FrancophonIA/ELRC3.0 huggingface dataset:
English: Topotecan monotherapy is indicated for the treatment of:
Croatian: Topotekan u monoterapiji indiciran je za liječenje:
English: When given in combination with cisplatin (cisplatin day 1, topotecan days 1 to 5), the clearance of topotecan was reduced on day 5 compared to day 1 (19.1 l/h/m compared to 21.3 l/h/m
Croatian: Kad se primjenjuje u kombinaciji s cisplatinom (cisplatin 1. dan, topotekan 1. do 5. dan), klirens topotekana 5. dan smanjen je u odnosu na 1. dan (19,1 l/h/m u odnosu na 21,3 l/h/m
English: Underlying risk factors include history of ILD, pulmonary fibrosis, lung cancer, thoracic exposure to radiation and use of pneumotoxic substances and/or colony stimulating factors.
Croatian: Rizični čimbenici uključuju anamnezu IBP-a, plućne fibroze, karcinoma pluća, izloženosti prsnog koša zračenju i primjene pneumotoksičnih tvari i/ili čimbenika stimulacije kolonija.
English: You should not receive Hycamtin:
Croatian: Ne smije Vam se dati Hycamtin:
English: In a population of patients with refractory SCLC (those not responding to first-line therapy), the response rate to topotecan was 4.0%.
Croatian: U bolesnika s refraktornim karcinomom pluća malih stanica (onih koji nisu odgovorili na prvu liniju liječenja) stopa odgovora na topotekan iznosila je 4,0%.
English: Topotecan-induced neutropenia can cause neutropenic colitis.
Croatian: Neutropenija izazvana topotekanom može uzrokovati neutropenijski kolitis.
English: When combining topotecan with other chemotherapy agents, reduction of the doses of each medicinal product may be required to improve tolerability.
Croatian: Kad se topotekan primjenjuje istovremeno s drugim kemoterapijskim lijekovima, može biti potrebno smanjiti dozu svakog primijenjenog lijeka u svrhu poboljšanja njihove podnošljivosti.
English: Other severe events that were recorded as related or possibly related to topotecan treatment were anorexia (12%), malaise (3%) and hyperbilirubinaemia (1%).
Croatian: Ostale teške nuspojave koje su povezane ili se mogu povezati s liječenjem topotekanom bile su anoreksija (12%), opća slabost (3%) i hiperbilirubinemija (1%).
English: Medicines should not be disposed of via wastewater or household waste.
Croatian: Nikada nemojte nikakve lijekove bacati u otpadne vode ili kućni otpad.
English: Plasma clearance of total topotecan (active and inactive form) in patients with hepatic impairment only decreased by about 10% compared with the control group of patients.
Croatian: Ukupni klirens plazme za topotekan (aktivni i neaktivni oblik) kod bolesnika s oštećenjem jetre smanjio se samo oko 10% u usporedbi s kontrolnom skupinom.
English: Topotecan in combination with cisplatin is indicated for patients with carcinoma of the cervix recurrent after radiotherapy and for patients with Stage IVB disease.
Croatian: Topotekan u kombinaciji s cisplatinom indiciran je za liječenje recidiva karcinoma vrata maternice nakon provedene radioterapije i za liječenje bolesnica u stadiju IVB.
English: HYCAMTIN capsules should only be prescribed and therapy supervised by a physician experienced in the use of chemotherapeutic agents.
Croatian: HYCAMTIN kapsule trebao bi propisati i liječenje nadzirati isključivo liječnik s iskustvom u primjeni kemoterapije.
English: • Staff handling this medicinal product during reconstitution should wear protective clothing including mask, goggles and gloves.
Croatian: • Osoblje koje rukuje lijekom tijekom rekonstitucije lijeka mora nositi zaštitnu odjeću koja uključuje masku, zaštitne naočale i rukavice.
English: Novartis Hrvatska d.o.o.
Croatian: Novartis Hrvatska d.o.o. Tel.
English: A 5-HT3 antagonist was administered to 30% of patients in 24% of courses.
Croatian: 5-HT3 antagonisti primijenjeni su u 30% bolesnika, u 24% ciklusa liječenja.
English: HYCAMTIN capsules are indicated as monotherapy for the treatment of adult patients with relapsed small cell lung cancer (SCLC) for whom re-treatment with the first-line regimen is not considered appropriate (see section 5.1).
