Etoposide (Intravenous)

Etoposide is a drug used in the treatment of small cell lung cancer and testicle cancer. It is used alongside other cancer medications.

Overview

Etoposide injection is a drug used in combination with other cancer medicines to treat small cell lung cancer and cancer of the testicles. It can also be used to treat other types of cancer in both females and males. This medication is also known as VP-16.

This drug belongs to the group of medications which are known as antineoplastic agents. It is unknown the exact way that etoposide acts against cancer. However, it seems to eventually destroy the growth of the cancer cells by interfering with the growth of them. Other effects will occur since the growth of normal body cells may also be affected by etoposide. Some of these could be serious and will need to be reported to your doctor. Others, such as hair loss, may not be serious but can cause concern. Some of the side effects associated with this drug may not occur months or years until after the medication has been used.

Before you start treatment with etoposide, you should discuss the benefits and risks of using this medication alongside your doctor. This medication can only be given under the supervision of a trained health professional or your doctor. It is available in the dosage form of solution and powder for solution.

Conditions treated?

  • Kaposi's

Type of medicine?

  • Powder for solution

Side effects

Along with the intended effects of etoposide, there can be some unwanted side effects that occur. Not all of these may be present at one time, but if they are present, they could require medical attention.

Contact your doctor or healthcare professional immediately if any of the following side effects occur whilst taking etoposide:

More common side effects

  • Blood in the urine or stools

Less common side effects

  • Tightness in the chest

Tongue

  • Numbness or tingling in the fingers or toes

Rare side effects

  • Difficulty with walking

Incidence not known

  • Loss of appetite

Some of the side effects that occur with the use of this drug do not usually require medical attention. You usually find that these side effects begin to disappear once your body begins adjusting to the medication. If they are bothering your daily life, you can contact your local pharmacist or healthcare professional for advice on ways to reduce or prevent the intensity of these side effects.

More common side effects

  • Swelling or inflammation of the mouth

This medication can cause a temporary loss of hair. You will usually find that once treatment with etoposide has finished, your normal hair growth will return.

Dosage

The final dose of any medication will depend on a number of different factors. This can include your age, weight, and height. It may also include any current medications you are taking, alongside any other medical conditions that you suffer from. Your reaction to your first dose may also determine your final dose. The following doses are guidelines. Your final dose will be based on you as an individual.

Typical Adult Dose for Testicular Cancer

In conjunction with other approved chemotherapeutic agents:

50 to 100 mg/m2 IV over thirty to sixty minutes once daily on days one through five every three to four weeks to 100 mg/m2 IV over thirty to sixty minutes once daily on days one, three, and five every three to four weeks.

Typical Adult Dose for Small Cell Lung Cancer

In conjunction with other approved chemotherapeutic agents:

35 mg/m2 IV over thirty to sixty minutes once daily for four days to 50 mg/m2 IV over thirty to sixty minutes once daily for five days every three to four weeks.

Interactions

Drug interactions can cause severe side effects and can reduce the effectiveness of either drug. To avoid these interactions, it's important that you give your doctor or healthcare professional a full list of all the current and past medications you are taking. This should include all prescription, nonprescription drugs, vitamins and herbal products. You should also let your doctor know of any other medical conditions you suffer from as this could increase your risk of interactions.

The use of this medication alongside any of the following medications is not recommended. Your doctor may avoid treating you with this drug or change some of the other drugs you are taking.

  • Varicella Virus Vaccine

The use of this medication with any of the following medications isn't usually recommended, however it some cases it may prove necessary. If you are treated with both drugs, your doctor may alter the frequency or dose of either medication.

  • Poliovirus Vaccine, Live

There are over 280 drugs that interact with etoposide. Let your doctor know if you are currently taking any of the following medications.

