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Etoposide Pregnancy and Breastfeeding Warnings

Etoposide is also known as: Etopophos, Toposar, VePesid

Etoposide Pregnancy Warnings

Etoposide is teratogenic and embryocidal in rats and mice at doses of 1% to 3% of the recommended clinical dose based on body surface area. In a teratogenicity study in rats, etoposide was administered intravenously at doses of 0.13, 0.4, 1.2, and 3.6 mg/kg/day on days 6 to 15 of gestation. Dose-related maternal toxicity, embryotoxicity and teratogenicity at dose levels of 0.4 mg/kg/day and higher were reported. Embryonic resorptions were 90% and 100% at the 2 highest dosages. At 0.4 and 1.2 mg/kg, fetal weights were decreased and fetal abnormalities including decreased weight, major skeletal abnormalities, exencephaly, encephalocele and anophthalmia occurred. Even at the lowest dose tested, 0.13 mg/kg, a significant increase in retarded ossification was observed. Etoposide administered as a single intraperitoneal injection in mice at dosages of 1, 1.5, and 2 mg/kg on days 6, 7, or 8 of gestation caused dose related embryotoxicity, cranial abnormalities and major skeletal malformations.

Etoposide has been assigned to pregnancy category D by the FDA. Animal studies have revealed evidence of teratogenicity in mice and rats. There are no controlled data in human pregnancy. If this drug is used during pregnancy, or if the patient becomes pregnant while receiving this drug, the patient should be apprised of the potential hazard to the fetus. Women of childbearing potential should be advised to avoid becoming pregnant during therapy. Etoposide should only be given during pregnancy when there are no alternatives and benefit outweighs risk.

Etoposide Breastfeeding Warnings

There are no data on the excretion of etoposide into human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from etoposide phosphate, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

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