Croatian: HYCAMTIN kapsule su indicirane u monoterapiji odraslih bolesnika s recidivom karcinoma pluća malih stanica (SCLC, od engl. small cell lung cancer) koji nisu pogodni za ponovno uvođenje prve linije liječenja (vidjeti dio 5.1).
English: Death due to sepsis occurred in 1% of patients.
Croatian: Smrt uslijed sepse nastupila je u 1% bolesnika.
English: Hycamtin 0.25 mg and 1 mg capsules are available in packs containing 10 capsules.
Croatian: Hycamtin 0,25 mg i 1 mg kapsule su dostupne u pakiranju koje sadrži 10 kapsula.
English: Tell your doctor immediately if you get any symptoms of these conditions, as hospitalisation may be necessary.
Croatian: Odmah obavijestite liječnika ako primijetite bilo što od navedenog jer ćete možda morati biti liječeni u bolnici.
English: In reproductive toxicity studies with topotecan in rats there was no effect on male or female fertility; however, in females super-ovulation and slightly increased pre-implantation loss were observed.
Croatian: U ispitivanjima reproduktivne toksičnosti topotekana u štakora nije primijećen učinak na mušku ili žensku plodnost; međutim, u ženki je primijećena super-ovulacija i blagi porast predimplantacijskog gubitka.
English: There were no signs of cumulative haematological or non-haematological toxicity.
Croatian: Nema dokaza koji bi upućivali na kumulativnu hematološku ili nehematološku toksičnost.
English: In clinical studies, rash was reported in 4% of patients and pruritus in 1.5% of patients.
Croatian: U kliničkim ispitivanjima osip je prijavljen u 4% bolesnika, a svrbež u 1,5% bolesnika.
English: Median time to progression was similar in the two groups (13.3 weeks and 12.3 weeks, respectively).
Croatian: Medijan vremena do progresije bio je sličan u obje skupine (13,3 tjedana za topotekan i 12,3 tjedana za CAV protokol).
English: • All items for administration or cleaning, including gloves, should be placed in high-risk, waste disposal bags for high-temperature incineration.
Croatian: • Svi predmeti za primjenu lijeka ili čišćenje, uključujući rukavice, moraju se odložiti u vreće za odlaganje otpada visokog rizika koji se spaljuje na visokim temperaturama.
English: In a population study using the intravenous route, the co-administration of granisetron, ondansetron, morphine or corticosteroids did not appear to have a significant effect on the pharmacokinetics of total topotecan (active and inactive form).
Croatian: U populacijskom ispitivanju u kojem se koristila intravenska primjena, istovremena primjena granisetrona, ondansetrona, morfija ili kortikosteroida nije pokazala značajan učinak na farmakokinetiku ukupnog topotekana (aktivnog i neaktivnog oblika).
English: Pharmacokinetics of HYCAMTIN capsules have not been specifically studied in patients with impaired hepatic function.
Croatian: Farmakokinetika HYCAMTIN kapsula nije ciljano ispitivana u bolesnika s oštećenom funkcijom jetre.
English: Topotecan must be reconstituted and further diluted before use (see section 6.6).
Croatian: Način primjene Topotekan se mora prije primjene rekonstituirati i dodatno razrijediti (vidjeti dio 6.6).
English: The most frequently reported non-haematological effects were nausea (37%), diarrhoea (29%), fatigue (26%), vomiting (24%), alopecia (21%) and anorexia (18%).
Croatian: Najčešće prijavljene nehematološke nuspojave bile su mučnina (37%), proljev (29%), umor (26%), povraćanje (24%), alopecija (21%) i anoreksija (18%).
English: Toxicities of topotecan in paediatric patients with recurrent and refractory solid tumours were similar to those historically seen in adult patients.
Croatian: Toksičnost topotekana u djece s recidivirajućim i refraktornim solidnim tumorima slična je onoj već zabilježenoj u odraslih bolesnika.
English: White polyvinyl chloride / polychlorotrifluoroethylene blister sealed with aluminium / Polyethylenterephtalate (PET) / paper foil lidding.
Croatian: Bijeli blister od polivinilklorida/poliklorotrifluoretilena s pokrovnom folijom od aluminija/polietilentereftalata (PET)/papira.
