Topotecan

Manufacturer
Hospira, Inc. | Zydus Hospira Oncology Private Limited | Hospira Australia Pty Ltd
Effective date
2021-02-01
Label type
HUMAN PRESCRIPTION DRUG LABEL
Version
23
Source
full-release
Hydrated at
2026-05-31 20:35:23

Label at a glance#

ProductTopotecan
Active ingredientTOPOTECAN HYDROCHLORIDE
Label structure19 sections

Boxed warning

Topotecan can cause severe myelosuppression. Administer first cycle only to patients with baseline neutrophil counts of greater than or equal to 1,500/mm 3 and platelet counts greater than or equal to 100,000/mm 3 . Monitor blood cell counts [see Warnings and Precautions (5.1) ] .

Indications and uses

Topotecan Injection is indicated for the treatment of patients with small cell lung cancer (SCLC) with platinum-sensitive disease who progressed at least 60 days after initiation of first-line chemotherapy.

Dosage and administration

Verify dosage using body surface area. Do not exceed a single dose of 4 mg intravenously. The recommended dosage of Topotecan Injection is 1.5 mg/m 2 by intravenous infusion over 30 minutes daily for 5 consecutive days, starting on Day 1 of a 21-day cycle. Hematologic Do not administer subsequent cycles of Topotecan Injection until neutrophils recover to greater than 1,000/mm 3 , platelets recover to greater than ...

Storage and handling

Topotecan Injection is supplied in 4 mg/4 mL (1 mg/mL topotecan free base) single-dose vials. Each vial contains 4 mL of the sterile, clear, yellow to yellow-green solution. NDC 0409-0302-01 (Package of 1 single-dose vial) Store refrigerated between 2°C and 8°C (36°F and 46°F) in the original carton to protect from light. Discard unused portion. Topotecan Injection is a cytotoxic drug. Follow applicable handling a...

Label contents#

Full prescribing information#

WARNING: MYELOSUPPRESSION

BOXED WARNING SECTION

Topotecan can cause severe myelosuppression. Administer first cycle only to patients with baseline neutrophil counts of greater than or equal to 1,500/mm3and platelet counts greater than or equal to 100,000/mm3. Monitor blood cell counts [see Warnings and Precautions (5.1)].

1 INDICATIONS AND USAGE

INDICATIONS & USAGE SECTION

Topotecan Injection is indicated for the treatment of patients with small cell lung cancer (SCLC) with platinum-sensitive disease who progressed at least 60 days after initiation of first-line chemotherapy.

2 DOSAGE AND ADMINISTRATION

DOSAGE & ADMINISTRATION SECTION

2.1 Important Safety Information

SPL UNCLASSIFIED SECTION

Verify dosage using body surface area. Do not exceed a single dose of 4 mg intravenously.

2.3 Dosage Modifications for Adverse Reactions

SPL UNCLASSIFIED SECTION

SPL UNCLASSIFIED SECTION

Hematologic

Do not administer subsequent cycles of Topotecan Injection until neutrophils recover to greater than 1,000/mm3, platelets recover to greater than 100,000/mm3, and hemoglobin levels recover to greater than or equal to 9 g/dL (with transfusion if necessary).

Reduce the dose of Topotecan Injection to 1.25 mg/m2/day for:

  • neutrophil counts of less than 500/mm3 or administer granulocyte-colony stimulating factor (G-CSF) starting no sooner than 24 hours following the last dose
  • platelet counts less than 25,000/mm3 during previous cycle

2.4 Dosage Modification for Renal Impairment

SPL UNCLASSIFIED SECTION

Reduce the dose of Topotecan Injection to 0.75 mg/m2/day for patients with creatinine clearance (CLcr) of 20 to 39 mL/min (calculated with the Cockcroft-Gault method using ideal body weight) [see Clinical Pharmacology (12.3)].

2.5 Preparation and Administration

SPL UNCLASSIFIED SECTION

Topotecan Injection is a cytotoxic drug. Follow applicable special handling and disposable procedures.1

Withdraw the appropriate volume from the vial and discard any unused portion.

Dilute Topotecan Injection in a minimum of 50 mL of 0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP prior to administration. Infuse diluted Topotecan Injection over 30 minutes.

Store diluted Topotecan Injection at 20°C and 25°C (68°F and 77°F) in ambient lighting conditions for no more than 24 hours. Discard unused portion after 24 hours.

Visually inspect for particulate matter and discoloration prior to administration, whenever solution and container permit. Discard if particulate matter or discoloration is observed.

3 DOSAGE FORMS AND STRENGTHS

DOSAGE FORMS & STRENGTHS SECTION

Injection: 4 mg/4 mL (1 mg/mL topotecan free base) clear, yellow to yellow-green solution in single-dose vial.

4 CONTRAINDICATIONS

CONTRAINDICATIONS SECTION

Topotecan Injection is contraindicated in patients who have a history of severe hypersensitivity reactions to topotecan. Reactions have included anaphylactoid reactions [see Adverse Reactions (6.2)].

5 WARNINGS AND PRECAUTIONS

WARNINGS AND PRECAUTIONS SECTION

5.1 Myelosuppression

SPL UNCLASSIFIED SECTION

Topotecan can cause severe myelosuppression.

Grade 4 neutropenia occurred in 78% of 879 patients, with a median duration of 7 days and was most common during Cycle 1 (58% of patients). Grade 4 neutropenia associated with infection occurred in 13% and febrile neutropenia occurred in 5%. Sepsis occurred in 4% and was fatal in 1%. Grade 4 thrombocytopenia occurred in 27%, with a median duration of 5 days. Grade 3 or 4 anemia occurred in 37% of patients.

