Etoposide: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Malaysia prescribing information.

Generic Medicine Info

Indications and Dosage

Intravenous
Small cell lung cancer

Adult: 35 mg/m² BSA/day for 4 days to 50 mg/m² BSA/day for 5 days. May repeat course at 3-4 wkly intervals after recovery from any toxicity. Inj must be diluted with 5% dextrose or normal saline to give a final concentration of 0.2-0.4 mg/ml and injected over 30-60 minutes. When given via oral capsules: the recommended dose is twice the IV dose rounded to the nearest 50 mg.

Intravenous
Testicular cancer

Adult: For combination therapy: 50-100 mg/m² BSA/day from days 1-5, or 100 mg/m² on days 1, 3 and 5. May repeat course at 3-4 wkly intervals after recovery from any toxicity. Inj must be diluted with 5% dextrose or normal saline to give a final concentration of 0.2-0.4 mg/ml and injected over 30-60 minutes.

Oral
Small cell lung cancer

Adult: Twice the IV dose, rounded to the nearest 50 mg.

Renal Impairment

Intravenous:
Testicular cancer:

CrCl (mL/min)	Dosage
15-50	75% of the recommended dose.

Administration

Should be taken on an empty stomach.

Contraindications

Hypersensitivity, pregnancy, lactation.

Special Precautions

Skin reactions may occur with accidental exposure; renal or hepatic disease. Periodic CBCs should be done before, during and after therapy. Increased risk of etoposide-toxicity in patients with low serum albumin. Acrylic material has been shown to crack and leak when used with undiluted etoposide inj.

Adverse Reactions

Nausea, vomiting, anorexia, diarrhoea, stomatitis; reversible alopoecia; rarely, disturbances of liver dysfunction, peripheral neuropathy, CNS effects, anaphylactoid reactions; hypotension with IV injection. Local irritation and thrombophloebitis at the site of inj.
Potentially Fatal: Severe myelosuppression, characterised by leucopaenia and thrombocytopaenia. Cardiotoxicity. Anaphylaxis.

Pregnancy Category (US FDA)

IV/Parenteral/PO: D

Drug Interactions

Synergism with other cytotoxic drugs. Caution when admin with drugs that inhibit phosphatase activity. Cyclosporin A may reduce the clearance of etoposide.

Action

Description:
Mechanism of Action: Etoposide is a derivative of podophyllotoxin that inhibits DNA synthesis resulting in the arrest of the cell cycle. At low doses, it inhibits cells from entering cell cycle and at high doses, cells entering mitosis are lysed.
Pharmacokinetics:
Absorption: Oral admin: 50% absorbed from the GI tract; plasma concentrations peak after 1 hr.
Distribution: Rapid distribution but poor penetration of the blood-brain barrier. Protein-binding: 94%.
Metabolism: Metabolised by CYP3A4.
Excretion: Terminal half-life: 4-11 hr. Excreted in urine and faeces.

Storage

Refrigerate between 2-8°C. Do not freeze. Conc for inj: Store between 15-30°C.

MIMS Class

Cytotoxic Chemotherapy

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