At least four courses is recommended because tumor response may be delayed. At least four courses is recommended because tumor response may be delayed. In clinical studies, sensitive disease was defined as disease responding to chemotherapy but later progressing at least 60-90 days after chemotherapy. No dosage adjustment appears to be needed in patients with mild renal impairment.
Insufficient data are available in patients with severe renal impairment to recommend a dosage.
Contraindicated in patients with severe bone marrow suppression. The nadir neutrophil count occurred at a median of 12 days. There were no episodes of serious bleeding. Contraindicated in patients who have a history of hypersensitivity reactions to topotecan or any component. If accidental contact with skin occurs, wash skin immediately and thoroughly with soap and water.