Topotecan can cause fatal typhlitis (neutropenic enterocolitis). Consider the possibility of typhlitis in patients presenting with fever, neutropenia, and abdominal pain.

Administer the first cycle of Topotecan Injection only to patients with a baseline neutrophil count of greater than or equal to 1,500/mm3 and a platelet count greater than or equal to 100,000/mm3. Monitor blood counts frequently during treatment. Withhold and reduce dose of Topotecan Injection based on neutrophil counts, platelet counts and hemoglobin levels [see Dosage and Administration (2.3)].

5.2 Interstitial Lung Disease

SPL UNCLASSIFIED SECTION

Interstitial lung disease (ILD), including fatalities, has occurred with topotecan [see Adverse Reactions (6.2)]. Underlying risk factors include history of ILD, pulmonary fibrosis, lung cancer, thoracic radiation, and use of pneumotoxic drugs and/or colony stimulating factors. Monitor patients for pulmonary symptoms indicative of ILD (e.g., cough, fever, dyspnea, and/or hypoxia), and discontinue Topotecan Injection if a new diagnosis of ILD is confirmed.

5.3 Extravasation and Tissue Injury

SPL UNCLASSIFIED SECTION

Extravasation with topotecan has been observed; severe cases have been reported. If signs or symptoms of extravasation occur, immediately stop administration of Topotecan Injection and institute recommended management procedures [see Adverse Reactions (6.2)].

5.4 Embryo-Fetal Toxicity

SPL UNCLASSIFIED SECTION

Based on animal data, topotecan can cause fetal harm when administered to a pregnant woman. Topotecan caused embryolethality, fetotoxicity, and teratogenicity in rats and rabbits when administered during organogenesis. Advise women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment and for 6 months after the last dose of Topotecan Injection. Advise males with a female partner of reproductive potential to use effective contraception during treatment with Topotecan Injection and for 3 months after the last dose [see Use in Specific Populations (8.1, 8.3), Nonclinical Toxicology (13.1)].

6 ADVERSE REACTIONS

ADVERSE REACTIONS SECTION

The following serious adverse reactions are described elsewhere in the labeling:

6.1 Clinical Trials Experience

CLINICAL TRIALS EXPERIENCE SECTION

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The data in Warnings and Precautions reflect exposure to topotecan from 8 trials in which 879 patients with small cell lung cancer (SCLC) and other solid tumors received topotecan 1.5 mg/m2 by intravenous infusion daily for 5 consecutive days, starting on Day 1 of a 21-day cycle.

SPL UNCLASSIFIED SECTION

Small Cell Lung Cancer (SCLC)

The safety of topotecan was evaluated in randomized, comparative trial in patients with recurrent or progressive SCLC (Study 090) [see Clinical Studies (14.1)]. Table 1 shows the Grade 3 or 4 hematologic and non-hematologic adverse reactions in patients with SCLC.

Table 1. Adverse Reactions Occurring in ≥5% of Patients with Small Cell Lung Cancer in Study 090
Adverse ReactionsTopotecan
(n = 107)
CAV*
(n = 104)
Grade 3–4 (%)Grade 3–4 (%)
Hematologic
Grade 4 neutropenia (< 500/mm3)7072
Grade 3 or 4 anemia (Hgb < 8 g/dL)4220
Grade 4 thrombocytopenia (< 25,000/mm3)295
Febrile neutropenia2826
Non-Hematologic
Respiratory, thoracic, and mediastinal
  Dyspnea914
  Pneumonia86
General and administrative site conditions
  Asthenia97
  Fatigue610
  Pain† 57
Gastrointestinal
  Nausea86
  Abdominal pain64
Infections
  Sepsis‡ 55

* CAV = cyclophosphamide, doxorubicin and vincristine.

† Pain includes body pain, skeletal pain, and back pain.

‡ Death related to sepsis occurred in 3% of patients receiving topotecan and 1% of patients receiving CAV.

SPL UNCLASSIFIED SECTION

Hepatobiliary Disorders

Based on 879 patients with small cell lung cancer or another solid tumor who were treated with topotecan, Grade 3 or 4 elevated aspartate (AST) or alanine transaminase (ALT) occurred in 4% and Grade 3 or 4 elevated bilirubin occurred in less than 2% of patients.

6.2 Postmarketing Experience

POSTMARKETING EXPERIENCE SECTION

The following reactions have been identified during postapproval use of topotecan. Because these reactions are reported voluntarily from a population of unknown size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

SPL UNCLASSIFIED SECTION

Blood and Lymphatic System

Severe bleeding (in association with thrombocytopenia)

SPL UNCLASSIFIED SECTION

Hypersensitivity

Allergic manifestations, anaphylactoid reactions, angioedema

SPL UNCLASSIFIED SECTION

Gastrointestinal

Abdominal pain potentially associated with neutropenic enterocolitis, gastrointestinal perforation

SPL UNCLASSIFIED SECTION

Pulmonary

Interstitial lung disease

SPL UNCLASSIFIED SECTION

Skin and Subcutaneous Tissue

Severe dermatitis, severe pruritus

SPL UNCLASSIFIED SECTION

General and Administration Site Conditions

Extravasation, mucosal inflammation

8 USE IN SPECIFIC POPULATIONS

USE IN SPECIFIC POPULATIONS SECTION

8.1 Pregnancy

PREGNANCY SECTION

SPL UNCLASSIFIED SECTION

Risk Summary

Based on animal data and its mechanism of action, Topotecan Injection can cause fetal harm when administered to a pregnant woman. There are no available clinical data on the use of topotecan in pregnancy. Topotecan caused embryolethality, fetotoxicity, and teratogenicity in rats and rabbits when administered during organogenesis at doses similar to the clinical dose (see Data). Advise pregnant women of the potential risk to a fetus.