English: However, as with other cytotoxic medicinal products, topotecan is genotoxic and effects on fertility, including male fertility, cannot be excluded.
Croatian: Međutim, kao i ostali citotoksični lijekovi, topotekan je genotoksičan te se učinci na plodnost muškaraca i žena ne mogu isključiti.
English: Adverse reactions are listed below, by system organ class and absolute frequency (all reported events).
Croatian: Nuspojave su navedene prema organskim sustavima i apsolutnoj učestalosti (sve prijavljene nuspojave).
English: Personnel handling this medicinal product during reconstitution should wear protective clothing including mask, goggles and gloves.
Croatian: Osoblje koje rukuje lijekom tijekom rekonstitucije lijeka mora nositi zaštitnu odjeću koja uključuje masku, zaštitne naočale i rukavice.
English: Severe bone marrow depression prior to starting first course, as evidenced by baseline neutrophils <1.5 x 10
Croatian: Teška depresija koštane srži prije započinjanja prvog ciklusa, na što ukazuje početni broj neutrofila < 1,5 x 10
English: Severe cases of diarrhoea may require administration of oral or intravenous electrolytes and fluids, and interruption of topotecan therapy (see sections 4.4 and 4.8).
Croatian: U slučaju teških proljeva može biti potrebna primjena elektrolita i tekućine, oralno ili intravenskim putem te prekid terapije topotekanom (vidjeti dijelove 4.4 i 4.8).
English: 9/l) in 25% of patients (15% of courses).
Croatian: 9/l) u 25% bolesnika (15% ciklusa).
English: Resulting from its mechanism of action, topotecan is genotoxic to mammalian cells (mouse lymphoma cells and human lymphocytes) in vitro and mouse bone marrow cells in vivo.
Croatian: Zbog mehanizma djelovanja, topotekan je genotoksičan za stanice sisavaca (stanice mišjeg limfoma i ljudske limfocite) in vitro i za stanice mišje koštane srži in vivo.
English: However, when combining with platinum agents, there is a distinct sequence-dependent interaction depending on whether the platinum agent is given on day 1 or 5 of the topotecan dosing.
Croatian: Međutim, kad se topotekan kombinira s derivatima platine, postoji jasna interakcija ovisna o redoslijedu, s obzirom na to je li derivat platine primijenjen prvi ili peti dan primjene topotekana.
English: If either cisplatin or carboplatin is given on day 1 of the topotecan dosing, a lower dose of each agent must be given to improve tolerability compared to the dose of each agent which can be given if the platinum agent is given on day 5 of the topotecan dosing.
Croatian: Ako se cisplatin ili karboplatin primjenjuju prvi dan primjene topotekana, mora se primijeniti manja doza svakog lijeka kako bi se poboljšala njihova podnošljivost u usporedbi s dozom svakog pojedinačnog lijeka ako se platina primjenjuje petog dana primjene topotekana.
English: What Hycamtin looks like and contents of the pack Hycamtin comes as a powder for concentrate for solution for intravenous infusion.
Croatian: Kako Hycamtin izgleda i sadržaj pakiranja Hycamtin je prašak za koncentrat za otopinu za infuziju u venu.
English: The primary complications of overdose are bone marrow suppression and mucositis.
Croatian: Osnovne komplikacije predoziranja topotekanom su supresija koštane srži i mukozitis.
English: The response rate to topotecan in the combined small cell lung cancer programme (n = 480) for patients with relapsed disease sensitive to first-line therapy was 20.2%.
Croatian: Stopa odgovora na topotekan u kombinacijskom liječenju karcinoma pluća malih stanica (n = 480) za bolesnike s recidivirajućom bolešću osjetljivom na prvu liniju liječenja iznosila je 20,2%.
English: Insufficient data are available to make a recommendation for patients with a creatinine clearance <30 ml/min.
Croatian: Nema dovoljno raspoloživih podataka na temelju kojih bi se mogle dati preporuke za bolesnike s klirensom kreatinina < 30 ml/min.
English: In vitro data using human liver microsomes indicate the formation of small amounts of Ndemethylated topotecan.
Croatian: In vitro podaci, dobiveni primjenom mikrosomalnih enzima ljudske jetre, upućuju na stvaranje male količine N-demetiliranog topotekana.
