Drug General Information (ID: DDIBLJ92VZ)
Drug Name			Topotecan		Drug Info		Cobimetinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Multikinase Inhibitors
Structure

Mechanism of Topotecan-Cobimetinib Interaction (Severity Level: Moderate)
Additive immunosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Topotecan				Cobimetinib
Mechanism		Myelosuppressive effects				Myelosuppressive effects
Key Mechanism Factor 1
		Factor Name		Immunosuppressive effects
		Factor Description		Immunosuppression is when your immune system is not functioning as it should. The immune system is made up of cells, tissues and organs that help the body fight off infections. If the immune system is suppressed, an infection that your body was able to control may become serious or even fatal.
Mechanism Description		Additive immunosuppressive effects by the combination of Topotecan and Cobimetinib

Recommended Action
Management		Caution is advised if topotecan is used with other cytotoxic agents. Dosage reductions may be required, and bone marrow function should be closely monitored. Patients should be advised to contact their physician if they develop signs and symptoms of myelosuppression such as pallor, dizziness, fatigue, lethargy, fainting, easy bruising or bleeding, or signs of infection such as fever, chills, sore throat, body aches, and other influenza-like symptoms.

References
1	Product Information. Hycamtin (topotecan). SmithKline Beecham, Philadelphia, PA.