In the U.S. general population, the background risk of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies.

SPL UNCLASSIFIED SECTION

Data

SPL UNCLASSIFIED SECTION

Animal Data

In rabbits, an intravenous dose of 0.10 mg/kg/day [(about equal to the 1.5 mg/m2 clinical dose based on body surface area (BSA)] given on Days 6 through 20 of gestation caused maternal toxicity, embryolethality, and reduced fetal body weight. In the rat, an intravenous dose of 0.23 mg/kg/day (about equal to the 1.5 mg/m2 clinical dose based on BSA) given for 14 days before mating through gestation Day 6 caused fetal resorption, microphthalmia, pre-implant loss, and mild maternal toxicity. Administration of an intravenous dose of 0.10 mg/kg/day (about half the 1.5 mg/m2 clinical dose based on BSA) given to rats on Days 6 through 17 of gestation caused an increase in post-implantation mortality. This dose also caused an increase in total fetal malformations. The most frequent malformations were of the eye (microphthalmia, anophthalmia, rosette formation of the retina, coloboma of the retina, ectopic orbit), brain (dilated lateral and third ventricles), skull, and vertebrae.

8.2 Lactation

LACTATION SECTION

SPL UNCLASSIFIED SECTION

Risk Summary

There are no data on the presence of topotecan or its metabolites in human milk or their effects on the breastfed infant or on milk production. Lactating rats excrete high concentrations of topotecan in milk (see Data). Because of the potential for serious adverse reactions in breastfed infants, advise women not to breastfeed during treatment with Topotecan Injection and for 1 week after the last dose.

SPL UNCLASSIFIED SECTION

Data

Following intravenous administration of topotecan to lactating rats at a dose of 4.72 mg/m2 (about twice the 1.5 mg/m2 clinical dose based on BSA), topotecan was excreted into milk at concentrations up to 48-fold higher than those in plasma.

8.3 Females and Males of Reproductive Potential

FEMALES & MALES OF REPRODUCTIVE POTENTIAL SECTION

SPL UNCLASSIFIED SECTION

Pregnancy Testing

Verify pregnancy status of females of reproductive potential prior to initiating Topotecan Injection [see Use in Specific Populations (8.1)].

SPL UNCLASSIFIED SECTION

Contraception

Topotecan can cause fetal harm when administered to a pregnant woman [see Use in Specific Populations (8.1)].

SPL UNCLASSIFIED SECTION

Females

Advise female patients of reproductive potential to use effective contraception during treatment with Topotecan Injection and for 6 months after the last dose.

SPL UNCLASSIFIED SECTION

Males

Topotecan may damage spermatozoa, resulting in possible genetic and fetal abnormalities. Advise males with a female partner of reproductive potential to use effective contraception during treatment with Topotecan Injection and for 3 months after the last dose [see Nonclinical Toxicology (13.1)].

SPL UNCLASSIFIED SECTION

Infertility

8.4 Pediatric Use

PEDIATRIC USE SECTION

Safety and effectiveness in pediatric patients have not been established.

8.5 Geriatric Use

GERIATRIC USE SECTION

Of the 879 patients with SCLC or another solid tumor who received topotecan in clinical trials, 32% were aged 65 years and older, while 3.8% were aged 75 years and older. No overall differences in effectiveness or safety were observed between these patients and younger patients and other reported clinical experience has not identified differences in responses between the elderly and younger patients.

8.6 Renal Impairment

RENAL IMPAIRMENT SUBSECTION

Reduce the dose of Topotecan Injection for patients with a CLcr of 20 to 39 mL/min [see Dosage and Administration (2.4), Clinical Pharmacology (12.3)]. No dosage adjustment is recommended for patients with CLcr greater than or equal to 40 mL/min. Insufficient data are available in patients with CLcr less than 20 mL/min to provide a dosage recommendation for Topotecan Injection.

10 OVERDOSAGE

OVERDOSAGE SECTION

Overdoses (up to 10-fold of the recommended dose) have occurred in patients receiving intravenous topotecan. The primary complication of overdosage is myelosuppression. Elevated hepatic enzymes, mucositis, gastrointestinal toxicity and skin toxicity have occurred with overdosages. If an overdose is suspected, monitor the patient closely for myelosuppression and institute supportive-care measures as appropriate.

11 DESCRIPTION

DESCRIPTION SECTION

Topotecan is a semi-synthetic derivative of camptothecin and a topoisomerase inhibitor. The chemical name for topotecan hydrochloride is (S)-10-[(dimethylamino)methyl]-4-ethyl-4,9-dihydroxy-1H-pyrano[3',4':6,7]indolizino[1,2-b]quinoline-3,14-(4H,12H)-dione 1.25 hydrochloride. It has the molecular formula C23H23N3O5∙xHCl (x=1.25) and a molecular weight of 467.02. It is soluble in water and melts with decomposition at 213°C to 218°C.