English: • The other ingredients are: hydrogenated vegetable oil, glyceryl monostearate, gelatin, titanium dioxide (E171), and for 1 mg capsules only, red iron oxide (E172).
Croatian: • Drugi sastojci su: hidrogenirano biljno ulje, glicerolmonostearat, želatina, titanijev dioksid (E171), a samo 1 mg kapsule sadrže i željezov oksid, crveni (E172).
English: Inhibitors of ABCB1 and ABCG2 administered with oral topotecan have been shown to increase topotecan exposure.
Croatian: Inhibitori ABCB i ABCG2 primijenjeni istovremeno s oralnim topotekanom povećavaju izloženost topotekanu.
English: Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu/.
Croatian: Detaljnije informacije o ovom lijeku dostupne su na internetskoj stranici Europske agencije za lijekove: http://www.ema.europa.eu/.
English: What Hycamtin looks like and contents of the pack Hycamtin 0.25 mg capsules are white to yellowish white and imprinted with “Hycamtin” and “0.25 mg”.
Croatian: Kako Hycamtin izgleda i sadržaj pakiranja Hycamtin 0,25 mg kapsule su bijele do žućkasto bijele, s oznakom „Hycamtin“ i „0,25mg“.
English: In patients refractory to or relapsing within 3 months after cisplatin therapy (n = 186), the response rate was 10%.
Croatian: U bolesnica čija je bolest rezistentna na liječenje ili koje dožive recidiv unutar 3 mjeseca od liječenja cisplatinom (n = 186), stopa odgovora na liječenje iznosila je 10%.
English: Should diarrhoea occur during treatment with oral topotecan, physicians are advised to aggressively manage diarrhoea.
Croatian: Ukoliko se pojavi proljev tijekom liječenja oralnim topotekanom, liječnicima se savjetuje agresivno zbrinjavanje.
English: Marketing Authorisation Holder Novartis Europharm Limited Vista Building
Croatian: Nositelj odobrenja za stavljanje lijeka u promet Novartis Europharm Limited Vista Building
English: • Mouth sores, difficulty swallowing, abdominal pain, nausea, vomiting, diarrhoea, bloody stools
Croatian: • ranice u ustima, otežano gutanje, bol u trbuhu, mučnina, povraćanje, proljev, krvave stolice
English: The pharmacokinetics of topotecan were generally unchanged when co-administered with ranitidine.
Croatian: Farmakokinetika topotekana općenito je nepromijenjena pri istovremenoj primjeni s ranitidinom.
English: For severe cases (CTC Grade 3/4) reported as related/possibly related to topotecan administration the incidence was diarrhoea 5% (see section 4.4), fatigue 4%, vomiting 3%, nausea 3% and anorexia 2%.
Croatian: Teške nuspojave (CTC stupanj 3/4), prijavljene kao povezane/vjerojatno povezane uz primjenu topotekana, javile su se sljedećom incidencijom: proljev 5% (vidjeti dio 4.4), umor 4%, povraćanje 3%, mučnina 3% i anoreksija 2%.
English: Topotecan plus cisplatin had a statistically significant benefit in overall survival relative to cisplatin monotherapy after adjusting for interim analyses (Log-rank p = 0.033).
Croatian: Kombinacija topotekana i cisplatina pokazala je statistički značajnu korist u ukupnom preživljenju u odnosu na monoterapiju cisplatinom nakon prilagodbe rezultata za međuanalizu (log-rang p = 0,033).
English: Vials 3 years.
Croatian: Bočice 3 godine.
English: Therapeutic interventions associated with non-haematological effects included anti-emetic agents, given to 47% of patients in 38% of courses and anti-diarrhoeal agents, given to 15% of patients in 6% of courses.
Croatian: Intervencije u liječenju zbog pojave nehematoloških učinaka uključivale su lijekove protiv mučnine koji su primijenjeni u 47% bolesnika u 38% ciklusa, i lijekove protiv proljeva koji su primijenjeni u 15% bolesnika u 6% ciklusa.
English: For patients who experience Grade 3 or 4 diarrhoea, the dose should be reduced by 0.4 mg/m2/day for subsequent courses (see section 4.4).
Croatian: Za bolesnike s proljevom stupnja 3 ili 4 dozu lijeka potrebno je smanjiti u sljedećim ciklusima za 0,4 mg/m2/dan (vidjeti dio 4.4).
