Etoposide (Eposin, Etopophos, Vepesid)

Brand name: Eposin, Etopophos, Vepesid  

Generic name: Etoposide  

Other names: Etoposide phosphate, VP-16  

Therapeutic Class: plant alkaloid/topoisomerase II inhibitor 

Availability: Etoposide is available by prescription only  

Dosage form: Etoposide can be taken by mouth or by injection into a vein  

Indications : Etoposide is  used to in the treatment of many cancers such as: 

• testicular cancer
• lung cancer
• non-Hodgkin's lymphomas 
• Hodgkin’s disease
• acute myelogenous leukemia 
• acute lymphocytic leukemia 
• chronic myelogenous leukemia
• Wilms' tumor 
• neuroblastoma 
• gestational trophoblastic tumors 
• ovarian germ-cell tumors 
• hepatoma 
• Ewing's sarcoma 
• rhabdomyosarcoma 
• brain tumors 
• advanced breast cancer 
• Kaposi's sarcoma related to acquired immune deficiency syndrome (AIDS). 

Etoposide may be prescribed for other medical conditions that are not mentioned in this article. For more information on diseases for which Etoposide is used to treat, talk to your doctor or pharmacist.  

Storage: Etoposide should be stored away from light and moisture.  Keep the drug at room temperature out of children reach.  

Dosage: Etoposide can be taken intravenously or by mouth in capsule form . Your doctor will base on several criteria to prescribe you the form and dosage more effective to treat your condition. In general, treatment will be determined depending on your state of health, severity of the tumor, and especially your body surface area (BSA) . In addition, the reaction of your body to the drug can obligate your oncologist to adjust the treatment.  It is important to complete the therapy as indicated by your health care provider.  

During each treatment (chemo session), your doctor will inject the solution into your vein. You can receive the drug as a short infusion or as a continuous infusion over 24 hours. In this case, Etoposide will be given with care, under the supervision of a physician or a medical professional having experience in chemotherapy medication. Etoposide injection is always given in a hospital or in a medical center. 

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: Before taking etoposide and all chemotherapy drugs, tell your doctor about all medications you are taking, whether prescription or non prescription. Talk to your doctor before taking aspirin, vitamins or nutritional 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 (which can be characterized by fever, chills, sore throat, etc.) 
• shortness of breath 
• breathing discomfort 
• irregular or fast heart beat 
• Swelling of the face or tongue.