Topotecan hydrochloride has the following structural formula:

Chemical Structure
Chemical Structure

Topotecan Injection for intravenous use is supplied as a sterile, non-pyrogenic, clear, yellow to yellow-green solution in single-dose vial at a topotecan free base concentration of 4 mg/4 mL (1 mg/mL).

Each mL contains 1 mg topotecan free base (equivalent to 1.11 mg of topotecan hydrochloride), 5 mg tartaric acid, NF and water for injection, USP. It may also contain hydrochloric acid and/or sodium hydroxide to adjust the pH. The solution pH ranges from 2.6 to 3.2.

12 CLINICAL PHARMACOLOGY

CLINICAL PHARMACOLOGY SECTION

12.1 Mechanism of Action

MECHANISM OF ACTION SECTION

Topoisomerase I relieves torsional strain in DNA by inducing reversible single-strand breaks. Topotecan binds to the topoisomerase I-DNA complex and prevents re-ligation of these single-strand breaks. The cytotoxicity of topotecan is thought to be due to double-strand DNA damage produced during DNA synthesis, when replication enzymes interact with the ternary complex formed by topotecan, topoisomerase I, and DNA. Mammalian cells cannot efficiently repair these double-strand breaks.

12.3 Pharmacokinetics

PHARMACOKINETICS SECTION

Following administration of topotecan at doses of 0.5 to 1.5 mg/m2 (0.3 to 1 times the recommended dose) administered as a 30-minute infusion, area under the curve (AUC) increases approximately proportional with dose.

SPL UNCLASSIFIED SECTION

Distribution

Protein binding of topotecan is approximately 35%.

SPL UNCLASSIFIED SECTION

Elimination

The terminal half-life of topotecan is 2 to 3 hours following intravenous administration.

SPL UNCLASSIFIED SECTION

Metabolism

Topotecan undergoes a reversible pH-dependent hydrolysis of its pharmacologically active lactone moiety. At pH ≤ 4, the lactone is exclusively present, whereas the ring-opened hydroxy-acid form predominates at physiologic pH. Topotecan is metabolized to an N-demethylated metabolite in vitro. The mean metabolite: parent AUC ratio was about 3% for total topotecan and topotecan lactone following intravenous administration.

SPL UNCLASSIFIED SECTION

Excretion

The overall recovery of total topotecan and its N-desmethyl metabolite in urine and feces over 9 days averaged 73% ± 2% following an intravenous dose. Mean values of 51% ± 3% as total topotecan and 3% ± 1% as N-desmethyl topotecan were excreted in the urine. Fecal elimination of total topotecan accounted for 18% ± 4% while fecal elimination of N-desmethyl topotecan was 1.7% ± 0.6%. An O-glucuronidation metabolite of topotecan and N-desmethyl topotecan has been identified in the urine.

SPL UNCLASSIFIED SECTION

Specific Populations

No clinically significant differences in the pharmacokinetics of topotecan were observed based on age, sex, or hepatic impairment following intravenous administration.

SPL UNCLASSIFIED SECTION

Patients with Renal Impairment

Compared to patients with CLcr > 60 mL/min (calculated by the Cockcroft-Gault method using ideal body weight), plasma clearance of topotecan lactone decreased by 33% in patients with CLcr 40 to 60 mL/min and decreased by 65% in patients with CLcr 20 to 39 mL/min. The effect on topotecan pharmacokinetics in patients with CLcr < 20 mL/min is unknown [see Dosage and Administration (2.4)].

SPL UNCLASSIFIED SECTION

Drug Interaction Studies

SPL UNCLASSIFIED SECTION

Clinical Studies

No clinically significant changes in topotecan pharmacokinetics were observed when coadministered cisplatin.

No clinically significant changes in the pharmacokinetics of free platinum were observed in patients coadministered cisplatin with topotecan.

SPL UNCLASSIFIED SECTION

In Vitro Studies

Topotecan does not inhibit CYP1A2, CYP2A6, CYP2C8/9, CYP2C19, CYP2D6, CYP2E, CYP3A, or CYP4A or dihydropyrimidine dehydrogenase.

13 NONCLINICAL TOXICOLOGY

NONCLINICAL TOXICOLOGY SECTION

13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

CARCINOGENESIS & MUTAGENESIS & IMPAIRMENT OF FERTILITY SECTION

Carcinogenicity testing of topotecan has not been performed. Topotecan is known to be genotoxic to mammalian cells and is a probable carcinogen. Topotecan was mutagenic to L5178Y mouse lymphoma cells and clastogenic to cultured human lymphocytes with and without metabolic activation. It was also clastogenic to mouse bone marrow. Topotecan did not cause mutations in bacterial cells.

Topotecan given to female rats prior to mating at an intravenous dose of 1.4 mg/m2 (about equal to the 1.5 mg/m2 clinical dose based on BSA) caused superovulation possibly related to inhibition of follicular atresia. This dose given to pregnant female rats also caused increased pre-implantation loss. A one month study in dogs given a daily intravenous topotecan dose of 0.4 mg/m2 (about 0.25 times the 1.5 mg/m2 clinical dose based on BSA) suggests that treatment may cause an increase in the incidence of multinucleated spermatogonial giant cells in the testes.

14 CLINICAL STUDIES

CLINICAL STUDIES SECTION

14.1 Small Cell Lung Cancer

SPL UNCLASSIFIED SECTION

The efficacy of topotecan was studied in 426 patients with recurrent or progressive SCLC in a randomized, comparative trial and in 3 single-arm trials.

