Topotecan is a chemotherapy medicine used in combination with other drugs for the treatment of certain types of cancer. This page explains what topotecan is, how it is given and some of the possible side effects. Each person reacts differently to medicines, so your child will not necessarily suffer from every side effect mentioned.

What is topotecan?

Topotecan is a chemotherapy medicine used in combination with other drugs for the treatment of certain types of cancer.

How is it given?

It is usually given as an infusion into a vein (intravenously or IV) through a cannula, central venous catheter or implantable port in hospital.

What are the side effects?

Bone marrow suppression

There will be a temporary reduction in how well your child’s bone marrow works. This means that they may become anaemic, bruise or bleed more easily than usual and have a higher risk of infection. Your child’s blood count will be examined regularly to check how well the bone marrow is working. Please tell your doctor if your child seems to be unusually tired, has bruising or bleeding or any signs of infection, especially a high temperature.

Nausea and vomiting 

Anti-sickness drugs can be given to reduce or prevent these symptoms. Please tell your doctor or nurse if your child’s sickness is not controlled or persists.


Please tell the doctor or nurse if your child has diarrhoea that is not controlled or persists. Some people may need to go to hospital to have fluids through a drip (IV infusion).


Your child may become constipated and have tummy pain. This can generally be helped by drinking lots of fluids and eating a high-fibre diet. Sometimes the doctor may prescribe laxative medicines to stimulate your child’s bowel function.

Mouth sores and ulcers 

Your child’s mouth may become sore or get painful ulcers. You will be given advice about appropriate mouth care including a copy of the mouth care leaflet. If your child complains about having a sore mouth, please tell your doctor or nurse.

Loss of appetite

Your child may ‘go off’ food and their appetite may be reduced during treatment. The dietitian at the hospital will be able to suggest ways of making food more attractive to your child.


Your child may feel a bit more tired than usual. If you are concerned, please tell your doctor.

Hair loss 

Your child may lose all their hair, including eyebrows and eyelashes, or it may become thinner. This is temporary and the hair will grow back once the treatment has finished.

Changes in liver function 

Topotecan can cause some mild changes to your child’s liver function. This should return to normal when the treatment is finished. Blood tests may be taken to monitor your child’s liver function (LFTs). Please discuss this with your doctor if you have further questions.

Flu-like symptoms

Your child may have headache, tiredness, aching joints and muscles, a high temperature and chills. This effect is temporary and paracetamol may be given to relieve these symptoms.

Less common side effects

Children may also develop other side effects although these are less common. Possible side effects include rashes or sore skin, reduced blood pressure, shortness of breath, changes in kidney function and allergic reactions to the medicine.

Interactions with other medicines

Some medicines can react with topotecan altering how well it works. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines.

Compiled by:
The Pharmacy department in collaboration with the Child and Family Information Group
Last review date:
April 2020