etoposide

Pronunciation

Generic Name: etoposide (oral) (e TOE poe side)
Brand Name: VePesid

What is etoposide?

Etoposide is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Etoposide is used to treat cancer of the lung or testicles. It is usually given with other cancer medicines in a combination chemotherapy.

Etoposide may also be used for purposes not listed in this medication guide.

What is the most important information I should know about etoposide?

Etoposide is a cancer medication.

Etoposide can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).

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The medicine from a broken capsule can be dangerous if it gets in your eyes, mouth, or nose, or on your skin. If this occurs, wash your skin with soap and water or rinse your eyes with water.

Etoposide can cause a severe allergic reaction. Tell your caregiver right away if you feel light-headed or have a fast heart rate, trouble breathing, or swelling in your face.

What should I discuss with my healthcare provider before taking etoposide?

You should not use etoposide if you are allergic to it.

To make sure you can safely take etoposide, tell your doctor if you have kidney disease.

Using etoposide may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.

FDA pregnancy category D. Do not use etoposide if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

It is not known whether etoposide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using etoposide.

How should I use etoposide?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Etoposide is usually given as part of a 4-day or 5-day treatment cycle every 3 or 4 weeks. Follow your doctor's dosing instructions very carefully.

Take this medicine with a full glass of water.

Do not break or open the etoposide capsule. Do not use a pill that has been accidentally broken.

The medicine from a broken capsule can be dangerous if it gets in your eyes, mouth, or nose, or on your skin. If this occurs, wash your skin with soap and water or rinse your eyes with water. Wear disposable rubber gloves when you handle a etoposide capsule. Throw the gloves away after one use.

Etoposide can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

Store etoposide capsules in the refrigerator, do not freeze.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of etoposide.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking etoposide?

This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Do not receive a "live" vaccine while using etoposide. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Etoposide side effects

Get emergency medical help if you have any of these signs of an allergic reaction: fever, chills, sweating, fast heartbeats, fainting; hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • vision problems;

  • seizure (convulsions);

  • sudden chest pain or discomfort, wheezing, dry cough or hack; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, vomiting, stomach pain;

  • diarrhea, constipation;

  • trouble swallowing;

  • unusual or unpleasant taste in your mouth;

  • numbness or tingly feeling;

  • mild itching or skin rash; or

  • temporary hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Etoposide dosing information

Usual Adult Dose for Testicular Cancer:

(In combination with other approved chemotherapeutic agents) Initial dose: 50 to 100 mg/m² 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.

What other drugs will affect etoposide?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with etoposide, especially:

  • cyclosporine (Gengraf, Neoral, Sandimmune).

This list is not complete. Other drugs may interact with etoposide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about etoposide.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.02. Revision Date: 2013-07-15, 2:49:56 PM.

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