English: Ovarian and small cell lung carcinoma Initial dose
Croatian: Karcinom jajnika i karcinom pluća malih stanica Početna doza
English: Although it is not known whether topotecan is excreted in human breast milk, breast-feeding should be discontinued at the start of therapy.
Croatian: Iako nije poznato izlučuje li se topotekan u majčino mlijeko, treba prekinuti dojenje na početku liječenja topotekanom.
English: If well tolerated, treatment may continue until disease progression (see sections 4.8 and 5.1).
Croatian: Ukoliko bolesnici dobro podnose HYCAMTIN, liječenje se može nastaviti sve do progresije osnovne bolesti (vidjeti dijelove 4.8 i 5.1).
English: In clinical studies, topotecan was discontinued if the dose needed to be reduced below 1.5 mg/m 2/day.
Croatian: U kliničkim se ispitivanjima primjena topotekana obustavljala ako je doza smanjena ispod 1,5 mg/m 2/dan.
English: The normal procedures for proper handling and disposal of anticancer medicinal products should be adopted, namely:
Croatian: Potrebno je slijediti uobičajena pravila za ispravno rukovanje i odlaganje lijekova za liječenje karcinoma:
English: The product should be used immediately after it is prepared for infusion.
Croatian: Preporučuje se primjena neposredno nakon pripreme otopine za infuziju.
English: Table 1 Summary of survival, response rate, and time to progression in SCLC patients treated with oral or intravenous topotecan
Croatian: Tablica 1 Sažeti prikaz preživljenja, stope odgovora i vremena do progresije bolesti u bolesnika s karcinomom pluća malih stanica liječenih peroralnim ili intravenskim topotekanom
English: Detailed information on this medicinal product is available on the website of the European Medicines Agency http://www.ema.europa.eu/.
Croatian: Detaljnije informacije o ovom lijeku dostupne su na internetskoj stranici Europske agencije za lijekove http://www.ema.europa.eu/.
English: Fatigue was observed in approximately 25% and asthenia in 16% of patients receiving topotecan.
Croatian: Umor je primijećen u otprilike 25%, a astenija u 16% bolesnika koji su primali topotekan.
English: Mild abdominal pain was reported in 4% of patients.
Croatian: Prijavljena je pojava blage abdominalne boli u 4% bolesnika.
English: Sepsis Blood and lymphatic system disorders Very common Febrile neutropenia, neutropenia (see “Gastrointestinal disorders”), thrombocytopenia, anaemia, leucopenia
Croatian: Poremećaji krvi i limfnog sustava Vrlo često febrilna neutropenija, neutropenija (vidjeti „Poremećaji probavnog sustava”), trombocitopenija, anemija, leukopenija
English: Hard capsule.
Croatian: Tvrde kapsule.
English: The pharmacokinetics of oral topotecan have not been studied in patients with hepatic impairment (see section 4.2 and 4.4).
Croatian: Farmakokinetika oralnog topotekana nije bila proučavana u bolesnika s oštećenjem jetre (vidjeti dijelove 4.2 i 4.4).
English: In association with severe neutropenia, fever or infection occurred in 16% of patients during course 1 and overall in 23% of patients (6% of courses).
Croatian: Tijekom prvog ciklusa vrućica ili infekcija povezana s teškom neutropenijom javila se u 16% bolesnika, a tijekom čitavog liječenja u 23% bolesnika (6% ciklusa).
English: • Swelling caused by fluid build-up (angioedema).
Croatian: • oticanje uzrokovano nakupljanjem tekućine (angioedem)
English: In clinical studies with topotecan in combination with cisplatin for the treatment of cervical cancer, therapy was only initiated in patients with serum creatinine less than or equal to 1.5 mg/dl.
Croatian: U kliničkim ispitivanjima kombinacije topotekana i cisplatina u liječenju karcinoma vrata maternice, liječenje je započeto samo u bolesnica s vrijednošću kreatinina u serumu manje ili jednako 1,5 mg/dl.
English: Median survival was 30.3 weeks (95% CI: 27.6, 33.4).
Croatian: Medijan vremena preživljenja bio je 30,3 tjedana (95% CI: 27,6; 33,4).
English: If reconstitution is performed under strict aseptic conditions Hycamtin infusion may be completed within 12 hours at room temperature (or 24 hours if stored at 2-8oC).