  • Colchicine / probenecid

Other medical conditions

If you suffer from other medical conditions, this could affect the use of this medication. Ensure you tell your doctor if you have any other medical conditions, especially:

  • Infection'The use of this medication may decrease your body's ability to fight infection.
  • Low serum albumin (protein in the blood)'The use of this medication may increase your experience of side effects.
  • Kidney disease' Caution should be exercised as the effects of this drug may be increased due to a slower removal from the body.

Warnings

Use in pediatric patients

Appropriate studies have not been conducted on the relationship of age to the effects of etoposide injection in the younger population. Therefore efficacy and safety have not yet been established.

Use in geriatric patients

Appropriate studies conducted to date have not indicated a geriatric-specific problem that could limit the effectiveness of etoposide injection in the older population. However, elderly patients are more likely to experience unwanted side effects (eg, nausea, infection, and vomiting) and have age-related liver, kidney, or heart issues which could require a degree of caution in elderly patients receiving this drug.

Use in pregnancy and breastfeeding

This drug is under FDA pregnancy category D. Do not use this drug if you are pregnant. It could harm the infant. Use an effective form of birth control, and let your doctor or healthcare professional know if you fall pregnant during treatment.

With regards to breastfeeding, it's unknown whether this drug passes into breast milk or if it could harm a nursing baby. You should avoid breastfeeding whilst using this drug.

It's important that your doctor monitors your progress at regular appointments to ensure that this medication is working properly. Blood tests can check for unwanted effects.

The use of this medication whilst pregnant can harm your unborn child. Use an effective form of birth control to prevent you from falling pregnant during treatment and for at least six months after you have taken your final dose. If you believe you have fallen pregnant whilst using the medication, inform your doctor or healthcare professional immediately.

Etoposide can cause birth defects if the father is using the medication when his sexual partner falls pregnant. Men who use this medication should use condoms as a form of birth control during treatment and for at least four months after taking the final dose.

Etoposide can temporarily lower the number of white blood cells in your blood, which can, therefore, increase your risk of infection. It can also lower the number of platelets, which are needed for proper blood clotting. If this happens, you can take some precautions to reduce the risk of bleeding or infection.

Try and avoid people with infections and consult your doctor urgently if you think you've got an infection such as chills or fever, hoarseness or a cough, lower back or side pain, or painful urination.

Consult with your doctor immediately if you notice any unusual bruising or bleeding, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.

Exercise caution when using dental floss, a regular toothbrush, or toothpick. Your medical dentist or doctor may recommend other ways to clean your gums and teeth whilst using this medication.

Don't touch your eyes or the inside of your nose unless you have washed your hands and not touch anything else.

Be careful not to cut yourself when you are using sharp objects such as toenail cutters or a safety razor.

Avoid contact sports or other situations where injury or bruising can occur.

This medication can cause a serious allergic reaction called anaphylaxis which can be life-threatening and requires immediate emergency attention. Let your doctor known immediately if you suffer from fever, chills, dizziness, fainting, pounding fast heartbeat, swelling of the tongue, face or throat, or trouble breathing when using this medication.

Reactions at the injection site can occur while you are receiving this medication. Let your doctor know immediately if you notice pain, swelling, or redness at the injection site.

This medication can cause leukemia. Speak with your doctor about any concerns you have about this.

Speak with your doctor or healthcare professional before receiving flu shots or other vaccines while taking this medication because there are some vaccinations that you should not receive alongside this drug.

Storage

This drug will be stored in a clinical setting. It should be refrigerated and not allowed to freeze.

Summary

When used correctly, etoposide is successful in the treatment of various strands of cancer including cancer of the testicles and small cell lung cancer. Due to a large number of interactions possible, it's very important that you give your doctor a full list of all medications you are currently taking. This drug you should not be used during pregnancy or breastfeeding and you should use effective forms of birth control to avoid falling pregnant. A nurse or doctor will give you this drug in a clinical setting via injection into your vein. The medication is given slowly over a period of thirty to sixty minutes. Let your doctor know urgently if you do fall pregnant whilst taking this drug. If you have any other questions about the use of this drug, then contact your doctor or healthcare professional for advice.