SPL UNCLASSIFIED SECTION

Randomized Comparative Trial

In a randomized, comparative trial, 211 patients were randomized 1:1 to received topotecan (1.5 mg/m2 once daily intravenously for 5 days starting on Day 1 of a 21-day cycle) or CAV (cyclophosphamide 1,000 mg/m2, doxorubicin 45 mg/m2, vincristine 2 mg administered sequentially on Day 1 of a 21-day cycle). All patients were considered sensitive to first-line chemotherapy (responders who then subsequently progressed greater than or equal to 60 days after completion of first-line therapy). A total of 77% of patients treated with topotecan and 79% of patients treated with CAV received platinum/etoposide with or without other agents as first-line chemotherapy. The efficacy outcome measures were overall response rate, response duration, time to progression and overall survival (OS).

The results of the trial did not show statistically significant improvements in response rates, response duration, time to progression, and OS as shown in Table 2.

Table 2. Efficacy Results in Patients with Small Cell Lung Cancer Sensitive to First-Line Chemotherapy in Study 090
ParameterTopotecan
(n = 107)
CAV*
(n = 104)
Abbreviations: CI = confidence interval.
Overall response rate (95% CI)24% (16% to 32%)18% (11% to 26%)
  Complete response rate0%1%
  Partial response rate24%17%
Response duration† (months)
  Median (95% CI)3.3 (3.0 to 4.1)3.5 (3.0 to 5.3)
Time to progression (months)
  Median (95% CI)3.1 (2.6 to 4.1)2.8 (2.5 to 3.2)
  Hazard ratio (95% CI)0.92 (0.69 to 1.22)
Overall survival (months)
  Median (95% CI)5.8 (4.7 to 6.8)5.7 (5.0 to 7.0)
  Hazard ratio (95% CI)1.04 (0.78 to 1.39)

* CAV = cyclophosphamide, doxorubicin and vincristine.

† The calculation for duration of response was based on the interval between first response and time to progression.

The median time to response was similar in both arms: topotecan 6 weeks (2.4 weeks to 3.6 months) versus CAV 6 weeks (5.1 weeks to 4.2 months).

Changes on a disease-related symptom scale are presented in Table 3. It should be noted that not all patients had all symptoms, nor did all patients respond to all questions. Each symptom was rated on a 4-category scale with an improvement defined as a change in 1 category from baseline sustained over 2 cycles. Limitations in interpretation of the rating scale and responses preclude formal statistical analysis.

Table 3. Symptom Improvement* in Patients with Small Cell Lung Cancer in Study 090
SymptomTopotecan
(n = 107)
CAV†
(n = 104)
n‡ %n‡ %
Shortness of breath6828617
Interference with daily activity67276311
Fatigue7023659
Hoarseness40333813
Cough69256115
Insomnia57335319
Anorexia56325716
Chest pain44254117
Hemoptysis15271233

* Defined as improvement sustained over at least 2 cycles compared with baseline.

† CAV = cyclophosphamide, doxorubicin and vincristine.

‡ Number of patients with baseline and at least 1 post-baseline assessment.

SPL UNCLASSIFIED SECTION

Single-Arm Trials

Topotecan was also studied in 3 open-label, non-comparative trials (Studies 014, 092 and 053) in a total of 319 patients with recurrent or progressive SCLC after treatment with first-line chemotherapy. In all 3 trials, patients were stratified as either sensitive (responders who then subsequently progressed greater than or equal to 90 days after completion of first-line therapy) or refractory (no response to first-line chemotherapy or who responded to first-line therapy and then progressed within 90 days of completing first-line therapy). Response rates ranged from 11% to 31% for sensitive patients and 2% to 7% for refractory patients. Median time to progression and median survival were similar in all 3 trials and the comparative trial.

16 HOW SUPPLIED/STORAGE AND HANDLING

HOW SUPPLIED SECTION

Topotecan Injection is supplied in 4 mg/4 mL (1 mg/mL topotecan free base) single-dose vials. Each vial contains 4 mL of the sterile, clear, yellow to yellow-green solution.

NDC 0409-0302-01 (Package of 1 single-dose vial)

STORAGE AND HANDLING SECTION

Store refrigerated between 2°C and 8°C (36°F and 46°F) in the original carton to protect from light. Discard unused portion.

Topotecan Injection is a cytotoxic drug. Follow applicable handling and disposal procedures.1

17 PATIENT COUNSELING INFORMATION

INFORMATION FOR PATIENTS SECTION

SPL UNCLASSIFIED SECTION

Myelosuppression

Inform patients that topotecan decreases blood cell counts such as white blood cells, platelets, and red blood cells. Advise patients to notify their healthcare provider promptly for fever, other signs of infection, or bleeding [see Warnings and Precautions (5.1)].

SPL UNCLASSIFIED SECTION

Interstitial Lung Disease (ILD)

Inform patients of the risks of severe ILD. Advise patients to contact their healthcare provider immediately to report new or worsening respiratory symptoms [see Warnings and Precautions (5.2)].

SPL UNCLASSIFIED SECTION

Embryo-Fetal Toxicity

Advise females of reproductive potential and males with female partners of reproductive potential of the potential risk to a fetus. Advise women to contact their healthcare provider if they become pregnant, or if pregnancy is suspected during treatment with Topotecan Injection [see Warnings and Precautions (5.4), Use in Specific Populations (8.1, 8.3)].