Croatian: Ako je rekonstitucija provedena pod strogim aseptičkim uvjetima, Hycamtin infuziju treba završiti unutar 12 sati na sobnoj temperaturi (ili unutar 24 sata ako se čuva pri temperaturi od 2°C - 8°C).
English: Hycamtin is used to treat small cell lung cancer that has come back after chemotherapy.
Croatian: Hycamtin se primjenjuje u liječenju raka pluća malih stanica koji se ponovno pojavio nakon prethodne kemoterapije.
English: In 18% of courses with severe thrombocytopenia the duration was >7 days.
Croatian: U 18% ciklusa teška trombocitopenija je trajala > 7 dana.
English: Median (95% CI) Hazard ratio (95% CI)
Croatian: Medijan (95% CI) Omjer hazarda (95% CI)
English: • ovarian cancer or small cell lung cancer that has come back after chemotherapy.
Croatian: • raka jajnika ili raka pluća malih stanica koji su se ponovno pojavili nakon prethodne kemoterapije.
English: All items for administration or cleaning, including gloves, should be placed in high-risk, waste disposal bags for high-temperature incineration.
Croatian: Svi predmeti za primjenu lijeka ili čišćenje, uključujući rukavice, moraju se odložiti u vreće za odlaganje otpada visokog rizika koji se spaljuje na visokim temperaturama.
English: In the oral topotecan plus BSC group there was a statistically significant improvement in overall survival compared with the BSC alone group (Log-rank p = 0.0104).
Croatian: U skupini koja je primala oralni topotekan uz BSC bilo je statistički značajno poboljšanje u ukupnom preživljenju u odnosu na skupinu koja je liječena samo BSC-om (log-rang p = 0,0104).
English: Anaemia
Croatian: Anemija
English: 1.9 mg/m 2/day (or subsequently down to 1.5 mg/m 2/day if necessary).
Croatian: 1,9 mg/m 2/dan (ili ukoliko je potrebno nadalje smanjiti dozu na 1,5 mg/m 2/dan).
English: There are insufficient data available with HYCAMTIN capsules to make a dose recommendation for this patient group (see section 4.4).
Croatian: Nema dovoljno podataka o HYCAMTIN kapsulama koji bi omogućili preporuku doze za ovu grupu bolesnika (vidjeti dio 4.4).
English: Topotecan inhibits topoisomerase-I by stabilising the covalent complex of enzyme and strand-cleaved DNA which is an intermediate of the catalytic mechanism.
Croatian: Topotekan inhibira topoizomerazu-I na način da stabilizira kovalentni kompleks enzima i jednostrukog lanca DNK koji je međuproizvod katalitičkog mehanizma.
English: Patients should be monitored for pulmonary symptoms indicative of ILD (e.g. cough, fever, dyspnoea and/or hypoxia), and topotecan should be discontinued if a new diagnosis of ILD is confirmed.
Croatian: Potrebno je pratiti bolesnike kako bi se na vrijeme uočili znakovi i simptomi IBP-a (npr. kašalj, vrućica, dispneja i/ili hipoksija) te prekinuti primjenu topotekana ako se potvrdi dijagnoza.
English: Overall recovery of topotecan-related material following five daily doses of topotecan was 49 to 72% (mean 57%) of the administered oral dose.
Croatian: Ukupni nalaz materijala povezanog s topotekanom nakon pet dnevnih doza topotekana iznosio je 49% do 72% (srednja vrijednost 57%) primijenjene peroralne doze.
English: The capsules are printed with black ink that contains black iron oxide (E172), shellac, anhydrous ethanol, propylene glycol, isopropyl alcohol, butanol, concentrated ammonia solution and potassium hydroxide.
Croatian: Kapsule su označene crnom tintom koja sadrži: željezov oksid, crni (E172), šelak, etanol bezvodni, propilenglikol, izopropilni alkohol, butanol, koncentriranu otopinu amonijaka i kalijev hidroksid.
English: Results of a cross-study analysis suggest that the exposure to topotecan lactone, the active moiety following topotecan administration, increases with decreased renal function.
Croatian: Rezultati analize većeg broja ispitivanja pokazuju da se izloženost topotekan laktonu, djelatnoj tvari nakon primjene topotekana, povećava sa smanjenjem bubrežne funkcije.