Hycamtin (topotecan) is a prescription medication FDA-approved to treat certain types of small cell lung cancer, ovarian cancer, and cervical cancer. It may be used alone or with other drugs.
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What Is Hycamtin?
Hycamtin is a brand-name product. It contains the active drug topotecan, an anticancer (antineoplastic) agent in the category of medicines called topoisomerase I inhibitors.
How Does Hycamtin Work?
Topotecan blocks an enzyme that cancer cells need to divide. It may also kill cancer cells.
What Is Hycamtin Used To Treat?
Topotecan oral capsules are used to treat small cell lung cancer (SCLC) that previously responded to other chemotherapy medicine but has returned.
Topotecan injections are used to treat:
- Metastatic ovarian cancer (cancer started in the ovaries but has spread to other areas) unresponsive to other treatments
- Small cell lung cancer (SCLC) previously treated with platinum-containing drugs
- Advanced, recurrent, or persistent cancer of the cervix (combined with cisplatin)
How Is Hycamtin Supplied and Used?
The following preparations and strengths are available:
- Oral capsules. Each capsule contains 0.25 mg or 1 mg of the active drug.
- Injection for intravenous (IV) use. Injections come as a sterile, light yellow to greenish powder in single-dose vials. Each vial contains 4 mg of the active drug.
Take the oral capsules exactly as directed. Your doctor will tell you how many capsules to take and when to take them. You may take them with or without food. Swallow the entire capsule; avoid opening, chewing, or crushing them.
You may need to take both strengths of capsules for a full dose. Note the color of the capsule before you take it. The 1 mg capsule is pink, and the 0.25 mg capsule is white to yellowish-white.
A doctor or nurse injects Hycamtin into your vein as an intravenous (IV) infusion over 30 minutes.
Proper Use, Storage, and Disposal
- If you vomit after taking a capsule, do not take another dose that same day. Instead, call your doctor immediately.
- If your skin is exposed to the capsule contents, wash the exposed area with soap and water. Call your doctor immediately if skin reactions occur.
- If your eyes are exposed, wash them immediately with water for at least 15 minutes. Then, talk to your doctor.
- Store in a refrigerator (36°F to 46°F) in the original carton. Avoid freezing and exposure to light.
- If a capsule opens or breaks, do not touch its contents with bare hands. Carefully throw it out without touching it directly. Then, wash your hands with soap and water.
- Ask your pharmacist or contact your local garbage/recycling department to learn about medicine take-back programs in your community.
- Learn how to dispose of unused or expired drugs here.
What Should You Know Before Taking Hycamtin?
Before receiving the first dose, tell your doctor if you:
- Have a history of allergy to topotecan or related medications.
- Take certain medicines like cyclosporine (Sandimmune), ketoconazole (Nizoral), ritonavir (Norvir), or saquinavir (Invirase).
- Have current or past kidney disease.
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Hycamtin Dosage
Small Cell Lung Cancer
- IV infusion: 1.5 mg/m² IV daily for 5 consecutive days starting on Day 1 of a 21-day cycle.
- Oral capsules: 2.3 mg/m² orally once daily for 5 consecutive days starting on Day 1 of a 21-day cycle.
Ovarian Cancer
- 1.5 mg/m² IV daily for 5 consecutive days starting on day 1 of a 21-day cycle.
Cervical Cancer
- 0.75 mg/m² IV infused over 30 min on Days 1, 2, and 3 (with cisplatin 50 mg/m² on Day 1) of a 21-day cycle.
Side Effects
Side effects can be mild or severe.
Common Side Effects
- Low blood cell counts
- Nausea
- Diarrhea
- Vomiting
- Stomach pain
- Loss of appetite
- Hair loss
- Weakness
Talk to your doctor or pharmacist if any side effect worsens or persists.
Severe Side Effects
Talk to your doctor immediately or seek emergency care if you have:
- New or worsening cough
- Fever
- Difficulty breathing
- Diarrhea with fever and stomach cramps
- Pain or burning when passing urine
- Pneumonia (lung infection). Symptoms include fever, chills, cough with mucus, chest pain, and shortness of breath.
- Low blood cell counts (higher risk of infection or bleeding). Symptoms include fever, chills, flu-like symptoms, mouth sores, skin sores, pale skin, cold hands/feet, bruising or bleeding, and light-headedness.
Your doctor may change the dose or discontinue therapy if you have certain symptoms.
Allergic Reactions
Seek emergency medical help if you experience the following:
- Chest pain
- Hives
- Shortness of breath
- High or low blood pressure
- Fever
- Chills
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Use in Pregnancy, Lactation, and Children
Avoid use if you are pregnant. Your doctor will require a test to verify your pregnancy status before starting treatment if you have reproductive potential. Tell your doctor if you are pregnant or plan to become pregnant. Use effective contraception during treatment and for 6 months after your last dose.
If you are a male taking Hycamtin and your partner is of reproductive potential, use effective contraception during treatment and for 3 months after your last dose.
Avoid nursing a child during treatment and for 7 days after your last dose.
It is unknown if this medication is safe and effective in children.
How Much Does Hycamtin Cost?
Cost can vary depending on your insurance plan, location, and pharmacy. Contact your insurance provider to find out if your plan covers this medication or if you need prior authorization.
Novartis, which makes Hycamtin, offers programs to help you access Hycamtin treatment. Contact us I you are interested in receiving financial assistance for Hycamtim.
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Dr. Mark Alfonso, PharmD was born and raised in Pueblo, CO. He received his pharmacy degree from the University of Colorado School of Pharmacy at the Anschutz Medical Campus in 2010. He was board certified in medication therapy management in 2022. The most rewarding part of his job is helping to answer patient questions and concerns. His areas of expertise are community pharmacy and medication therapy management. In his free time, he enjoys reading and running.