Advise females of reproductive potential to use effective contraception during treatment with Topotecan Injection and for 6 months after the last dose [see Use in Specific Populations (8.1, 8.3)].

Advise males with a female sexual partner of reproductive potential to use effective contraception during treatment with Topotecan Injection and for 3 months after the last dose [see Use in Specific Populations (8.1, 8.3), Nonclinical Toxicology (13.1)].

SPL UNCLASSIFIED SECTION

Lactation

Advise women to discontinue breastfeeding during treatment with Topotecan Injection and for at least 1 week after the last dose [see Use in Specific Populations (8.2)].

SPL UNCLASSIFIED SECTION

Asthenia and Fatigue

Advise patients that topotecan may cause asthenia or fatigue. These symptoms may impair the ability to safely drive or operate machinery.

SPL UNCLASSIFIED SECTION

LogoLogo

Distributed by Hospira, Inc., Lake Forest, IL 60045 USA

LAB-1355-2.0

PRINCIPAL DISPLAY PANEL - 4 mg/4 mL Vial Label

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

Topotecan Injection

4 mg/4 mL

(1 mg/mL)

Must Dilute Before
Intravenous Infusion

Caution: Cytotoxic agent

PRINCIPAL DISPLAY PANEL - 4 mg/4 mL Vial Label
PRINCIPAL DISPLAY PANEL - 4 mg/4 mL Vial Label

PRINCIPAL DISPLAY PANEL - 4 mg/4 mL Vial Carton

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

Single-dose Vial
Discard Unused Portion

Hospira

NDC 0409-0302-01
Sterile

Rx only

Topotecan
Injection

4 mg/4 mL

(1 mg/mL)

Must Dilute Before
Intravenous Infusion

Caution: Cytotoxic Agent

PRINCIPAL DISPLAY PANEL - 4 mg/4 mL Vial Carton
PRINCIPAL DISPLAY PANEL - 4 mg/4 mL Vial Carton

DailyMed RxNorm Mappings#

RxCUI, RxNorm string, TTY table
RxCUIRxNorm stringTTYSPL version
1799424topotecan 4 MG in 4 ML InjectionPSN23
17994244 ML topotecan 1 MG/ML InjectionSCD23
1799424topotecan (as topotecan hydrochloride) 4 MG per 4 ML InjectionSY23
1799424topotecan 4 MG per 4 ML InjectionSY23

DailyMed Pharmacologic Classes#

Class, Version, Type table
ClassVersionTypeEffective
TOPOTECAN Pharmacologic Class Indexing2Indexing - Pharmacologic Class20180813

DailyMed Product Concepts#

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302dcbc5-1902-d63c-93ac-bac5e14c2822Product name120140508

DailyMed Package Descriptions#

Package NDC, Product, Description table
Package NDCProductDescriptionFormQuantityStrengthSPL version
0409-0302-01Topotecan4 mL in 1 VIAL, SINGLE-DOSEINJECTION, SOLUTION, CONCENTRATE423
0409-0302-01Topotecan1 in 1 CARTONINJECTION, SOLUTION, CONCENTRATE123

DailyMed Dashboard NDC Coverage#

NDC, Dashboard title, SPL version table
NDCDashboard titleSPL versionValidationDashboard ZIP
0409-0302TOPOTECAN INJECTION, SOLUTION, CONCENTRATE [HOSPIRA, INC.]23Current NDC, Legacy NDC, 2 package rows20210203_1d4e1cce-c57e-4a8b-be96-f95a2778e221.zip

DailyMed Billing Units#

Package NDC, Billing unit, Product NDC table
Package NDCBilling unitProduct NDCDailyMed indexing SPLSPL versionEffective
0409-0302-01ML - Milliliter0409-0302b5b030fb-2afe-47be-91e0-6516d2269e7412012-07-24
0409-0302-25ML - Milliliter0409-0302653caa22-f038-4545-8eaf-ae72ec05c2d912014-04-03

DailyMed Socrata Ingredients#

Ingredient, Type, UNII table
IngredientTypeUNIISPL versionUploaded
TOPOTECAN HYDROCHLORIDEACTIVE INGREDIENT956S425ZCY16
TOPOTECANACTIVE MOIETY7M7YKX2N1516
HYDROCHLORIC ACIDINACTIVE INGREDIENTQTT17582CB16
SODIUM HYDROXIDEINACTIVE INGREDIENT55X04QC32I16
TARTARIC ACIDINACTIVE INGREDIENTW4888I119H16
WATERINACTIVE INGREDIENT059QF0KO0R16

Products#

Every source-derived product name is available through these pages.

DailyMed product names page 1 of 1 · 6 matching rows.

NDC Codes#

Product NDC, Package NDC table
Product NDCPackage NDC
0409-03020409-0302-01

Ingredients#

Every source-derived ingredient row is available through these pages.

DailyMed ingredient rows page 1 of 1 · 5 matching rows.

Source Document#

Source XML

Inactive ingredient matches#

Inactive Ingredient Database values describe FDA-listed use contexts. The match method and ambiguity count are shown because ingredient names, routes, and dosage forms are not always unique. Browse recovered IID releases and source provenance.

Inactive ingredient links page 1 of 2 · 62 matching rows.

