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Etoposide (Eposin, Etopophos, Vepesid)

 

Warning:  Blood count may lower significantly while on this drug, which can lead to infection and intense bleeding.  There are reported deaths linked to bleeding, caused by Etoposide.  The physician should be contacted immediately if symptoms including chills, fever, or a sore throat that won’t go away, are experienced as this can be signs of an infection.

 

This drug should not be taken by patients who have low blood platelet count, low white blood count, lung fibrosis, acute hemorrhage, kidney impairments that are moderate to severe, drug induced hepatitis, or interstitial pneumonitis.  Women who are nursing or producing milk should not take this drug and women who are pregnant or planning to become pregnant should not handle the drug with bare skin.

 

Indications: Etoposide is used to block enzymes from doing their job in small cells.  The drug prevents the enzyme, known as topoisomerase II, from keeping DNA in its proper shape, leading to the death of the malignant cell.  When the DNA is not supported by the enzyme, it breaks up and the cell cannot split and create two cells.  The broken DNA does not only prevent the cell from dividing, but actually leads to the cell dying since it is no longer complete.  The drug is used mainly on patients with small cell lung cancer or testicular cancer.  However, occasionally, it is used on patients who have some forms of leukemia, ovarian cancer, lymphomas, and one type of prostate cancer. 

 

Other cancers that Etoposide is used to treat include:

 

  • non-Hodgkin's lymphomas
  • Hodgkin’s disease
  • Wilms' tumor
  • neuroblastoma
  • gestational trophoblastic tumors
  • hepatoma
  • Ewing's sarcoma
  • rhabdomyosarcoma
  • brain tumors
  • advanced breast cancer
  • Kaposi's sarcoma related to acquired immune deficiency syndrome (AIDS).

Patients on this drug can experience a wide range of side effects that include diarrhea, vomiting, nausea, drowsiness, mouth sores, aches in the muscles, and some change of color in the skin.  While rare, more serious side effects have been known to occur and patients should contact their doctor at once if they experience a yellowing of the skin or eyes, symptoms indicating infection, blood in their stools, pain in the lower part of the torso, vision disruption, or veins that become reddened or show signs of swelling.   If you have allergies, you should alert your doctor since this drug has been known to aggravate those allergies.

 

Dosage: There are two ways to take Etoposide—orally and intravenously.  Doses for oral consumption will vary depending on the patient and their response to cancer treatment.  Patients need to follow their doctor’s instructions regarding this drug and avoid grapefruit and grapefruit juice.  If given intravenously, patients receive the dose at a very slow rate over a period of time from 30 minutes to an hour to prevent a drastic high blood pressure.

 

Etoposide capsules should be taken on empty stomach, once or many times per day, as recommended by your doctor. It is important to use Etoposide and all chemotherapy drugs exactly as prescribed. Misusing of any drug can lead to death.  

Overdose: when etoposide is given through injection in hospital by professionals, the risk of overdose is very low. However, there is an increased risk of overdose when the drug is taken by mouth at home. An Etoposide overdose can cause a decrease in the number of blood cells in your bone marrow, severe health problems and even death among elderly and young children. If you think you have taken or given an Etoposide overdose, contact your doctor or a poison control center as soon as possible.  

Missing dose: If for some valuable reasons you cannot be present at the hospital for the treatment, contact your oncologist before the date you were scheduled to receive the injection. If you are recommended to take the medication at home, you can easily forget. If you miss a dose, take it as soon as you remember it. If you forgot to take the medicine for hours, and it is almost time for the nest dose, the best thing to do is wait for the next dose; in any case, do not double the dose.  

Contraindication: Etoposide is contraindicated or should be used with precaution in the following conditions: 

  • allergic to etoposide or any of its ingredients  
  • pregnancy  
  • breastfeeding  
  • low white blood cell count  
  • low blood platelet count 
  • liver dysfunction  
  • Kidney dysfunction.   

Mechanism of action (MOA): Etoposide is one of the antineoplastics, a group of chemotherapy drugs widely used in cancer treatment. It slows or stops the growth of cancer cells by attacking the genetic material (DNA) required for their division.  

Interactions:  Etoposide does not work with live vaccines and patients should notify their doctor if they have recently received a vaccine or are planning to.  Patients should also make sure to notify their doctor on all medications, herbal treatments, or non-prescription medications they may be taking.

 

Talk to your doctor before taking aspirin, vitamin supplements. Some drugs such as Cyclosporine and Vincristine can cause adverse reaction when taken with Etoposide .  

Side effects: some patients can experience adverse effects when taking  etoposide. Common Etoposide side effects include:     

  • sweating
  • mouth sores
  • diarrhea
  • fatigue
  • constipation
  • hair loss
  • decreased appetite
  • taste changes
  • skin rashes
  • sleep disturbances
  • nausea and vomiting
  • Unusual weakness

Contact your doctor if you experience any of these symptoms: 

  • unusual bruising or bleeding
  • dizziness or/and fainting
  • pain at the injection site
  • persistent diarrhea
  • Infection signs:fever, chills, sore throat, etc.
  • severe depression symptoms
  • shortness of breath
  • breathing discomfort
  • irregular or fast heart beat
  • Swelling of the face or tongue