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The major side effects of topotecan are:

1. Myelosuppression
2. Diarrhea
3. Low blood counts
4. Susceptibility to infection

Topotecan hydrochloride (trade name Hycamtin) is a chemotherapy agent that is a topoisomerase I inhibitor.

 It is often used in the treatment of ovarian and lung cancers, as well as other cancer types.

Topotecan intercalates between DNA. This intercalation disrupts the DNA duplication machinery when it finds a site in the DNA where topotecan is intercalated. This disruption prevents DNA replication, and ultimately leads to cell death.