DailyMed ingredient, IID ingredient, UNII table
DailyMed ingredientIID ingredientUNIIDosage form / routePotencyMaximum daily exposureMatch
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32ISOLUTION / INTRAVENOUS2.78 %w/vExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, POWDER, FOR SOLUTION / INTRAVENOUS0.18 %w/vExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION, POWDER, FOR SOLUTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, SOLUTION / INTRAVENOUS1037 mgExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HSOLUTION, CONCENTRATE / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HSOLUTION, CONCENTRATE / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTABLE, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, EMULSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, SUSPENSION, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION / INTRAVENOUS160 mgExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, POWDER, FOR SUSPENSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, POWDER, FOR SOLUTION / INTRAVENOUS136.55 mgExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION / INTRAVENOUS720 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTABLE, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION / INTRAVENOUS456 mgExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION, SOLUTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32ILIQUID / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IPOWDER / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, POWDER, FOR SOLUTION / INTRAVENOUS136.55 mgExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, POWDER, FOR SUSPENSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32ISOLUTION, CONCENTRATE / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32ISOLUTION / INTRAVENOUS2.78 %w/vExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, POWDER, FOR SOLUTION / INTRAVENOUS0.18 %w/vExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTABLE, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, POWDER, FOR SUSPENSION / INTRAVENOUS4.17 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, POWDER, FOR SUSPENSION / INTRAVENOUS4.17 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION / INTRAVENOUS160 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, SUSPENSION, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBPOWDER / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBLIQUID / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION, POWDER, FOR SOLUTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, SOLUTION / INTRAVENOUS78 mgExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION / INTRAVENOUS78.36 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTABLE, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, SOLUTION / INTRAVENOUS78 mgExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, EMULSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, SUSPENSION, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32ILIQUID / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBSOLUTION / INTRAVENOUS18.25 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, EMULSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, SUSPENSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32ISOLUTION, CONCENTRATE / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBPOWDER / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, SOLUTION / INTRAVENOUS1037 mgExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, SUSPENSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION / INTRAVENOUS78.36 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBSOLUTION / INTRAVENOUS18.25 mgExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION, SOLUTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IPOWDER / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
TARTARIC ACIDTARTARIC ACIDW4888I119HINJECTION / INTRAVENOUS20 mgExact identifier — unii+route
10 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, EMULSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION / INTRAVENOUS720 mgExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, SUSPENSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBSOLUTION, CONCENTRATE / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
SODIUM HYDROXIDESODIUM HYDROXIDE55X04QC32IINJECTION, SUSPENSION / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBINJECTION, SUSPENSION, LIPOSOMAL / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates
HYDROCHLORIC ACIDHYDROCHLORIC ACIDQTT17582CBSOLUTION, CONCENTRATE / INTRAVENOUSADJ PHExact identifier — unii+route
26 equally ranked IID candidates

Orange Book application contexts#

All distinct exact application/product contexts derived from this label’s complete NDC list are paginated below.

Orange Book application contexts page 1 of 1 · 1 matching rows.

Source provenance: Browse the complete Orange Book source catalog · source snapshot 44.

Orange Book products#

Current product rows page 1 of 1 · 1 matching rows.

Application-product, Trade name, Ingredient table
Application-productTrade nameIngredientStrengthDosage form / routeTE codesRLD / RSApproval date
N200582-001TOPOTECAN HYDROCHLORIDETOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02

Therapeutic equivalence codes#

Current TE-code rows page 1 of 1 · 1 matching rows.

Application-product, TE code table
Application-productTE code
N200582-001AP

Observed Orange Book product history#

Observed FDA ZIP history: Each table is queried independently by exact application/product key from successfully parsed Orange Book snapshots. Capture times identify archived source observations; absence or a change between snapshots is not inferred. FDA publication files that were not recoverable as structured ZIP data are not represented as states.

Product history page 1 of 2 · 44 observed states.

