Renal Dose Adjustment (Based on CrCl)
- CrCl >50 mL/min: 100% dose
- CrCl 15-50 mL/min: Administer 75% dose
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Cases of myelosuppression resulting in death have been reported with therapy, frequently monitor myelosuppression during and after therapy
- Dose-limiting bone marrow suppression toxicity is commonly associated with therapy. Therefore, platelet count, hemoglobin, white blood cell count should be assessed at the start of therapy and prior to each subsequent cycle
- Withhold the therapy if platelet count <50,000/mm3 or an absolute neutrophil count <500/mm3
- Therapy may cause fetal harm when administered to a pregnant woman. Advise women to avoid becoming pregnant while on therapy, and warn about potential hazard to the fetus if therapy is taken during pregnancy
- Rare cases of acute leukemia with or without a preleukemic phase have been reported with etoposide treatment
- Evaluate the need and usefulness of the therapy against the risk of adverse reactions when use of drug is considered for chemotherapy
- If severe reaction occurs therapy should be either reduced or discontinued, and corrective measures should be taken according to the physician
- Patients with low serum albumin are at increased risk of etoposide associated toxicities
Cautions: Use cautiously in
- Low albumin
- Renal impairment
- Myelosuppression
- History of severe anaphylactic reaction
- Elderly patients
Pregnancy Category:D
Breastfeeding: To breastfeed safely during intermittent therapy with etoposide after an appropriate period of breastfeeding abstinence. A period of at least 24 hours is required after a dose of 80 mg/sq m or less. Longer periods of abstinence may be required after higher doses. Based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 07 March 2011)
