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Etoposide Disease Interactions

There are 3 disease interactions with etoposide:

Major

Antineoplastics (applies to etoposide) infections

Major Potential Hazard, High plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  4. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  5. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  6. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  9. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  10. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  11. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  12. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  13. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  14. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  15. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  16. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  17. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  18. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  19. "Product Information. Nipent (pentostatin)." Hospira Inc, Lake Forest, IL.
  20. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  21. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  22. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  23. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.
  24. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  25. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  26. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  27. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  28. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  29. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
  30. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  31. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
View all 31 references
Major

Etoposide (applies to etoposide) myelosuppression

Major Potential Hazard, High plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts, Fever, Bleeding

Etoposide induces dose-related myelosuppression. Leukopenia, thrombocytopenia, and anemia have been reported during etoposide therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Therapy should be administered cautiously in patients whose bone marrow reserve may be severely depressed and should be withheld if an absolute neutrophil counts fall below 500/mm3 and/or platelet counts fall below 50,000/mm3. Clinical monitoring of hematopoetic function is recommended. Periodic complete blood counts should be done during the course of etoposide treatment and it should be performed prior to each cycle of therapy and at appropriate intervals during and after therapy. At least one determination should be done prior to each dose.

References

  1. DeVore R, Higa G, Robbins A, Sarkar M "Protracted infusion of low-dose etoposide (E): preliminary results of a Phase I/II pharmacokinetic (PK) study (Meeting abstract)." Proc Annu Meet Am Soc Clin Oncol 12 (1993): a4491993
  2. Lokich J Corkery J "Phase I study of VP-16-213 (Etoposide) administered as a continuous 5- day infusion." Cancer Treat Rep 65 (1981): 887-9
  3. Niederle N Ostermann J Achterrath W Lenaz L Schmidt CG "Etoposide in patients with previously untreated non-small-cell lung cancer: a phase I study." Cancer Chemother Pharmacol 28 (1991): 59-62
  4. Kobayashi K, Ratain MJ "Pharmacodynamics and long-term toxicity of etoposide." Cancer Chemother Pharmacol 34 Suppl (1994): s64-8
  5. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
View all 5 references
Moderate

Etoposide (applies to etoposide) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Etoposide is primarily eliminated by the kidney. Less than 50% is eliminated as unchanged drug in the urine. Reduced clearance, increased AUC, and decreased volume of distribution have been noted in patients with impaired renal function. Therapy should be administered cautiously and dosages reduced in patients with compromised renal function. Patients with a creatinine clearance between 15 to 50 mL/min should receive 75% of the recommended dosage of etoposide. Data are not available in patients with creatinine clearances <15 mL/min and further dosage reductions are recommended. Clinical monitoring of renal function is recommended.

References

  1. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.

Etoposide drug interactions

There are 355 drug interactions with etoposide

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.