Etoposide
TOPOSAR
What it isTopoisomerase II inhibitor stabilizing the DNA-enzyme complex; small cell lung cancer and testicular cancer.
Why this oneOral and IV forms, and it is central to curative testicular regimens.
What limits itMyelosuppression is dose-limiting. Secondary leukemia; hypotension if infused too fast.
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Administer under supervision of a physician experienced in cancer chemotherapy; severe myelosuppression with resulting infection or bleeding may occur
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Small cell lung cancer | Adults | Oral dose = 2× the IV dose rounded to nearest 50 mg (2×35 mg/m2/day ×4 days to 2×50 mg/m2/day ×5 days) | Modify for myelosuppressive combination drugs and prior RT/chemo | 100 mg/m2/day ×5 days (2×50) |
Renal Dose adjustment required in renal impairment — label defers specifics to PRECAUTIONS section (not in fetched text)
Hepatic Undefined
Repeat chemotherapy courses at 3–4 week intervals, after adequate recovery from toxicity
Instructions
- Wear impervious gloves for all handling of blister packs (dermal-exposure risk)
- Store capsules refrigerated 2–8°C
- Handle/dispose as cytotoxic anticancer drug
Cautions
- Myelosuppression is dose-related and dose-limiting: granulocyte nadir day 7–14, platelet nadir day 9–16, recovery by day 20; deaths reported
- Secondary acute leukemia reported rarely with etoposide-containing regimens
- Anaphylactic-like reactions (<1% with capsules), can be fatal
Adverse reactions
- Leukopenia (<4,000 WBC: 60–91%)
- Thrombocytopenia
- Anemia
- Nausea/vomiting (31–43%)
- Anorexia
- Diarrhea
- Stomatitis/mucositis-esophagitis
- Alopecia (up to 66%)
- Peripheral neurotoxicity
- Hypotension
- Allergic reactions
- Rare: SJS/TEN, optic neuritis, interstitial pneumonitis, hepatic toxicity at high doses
Pregnancy Undefined
Lactation Undefined
⚠ BOXED WARNING
- Severe myelosuppression
Classes and tags
Clinical profile
Mechanism of action: Etoposide ballicule
