Etoposide


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Small cell lung cancer Twice the IV dose, rounded to the nearest 50 mg. IV Testicular cancer Combination therapy: 50-100 mg/m2/day from days 1-5. May repeat course 3-4 wkly. Small cell lung cancer 35 mg/m2/day for 4 days to 50 mg/m2/day for 5 days. May repeat course 3-4 wkly.
Dosage Details
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 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.
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: 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.
Disclaimer: This information is independently developed by MIMS based on Etoposide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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