Captured, Edition, Application-product table
CapturedEditionApplication-productTrade nameStrengthDosage form / routeProduct TE source textRLD / RSApproval dateSource SHA-256
2026-10-15 13:18:302026-09N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02c2088c7a36db…
2026-09-14 22:38:342026-08N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-0284e616aacf4f…
2026-08-18 06:07:402026-07N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02caaa826d4ba7…
2026-02-19 14:30 UTC2026-02N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02011fe1cb6892…
2025-12-14 10:44 UTC · 2 captures of this ZIP2025-12N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-0231067a03dcf5…
2025-08-23 18:47 UTC2025-08N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-026a471c1ec25d…
2025-03-22 03:13 UTC · 3 captures of this ZIP2025-03N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02fd3edfee7708…
2025-02-26 10:13 UTC · 3 captures of this ZIP2025-02N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02b8a1b40f171c…
2025-01-19 17:59 UTC · 7 captures of this ZIP2025-01N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-0203ed91905a0d…
2024-12-13 21:23 UTC · 2 captures of this ZIP2024-12N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-022680178bc6a6…
2024-09-14 05:58 UTC · 2 captures of this ZIP2024-09N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-025bbf6a4d5a75…
2024-11-08 22:44 UTC · 3 captures of this ZIP2024-11N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02d8e5a09893c0…
2024-10-29 15:01 UTC2024-10N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02d06236e962d9…
2024-08-13 05:28 UTC · 3 captures of this ZIP2024-08N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-0279d66fd596c7…
2024-07-13 05:37 UTC · 2 captures of this ZIP2024-07N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02301d65b070ca…
2024-06-18 03:08 UTC · 5 captures of this ZIP2024-06N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-021e350fbaab3a…
2024-05-31 18:47 UTC2024-05N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-028072bd15b7f6…
2022-06-29 02:47 UTC · 2 captures of this ZIP2022-06N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-025c6f7cd8ea54…
2022-04-08 23:34 UTC2022-04N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-025d02ea3f76ae…
2022-04-04 05:41 UTC2022-04N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-024b0b4de00fa7…
2019-12-13 00:20 UTC2019-12N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-0274a2ff9319b5…
2022-03-09 01:35 UTC2022-03N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02bb7c543d1eb4…
2021-12-28 21:50 UTC2021-12N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02782e0a99824c…
2021-05-05 16:15 UTC · 3 captures of this ZIP2021-05N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-0287673890dc5c…
2021-03-12 10:30 UTC2021-03N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-025aa47cf7b7d7…
2020-12-22 03:56 UTC2020-12N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-028869cabd3fbd…
2020-11-12 02:37 UTC2020-11N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02c0c555d07b60…
2019-12-14 00:12 UTC2019-12N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-023f01610625f2…
2019-09-15 20:21 UTC2019-09N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02b00525d2431f…
2019-07-19 19:46 UTC2019-07N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02ea99ee380514…
2024-03-16 18:09 UTC · 4 captures of this ZIP2024-03N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-026a51e52b5d6a…
2024-02-18 07:12 UTC2024-02N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-021c564ffb4f44…
2023-12-20 04:57 UTC2023-12N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02ea1830bbd6c7…
2023-11-28 05:40 UTC · 2 captures of this ZIP2023-11N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02a72a2bbeb626…
2023-10-25 00:34 UTC · 2 captures of this ZIP2023-10N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-029b2671bbb829…
2023-07-15 15:27 UTC · 2 captures of this ZIP2023-07N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02a67488948f0b…
2023-06-13 01:57 UTC · 3 captures of this ZIP2023-06N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-023f0d92c62455…
2023-05-13 08:27 UTC2023-05N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-02053a50430f4f…
2023-01-26 05:58 UTC2023-01N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-023bdfa0b2c4d7…
2022-11-12 20:34 UTC · 5 captures of this ZIP2022-11N200582-001TOPOTECAN HYDROCHLORIDEEQ 4MG BASE/4ML (EQ 1MG BASE/ML)SOLUTION / INTRAVENOUSAPRLD, RS2011-02-023a93d1ddd44b…

Observed Orange Book normalized TE history#

Normalized TE history page 1 of 2 · 44 observed states.

Captured, Edition, Application-product table
CapturedEditionApplication-productTE codeOrderSource SHA-256
2026-10-15 13:18:302026-09N200582-001AP1c2088c7a36db…
2026-09-14 22:38:342026-08N200582-001AP184e616aacf4f…
2026-08-18 06:07:402026-07N200582-001AP1caaa826d4ba7…
2026-02-19 14:30 UTC2026-02N200582-001AP1011fe1cb6892…
2025-12-14 10:44 UTC · 2 captures of this ZIP2025-12N200582-001AP131067a03dcf5…
2025-08-23 18:47 UTC2025-08N200582-001AP16a471c1ec25d…
2025-03-22 03:13 UTC · 3 captures of this ZIP2025-03N200582-001AP1fd3edfee7708…
2025-02-26 10:13 UTC · 3 captures of this ZIP2025-02N200582-001AP1b8a1b40f171c…
2025-01-19 17:59 UTC · 7 captures of this ZIP2025-01N200582-001AP103ed91905a0d…
2024-12-13 21:23 UTC · 2 captures of this ZIP2024-12N200582-001AP12680178bc6a6…
2024-09-14 05:58 UTC · 2 captures of this ZIP2024-09N200582-001AP15bbf6a4d5a75…
2024-11-08 22:44 UTC · 3 captures of this ZIP2024-11N200582-001AP1d8e5a09893c0…
2024-10-29 15:01 UTC2024-10N200582-001AP1d06236e962d9…
2024-08-13 05:28 UTC · 3 captures of this ZIP2024-08N200582-001AP179d66fd596c7…
2024-07-13 05:37 UTC · 2 captures of this ZIP2024-07N200582-001AP1301d65b070ca…
2024-06-18 03:08 UTC · 5 captures of this ZIP2024-06N200582-001AP11e350fbaab3a…
2024-05-31 18:47 UTC2024-05N200582-001AP18072bd15b7f6…
2022-06-29 02:47 UTC · 2 captures of this ZIP2022-06N200582-001AP15c6f7cd8ea54…
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openFDA label cross-check#

OpenFDA label data provides additional search and identifier links. DailyMed’s Structured Product Label is the canonical label on FDA.report. Matching records are deduplicated before they are shown below.

Matched openFDA labels page 1 of 1 · 1 matching rows.

Brand, Generic, Manufacturer table
BrandGenericManufacturerSPL set IDEffective dateAvailable safety fieldsJoin
TopotecanTOPOTECANHospira, Inc.1d4e1cce-c57e-4a8b-be96-f95a2778e2212021-02-01Boxed warning, Warnings, Adverse reactionsExact identifier
ndc (package): 0409-0302-01
ndc (product): 0409-0302
ndc11 (package): 00409030201
spl id: 293334d4-88f2-4ec2-9eed-20975ff65c0a
spl set id: 1d4e1cce-c57e-4a8b-be96-f95a2778e221

Reported adverse events (FAERS/openFDA)#

Adverse event summaries are temporarily unavailable. Other product information remains available.