Topotecan with Amiodarone Interaction Details
Brand Names Associated with Topotecan
- Hycamtin®
- Topotecan
Brand Names Associated with Amiodarone
- Amiodarone
- Cordarone®
- Pacerone®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 27, 2024
Interaction Effect
Increased topotecan exposure and risk of adverse events
Interaction Summary
Concomitant use of oral topotecan (a P-gp substrate) and a P-gp inhibitor may increase systemic exposure of topotecan and increase the risk of adverse events. In a clinical study, coadministration of oral topotecan with cyclosporine A (a P-gp inhibitor) increased topotecan exposure 2- to 3-fold. Concomitant use of orally administered topotecan and P-gp inhibitors should be avoided[1].
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Coadministration of topotecan (a P-gp substrate) and a P-gp inhibitor may result in increased topotecan exposure and adverse events. Concomitant use of orally administered topotecan and P-gp inhibitors should be avoided[1].
Mechanism Of Interaction
Inhibition of P-gp-mediated efflux transport of topotecan
Literature Reports
A) In a clinical study coadministration of single dose of cyclosporine A 15 mg/kg orally (P-gp inhibitor) within 4 hours of oral topotecan increased the dose-normalized AUC (0-24 hours) of topotecan lactone and total topotecan 2- to 3-fold compared with topotecan alone [1].
References
1 ) Product Information: HYCAMTIN(R) oral capsules, topotecan oral capsules. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2018.
Topotecan Overview
-
Topotecan is used to treat small cell lung cancer (a type of cancer that begins in the lungs) that was successfully treated with a different chemotherapy medication but has returned no sooner than 45 days after the last dose of the first chemotherapy medication was taken. Topotecan is in a class of medications called topoisomerase I inhibitors. It works by killing cancer cells.
Amiodarone Overview
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Amiodarone is used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias (a certain type of abnormal heart rhythm when other medications did not help or could not be tolerated. Amiodarone is in a class of medications called antiarrhythmics. It works by relaxing overactive heart muscles.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.