Applies to the following strength(s): 20 mg/mL ; 50 mg
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Usual Adult Dose for:
Usual Geriatric Dose for:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Testicular Cancer
(In combination with other approved chemotherapeutic agents) Initial dose: 50 to 100 mg/mÂ² IV once a day on days 1 through 5 or 100 mg/m2 IV once a day on days 1,3 and 5.
Usual Adult Dose for Small Cell Lung Cancer
(In combination with other approved chemotherapeutic agents) Initial dose: 35 to 50 mg/m2 IV once a day for 4 to 5 days or
70 to 100 mg/m2 orally once a day for 4 to 5 days.
Usual Adult Dose for Hodgkin's Disease
(In combination with other chemotherapeutic agents as a part of the BEACOPP and EVA regimens)
100 mg/m2/day on days 1, 2, and 3
Total Dose/Cycle = 300 mg/m2
(In combination with other chemotherapeutic agents as a part of the mini-BEAM regimen)
75 mg/m2/day on days 2 through 5
Total Dose/Cycle = 300 mg/m2
(In combination with other chemotherapeutic agents as a part of the Stanford V regimen)
60 mg/m2/day on days 15 and 16
Total Dose/Cycle = 120 mg/m2
Usual Adult Dose for Ovarian Cancer
For use in the treatment of epithelial ovarian cancer:
50 mg/m2 daily on days 1 through 21
For use in the treatment of germ cell ovarian cancer:
(In combination with other approved chemotherapeutic agents as a part of the BEP regimen)
100 mg/m2 IV on days 1 through 5
Usual Geriatric Dose for Testicular Cancer
The manufacturer has stated that clinical studies of etoposide for the treatment of refractory testicular tumors did not include sufficient numbers of patients aged 65 years or over to determine if they respond differently from younger patients.
Usual Pediatric Dose for Malignant Disease
Note: Oral doses are twice the IV doses listed below. Oral doses are to be administered once a day if <=400 mg. Divided doses are recommended if the dose exceeds 400 mg/day.
60 to 150 mg/m2/day IV for 2 to 5 days every 3 to 6 weeks.
Remission induction for AML: 150 mg/m2/day IV for 2 to 3 days for 2 to 3 cycles.
Intensification/Consolidation for AML: 250 mg/m2/day IV for 3 days, courses 2 to 5.
Brain Tumor: 150 mg/m2/day IV on days 2 and 3.
Neuroblastoma: 100 mg/m2/day IV over 1 hour on days 1
through 5 of the cycle, repeated every 4 weeks.
High-dose conditioning regimen for allogenic BMT: 60 mg/kg/dose IV as a single dose.
BMT conditioning regimen used in patients with rhabdomyosarcoma or neuroblastoma: IV continuous infusion: 160 mg/m2/day for 4 days.
Renal Dose Adjustments
CrCl less than 10 mL/min: Recommended to administer 50% of the normal dose.
CrCl 10 to 50 mL/min: Recommended to administer 75% of the normal dose.
Liver Dose Adjustments
Bilirubin 1.5 to 3 mg/dL or AST 60 to 180 units: Recommended to administer 50% of the normal dose.
Bilirubin 3 to 5 mg/dL or AST greater than 180 units: Recommended to administer 25% of the normal dose.
Bilirubin greater than 5 mg/dL: Recommended not to use.
The oral dose is twice the IV dose rounded to the nearest 50 mg and given in 2 divided doses if greater than 400 mg. Dosages of etoposide may vary based on specific indication for use and choice of cytotoxic agents coadministered. Reference to specific protocols is recommended. Dosages should be modified to take into account the myelosuppressive effects of other drugs in the combination or the effects of prior X-ray therapy or chemotherapy which may have compromised bone marrow reserve.
Patients must be frequently observed for myelosuppression both during and after therapy. Dose-limiting bone marrow suppression is the most significant toxicity. The platelet count, hemoglobin, white blood cell count, and differential should be obtained at the start of therapy and prior to each subsequent dose. A platelet count less than 50,000 mm3 or an absolute neutrophil count less than 500/mm3 is an indication to withhold further therapy until the blood counts have sufficiently recovered. A neutrophil count less than 1,500/mm3 may also be an indication to postpone further therapy. A 50% decrease in dosage may be appropriate for patients with a serum bilirubin greater than 1.5 mg/dL. A 75% decrease in dosage may be appropriate with a serum bilirubin greater than 3 mg/dL.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
A supplemental dose is not necessary with hemo- or peritoneal dialysis.
Courses of etoposide may be repeated at 3 to 4 week intervals, after adequate recovery from toxicity.
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