Dangerous Drug: Etoposide (VP-16)(e toe poe’ side)
Etopophos, Toposar
PREGNANCY CATEGORY D
Drug Classes
Antineoplastic
Mitotic inhibitor
Therapeutic Actions
G2-specific cell toxic: Lyses cells entering mitosis; inhibits cells from entering prophase; inhibits DNA synthesis, leading to cell death.
Indications
Refractory testicular tumors as part of combination therapy (IV)
First-line treatment of small-cell lung carcinoma as part of combination therapy (oral, IV)
Unlabeled uses: Bladder cancer, lymphomas, leukemias, Ewing sarcoma, Kaposi sarcoma, brain tumors, gestational trophoblastic tumors, ovarian germ-cell tumors, rhabdomyosarcomas, Wilms tumors, bone marrow transplants
Contraindications and Cautions
Contraindicated with allergy to etoposide, teniposide, Cremophor EL; pregnancy, lactation.
Use cautiously with bone marrow suppression.
Available Forms
Capsules—50 mg; injection—20 mg/mL; powder for injection—100 mg
Dosages
Modify dosage based on myelosuppression.
Adults
Parenteral
Refractory testicular cancer: 50–100 mg/m2 per day IV on days 1 to 5 or 100 mg/m2 per day IV on days 1, 3, and 5, every 3–4 wk in combination with other chemotherapeutics.
Oral
Small-cell lung cancer: Two times the IV dose rounded to the nearest 50 mg.
Pediatric patients
Safety and efficacy not established.
Patients with renal impairment
For CrCl of 15–50 mL/min, give 75% of dose. For CrCl of less than 15 mL/min, consider further dosage reduction.
Patients with hepatic impairment
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