or swelling. Some allergic reactions can be life threatening. Alert your nurse straightaway if you think you are having an allergic reaction. Or call 999 if you are at home and have swelling of your mouth, throat or any difficulty breathing
high levels of in the blood - symptoms can include yellowing of the skin and eyes and dark coloured urine (jaundice)
generally feeling unwell (malaise)
Topotecan can cause inflammation and scarring of the lungs. Symptoms can include shortness of breath, a dry cough, feeling tired and a sore chest. This side effect happens in fewer than 1 in 100 people (fewer than 1%). Let your healthcare team know of any breathing changes.
Topotecan can cause a hole in your stomach or bowel which can lead to a serious infection. Symptoms include severe pain or cramping, bloating, feeling or being sick and a fever. There isn't enough information to work out how often this side effect might happen.
We have more information about side effects and tips on how to cope with them.
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We do not list these interactions on this page. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment. Women must not become pregnant for at least 6 months after the end of treatment. Men should not get someone pregnant for at least 3 months after treatment.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Do not have live vaccines while you’re having treatment and for up to 12 months afterwards. For some people, it may be longer than this. The length of time you need to avoid live vaccines depends on the treatment you’ve had.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, chickenpox, BCG, and yellow fever. You can usually have non-live vaccines. But they might not give you as much protection as usual. These include the:
flu vaccine, as an injection
coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 25 Sept 2026
Next review due: 25 Sept 2029
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Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
Cancer drugs have side effects and these can vary from person to person. But there are things that you can do to help you cope.
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