Etoposide
Cytostatic · Podophyllo toxins derivative
Indications
Small cell carcinoma of the lung, Hodgkin's disease, malignant lymphomas, acute non-lymphocytic leukaemia.
Dosage
Adults: 60-120 mg/m² daily for 3-5 days followed by treatment-free interval of 14 days. Slow IV infusion over 1/2- 1 hr.
Administration
IV: Administer lower doses IVP Bolus over at least 30 min to minimize the risk of hypotensive reactions. At room temperature in D5W or NS in polyvinyl chloride, the concentration is stable as follows: 0.2 mg/mL: 96 hours; 0.4 mg/mL: 48 hours; 0.6 mg/mL: 8 hours; 1 mg/mL: 2 hours; 2 mg/mL: 1 hour; 20 mg/mL (undiluted): 24 hours. Standard IV Dilution: Lower dose regimens (<1 gm/dose): Doses may be diluted in 100-1000 mL of D5W or NS. If the concentration is less than or equal to 0.6 mg/mL, the bag should be mixed with the appropriate expiration dating. If the concentration is >0.6 mg/mL, the concentration is highly unstable and a syringe of undiluted etoposide accompanied with the appropriate volume of diluent will be sent to the nursing unit to be mixed at the bedside just prior to administration. High-dose regimens (>1 gm/dose): Total dose should be drawn into an empty Viaflex container…
Adverse Effects
Myelosuppression, GI upset, anorexia, stomatitis, reversible alopecia, temporary hypotension, allergic reactions, hypertension & flushing, neuropathy, leukaemia, infections, blood dyscrasias, anaemia, haemorrhage, anaphylactic reactions, dizziness, BP changes, MI, arrhythmia, mucositis, hepatotoxicity, pigmentation, rash, pruritus, asthenia, malaise, inj site reactions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Severe hepatic dysfunction; acute infection. Untreated bacterial infection. Severe myelosuppression (neutrophil count <1500/ mm3 or platelet count <100,000/mm3) (unless disease-related). Precautions: Debilitated patients; prolonged chemotherapy. Monitor blood count & measurement of Hb conc; avoid contact with skin & eyes; avoid extravasation. Not to be administered intrapleurally or intraperitoneally. Men must be advised not to father a child for up to 6 months after treatment and warned about risk of decreased fertility. Hepatic or moderate to severe renal (CrCl <50 mL/min) impairment. Severe myelosuppression. Herpes zoster infection. Low serum albumin. Risk of tumour lysis syndrome.
Interactions
Myelosuppressive drugs, phenylbutazone, anthracyclines, salicylates, aspirin, warfarin, cyclosporin, live vaccines, other antineoplastics, phenytoin and other antiepileptics. Etopophos: also, phosphatase inhibitors.
Advice to Patient
This medication is administered by infusion. Inform prescriber immediately if there is swelling/pain/burning/irritation/redness at infusion site or if there is chest pain, palpitations, swelling of extremities, difficulty in breathing, fast heartbeat. Contact prescriber if you experience severe GI disturbances, bruising or bleeding, increased fatigue, numbness or pain in extremities, fever, chills, sore throat, yellowing of skin or eyes, vaginal discharge, change in colour of urine or stool. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Take small, frequent meals to maintain good nutritional status. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber. Using soft toothbrush, cotton swabs, regular mouth care may help to prevent mouth sores.
Pharmacokinetics
Metabolism: Etoposide phosphate: Rapidly and completely converted to etoposide in plasma. Etoposide: Hepatic. Half-life elimination: Terminal: 4 to 11 hours; Children: Normal renal/hepatic function: 6 to 8 hours. Excretion: Urine (56%; 45% as etoposide, =8% as metabolites) with in 120 hours; feces (44%) within 120 hours.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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