Etoposide use while Breastfeeding
Drugs containing Etoposide: VePesid, Toposar, Etopophos
Etoposide Levels and Effects while Breastfeeding
Summary of Use during Lactation
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy. It appears possible to breastfeed safely during intermittent therapy with etoposide after an appropriate period of breastfeeding abstinence. A period of at least 24 hours is required after a dose of 80 mg/sq m or less. Others have suggested an abstinence period of 72 hours after etoposide use. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.
Maternal Levels. A woman treated with etoposide, mitoxantrone and cytarabine for promyelocytic leukemia received 5 daily etopside doses of 80 mg/sq m intravenously. Etoposide milk levels reached a peaks of about 600, 580 and 800 mcg/L immediately after the last 3 doses, respectively. Etoposide was undetectable (assay limit not specified) in milk 24 hours after each dose.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
One mother received with 5 daily doses of etopside 80 mg/sq m and cytarabine 170 mg/sq m intravenously as well as 3 daily doses of 6 mg/sq m of mitoxantrone intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
1. Pistilli B, Bellettini G, Giovannetti E et al. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: How should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013;39:207-11. PMID: 23199900
2. Urbaniak C, McMillan A, Angelini M et al. Effect of chemotherapy on the microbiota and metabolome of human milk, a case report. Microbiome. 2014;2 :24. PMID: 25061513
3. Azuno Y, Kaku K, Fujita N et al. Mitoxantrone and etoposide in breast milk. Am J Hematol. 1995;48:131-2. Letter. PMID: 7847330
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