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How does this medication work? What will it do for me?
Etoposide belongs to the group of cancer-fighting medications called antineoplastics. Etoposide kills cancer cells by interfering with the genetic material DNA, which is necessary for their growth and reproduction. Etoposide is used alone or in combination with other antineoplastic medications to treat many types of cancer. These include certain types of lung cancer, lymphoma (cancer of the lymph cells), and cancers of the testicles.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop receiving this medication without consulting your doctor.
What form(s) does this medication come in?
How should I use this medication?
The recommended dose and dosing schedule of etoposide varies according to the specific condition being treated, the response to therapy, and the other medications or treatments being used. The dose administered is also based on body size.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are receiving the medication without consulting your doctor.
Etoposide is available as an injectable preparation or as a capsule to be taken by mouth. It should only be prescribed or given by health care professionals familiar with the use of chemotherapy medications to treat cancer.
The injectable form is injected into a vein through a site on your skin that has been specially prepared for this purpose. This form of etoposide is always given under the direct supervision of a doctor. Very careful handling of this medication is required. It is always administered in a hospital or similar setting with access to sterile equipment for preparation.
Etoposide capsules should be taken on an empty stomach. Etoposide often causes nausea and vomiting, but it is very important that you continue to take the medication, even if you begin to feel ill. Your doctor, nurse, or pharmacist can advise you on how to reduce the effects of nausea and vomiting. If you vomit shortly after taking a dose of etoposide, call your doctor to determine whether you should take the dose again or wait until the next dose.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
As well as interfering with the genetic material (DNA) of cancer cells, etoposide can interfere with some of your normal cells. This can cause a number of side effects. Keep track of any side effects and report them to your doctor, as suggested in the section "What side effects are possible with this medication?"
Store the capsule form of this medication at room temperature, and keep it out of the reach of children. Any unused medication should be returned to your pharmacy or treatment clinic for proper disposal. The injectable form of etoposide will be stored at the hospital or clinic where you receive treatment.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use etoposide if you:
- are allergic to etoposide or to any of the ingredients of the medication
- have severe kidney or liver disease
- have severely reduced levels of white blood cells or platelets
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- appetite loss
- nausea and vomiting
- temporary loss of hair
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- dizziness or lightheadedness
- low blood pressure
- numbness or tingling in fingers and toes
- pain at site of injection
- painful swallowing
- signs of bleeding (e.g., bloody nose, blood in urine, coughing blood, cuts that don’t stop bleeding, unusual bleeding or bruising black or tarry stools, or blood in urine)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- skin rash or itching
- signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
- sores in mouth or on lips
- unusual tiredness or weakness
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, sweating, fast heartbeat, or swelling of the face and throat)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergic reactions: Allergic reactions, including difficulty breathing and swelling of the throat and mouth, can occur with the use of this medication. Tell your doctor immediately if you experience any of these symptoms.
Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly as usual. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won’t stop bleeding.
Infection: As well as killing cancer cells, etoposide can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people who have contagious infections. Tell your doctor if you begin to notice the signs of an infection such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.
Kidney function: Etoposide can reduce kidney function. If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, and how your medical condition may affect the dosing and effectiveness of this medication. Your doctor will routinely monitor your kidney function with blood tests.
Liver function: Etoposide can reduce liver function. If you have liver disease or reduced liver function, discuss with your doctor how this medication may affect your medical condition, and how your medical condition may affect the dosing and effectiveness of this medication. Your doctor will routinely monitor your kidney function with blood tests. Contact your doctor as soon as possible if you notice signs of decreased liver function, such as yellowing of the eyes and skin, dark urine, pale stools, or abdominal pain with nausea and vomiting.
Pregnancy: Etoposide can cause harm to the unborn baby when it is taken by pregnant women. It should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Etoposide can cause changes to sperm in men, decreasing fertility. Women and men receiving etoposide should use effective contraceptive methods.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking etoposide, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.Children: The safety and effectiveness of using this medication for children have not been clearly established. It should only be prescribed or given by health care professionals familiar with the use of chemotherapy medications to treat cancer in children.
What other drugs could interact with this medication?
There may be an interaction between etoposide and any of the following:
- amphotericin B
- azole antifungals (e.g., itraconazole, posaconazole, voriconazole)
- BCG vaccine
- calcium channel blockers (e.g., diltiazem, verapamil)
- grapefruit juice
- HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
- HIV protease inhibitors (e.g., darunavir, indinavir, lopinavir, saquinavir, tipranavir)
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- seizure medications (e.g., carbamazepine, phenobarbital, phenytoin, primidone)
- St. John’s wort
- tyrosine kinase inhibitors (e.g., crizotinib, dasatinib, imatinib, nilotinib)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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