topotecan

Nausea and vomiting (generally mild)

• Drink clear fluids and avoid large meals. Get fresh air and rest.
• Limit spicy, fried foods or foods with a strong smell.
• Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
• Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.
• Also see Nausea & Vomiting pamphlet.*

Hair thinning or loss 

• Use a gentle soft brush; care should be taken with hair sprays, bleaches, dyes and perms.
• Your hair usually grows back after your treatment ends, but the texture or colour may change.

Diarrhea (may rarely be severe or life-threatening)

• Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine, orange or prune juice. Try a low-fiber BRAT diet (Bananas, white Rice, Apple sauce, Toast made with white bread).
• If severe, contact your doctor immediately (for example, greater or equal to 7 stools/day over your usual, incontinence with bowel movements).
• Take anti-diarrhea drug(s) if given to you by your doctor.
• Also see Diarrhea pamphlet.*

Constipation

• Eat a balanced diet with fibres such whole grains, fruit and raw vegetables.
• Drink plenty of fluids. Try light exercise regularly.
• Speak to your doctor if no bowel movement for 3 or more days.
• Also see Constipation Pamphlet.*

Tiredness

• Rest often; take naps if needed. Move slowly when getting up.
• Eat well-balanced meals and drink plenty of fluids. Light exercise may help.
• Do not drive a motor vehicle or operate machinery when feeling tired.

Headache; mild joint, muscle pain

• Take painkiller(s) as directed, if given to you by your doctor.
• Otherwise, take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
• Rest often, but may try light exercise.

Pains or cramps in the belly

• Treat constipation or diarrhea.
• May be due to other causes; check with your doctor or nurse if pain is severe, does not go away or worsens.

Cough, Feeling short of breath (may rarely be severe)

• Get emergency medical help right away if you have sudden increased cough, breathing problems, chest pain, or coughing blood.

Poor Appetite; don't feel like eating; weight loss

• Eat foods that you like and try to eat regular small meals.
• Use meal supplements if possible.  See a dietitian.

Mouth sores

• Maintain good mouth hygiene. Regular teeth brushing with a soft toothbrush or Toothette®, and regular use of alcohol-free mouthwashes.
• Instead, try a homemade mouthwash: 
  Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.
• Avoid hot, spicy, acidic, hard or crunchy foods.
• Check with your doctor or nurse as soon as you notice sores in mouth/lips or pain with swallowing. Your doctor may prescribe a prescription mouthwash to relieve mouth sores and prevent infection.
• Also see Mouth Care pamphlet.*

Rash

• Stay out of the sun; wear sunblock, a hat and cover exposed skin.
• Use daily moisturizer.
• May be severe, including blisters and skin peeling; get emergency medical help right away if this occurs.

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

• 38.3°C (100.9°F) or higher at any time OR
• 38.0°C (100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

• Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
• Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
• Do not eat or drink anything hot or cold right before taking your temperature.
• Wash your hands often.
• Check with your doctor before getting any vaccines, surgeries or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Abnormal liver lab tests

• Your doctor will monitor these regularly.  Call your doctor if you have yellowish skin or eyes, or unusual dark urine.

Blocked or inflamed intestines
(severe belly pain, bloating, severe constipation or diarrhea)

Allergic reaction (fever, severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness; may occur during or shortly after the drug is given)