Kidney Disease Program

Topotecan

Metabolism/Excretion

Undergoes pH-dependent hydrolysis in plasma, 30-40% excreted in the urine, remaining drug is excreted in stool via biliary excretion

Plasma Protein Binding %

Dose For Normal Renal Function

Refer to individual protocols

Adjustment For Renal Function Gfr, Ml/Min/1.73M2 30-50

75%

Adjustment For Renal Function Gfr, Ml/Min/1.73M2 10-29

50% or reduce by 0.75 mg/m2/dose

Adjustment For Renal Function Gfr, Ml/Min/1.73M2 <10

25%

Supplement For Dialysis [Recommendation Level]: Ihd

IHD: Per reference 0.75 mg/m2

Supplement For Dialysis [Recommendation Level]: Pd

PD: No data

Supplement For Dialysis [Recommendation Level]: Crrt

CRRT: 50% or reduce by 0.75 mg/m2 dose, [B]

References

Iacono LC, Adams D, Homans AC, Guillot A, McCune JS, Stewart CF. Topotecan disposition in an anephric child. J Pediatr Hematol Oncol. 2004; 26: 596-600. [PMID: 15342988]