Brand Name
US Brand Name
Avopef
Etopophos
Vepesid
Canadian Brand Name
Dom-Etoposide
Eposin
Etoposide
Pms-Etoposide
Description
Etoposide injection is used in combination with other cancer medicines to treat refractory (cancer that did not respond to treatment) testicular cancer. This medicine is also used in combination with other medicines as first-line treatment of small cell lung cancer (SCLC). It is also sometimes used to treat some other kinds of cancer in both males and females.
Etoposide belongs to the group of medicines called antineoplastics (cancer medicines). It interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal cells may also be affected by the medicine, other effects may also occur. Some of these may be serious and must be reported to your doctor.
Before you begin treatment with etoposide, you and your doctor should talk about the benefits of this medicine as well as the risks of using it.
This medicine is to be given only by or under the immediate supervision of your doctor.
This product is available in the following dosage forms:
- Solution
- Powder for Solution
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies have not been performed on the relationship of age to the effects of etoposide injection in the pediatric population. Safety and efficacy have not been established.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of etoposide injection in the elderly. However, elderly patients are more likely to have unwanted side effects and have age-related kidney, liver, or heart problems, which may require caution in elderly patients receiving etoposide injection.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bacillus of Calmette and Guerin Vaccine, Live
- Dengue Tetravalent Vaccine, Live
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rubella Virus Vaccine, Live
- Smallpox Monkeypox Vaccine
- Typhoid Vaccine
- Varicella Virus Vaccine, Live
- Yellow Fever Vaccine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acenocoumarol
- Adagrasib
- Adenovirus Vaccine Type 4, Live
- Adenovirus Vaccine Type 7, Live
- Apalutamide
- Aprepitant
- Boceprevir
- Carbamazepine
- Ceritinib
- Cholera Vaccine
- Clarithromycin
- Cobicistat
- Cyclosporine
- Ebola Zaire Vaccine, Live
- Echinacea
- Encorafenib
- Enzalutamide
- Fosaprepitant
- Fosphenytoin
- Glucosamine
- Idelalisib
- Indinavir
- Influenza Virus Vaccine, Live
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lonafarnib
- Lumacaftor
- Mifepristone
- Mitotane
- Nefazodone
- Nelfinavir
- Paritaprevir
- Phenindione
- Phenprocoumon
- Phenytoin
- Posaconazole
- Ribociclib
- Rifampin
- Rifapentine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Rolapitant
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.
- Grapefruit Juice
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Bone marrow problems (eg, anemia, neutropenia, thrombocytopenia) or
- Infection—May decrease your body's ability to fight infection.
- Kidney disease—Use with caution. The effects of etoposide may be increased because of slower removal from the body.
- Low serum albumin (low protein in the blood)—May increase risk of serious side effects.
Proper Use
Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
A nurse or other trained health professional will give you this medicine in a hospital or cancer treatment center. This medicine is given through an IV catheter that is placed in one of your veins. The medicine must be injected slowly, so your IV will need to stay in place for 30 to 60 minutes.
Etoposide is sometimes given together with certain other medicines. If you are using a combination of medicines, make sure that you take each one at the proper time and do not mix them. If you are taking some of these medicines by mouth, ask your doctor to help you plan a way to remember to take your medicines at the right times.
Etoposide often causes nausea, vomiting, and loss of appetite, which may be severe. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your doctor for ways to lessen these effects.
Do not drink alcohol while you are using this medicine.
Precautions
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.
Receiving this medicine while you are pregnant can harm your unborn baby. If you can get pregnant, your doctor may do tests to make sure you are not pregnant before receiving this medicine. It can also cause birth defects if the father is using it when his sexual partner becomes pregnant. Female patients should use an effective form of birth control to keep from getting pregnant during treatment with this medicine and for 6 months after the last dose. Males with female partners who can become pregnant must use an effective birth control during treatment and for 4 months after the last dose. If you think you have become pregnant while receiving the medicine, tell your doctor right away.
Etoposide can temporarily lower the number of white blood cells in your blood, increasing the chance of your getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or have painful or difficult urination.
- Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
- Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injury could occur.
This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have chills, fever, lightheadedness, dizziness, or fainting, fast, pounding heartbeat, swelling of the face, tongue, and throat, or trouble breathing after you receive the medicine.
This medicine may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, or lightheadedness or fainting after receiving this medicine.
This medicine may cause secondary cancer (eg, leukemia). Talk with your doctor about any concerns you have about this.
Talk with your doctor before getting flu shots or other vaccines while you are receiving this medicine because there are certain vaccines that you should not receive.
Some men and women who use this medicine have become infertile (unable to have children). Talk to your doctor before using this medicine if you plan to have children.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
- Black, tarry stools
- bleeding gums
- blood in the urine or stools
- chest pain
- chills
- cough
- fever
- painful or difficult urination
- pale skin
- pinpoint red spots on the skin
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- swollen glands
- trouble breathing
- unusual bleeding or bruising
- unusual tiredness or weakness
Less common
- Blurred vision
- chest tightness
- confusion
- cough or hoarseness, accompanied by fever or chills
- difficulty with swallowing
- dizziness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- face is warm or hot to touch
- fast heartbeat
- headache
- hives, itching, or skin rash
- lower back or side pain, accompanied by fever or chills
- nervousness
- numbness or tingling in the fingers or toes
- pain at the injection site
- pale skin at the site of injection
- pounding in the ears
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- redness to face
- slow or fast heartbeat
- sweating
Rare
- Back pain
- difficulty with walking
- loss of consciousness
- swelling of the face or tongue
- tightness in the throat
Incidence not known
- Blindness
- blistering, peeling, or loosening of the skin
- blue-yellow color blindness
- dark urine
- decreased vision
- eye pain
- joint or muscle pain
- loss of appetite
- nausea or vomiting
- red, irritated eyes
- red skin lesions, often with a purple center
- seizures
- stomach pain
- swelling of the feet or lower legs
- yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Bad, unusual, or unpleasant (after) taste
- change in taste
- constipation
- cracked lips
- hair loss or thinning of the hair
- lack or loss of strength
- swelling or inflammation of the mouth
- weight loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
DRG-20063769
