Adult Dosing

Small cell lung cancer

• 70-100 mg/m² PO qd x 4-5 days

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Indicated as first line treatment in patients with small cell lung cancer, given in combination with other approved chemotherapeutic agents

• Hypersensitivity to any of the ingredients of the product
• Platelet count <50,000/mm³
• Absolute neutrophil count <500/mm³
• Breastfeeding
• Pregnancy

• Administer etoposide only under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Severe myelosuppression may occur leading to infection or bleeding

Renal Dose Adjustment (Based on CrCl)

• CrCl >50 mL/min: 100% of the dose
• CrCl 15-50 mL/min: 75% of the dose

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Cases of myelosuppression resulting in death have been reported with etoposide therapy; monitor frequently for myelosuppression during and after therapy
• Dose-limiting bone marrow suppression is the most significant toxicity associated with etoposide therapy. Hence, studies such as platelet count, hemoglobin, white blood cell and differential counts should be performed at the start of therapy and before each subsequent cycle
• Withhold therapy if platelet count <50,000/mm³ or an absolute neutrophil count <500/mm³ until the blood counts recover sufficiently
• Therapy may cause fetal harm when administered to a pregnant woman. Advise women of childbearing potential to avoid becoming pregnant while on therapy, and should be warned about the potential hazard to the fetus if etoposide is taken during pregnancy
• Rare cases of acute leukemia with or without a preleukemic phase have been reported during etoposide
• Evaluate the need and usefulness of the therapy against the risk of adverse reactions when etoposide use is considered for chemotherapy
• If severe adverse reactions occur, therapy should be either reduced or discontinued, and appropriate corrective measures should be undertaken according to the physician's judgement
• Patients with low serum albumin may be at an increased risk of etoposide associated toxicities

Cautions: Use cautiously in

• Renal impairment
• History of severe anaphylactic reaction
• Elderly patients

Vepesid interacts with :

	Agenerase
	Akne-mycin
	Amiodarone
	Amprenavir
	Atazanavir
	Barbiturates
	Biaxin
	Biaxin XL
	Boceprevir
	Bosentan
	Calan
	Calan SR
	Carbamazepine
	Carbatrol
	Cardizem
	Cardizem CD
	Cardizem LA
	Cartia XT
	Ceritinib
	Cetraxal
	Ciloxan
	Cipro
	Cipro IV
	Cipro XR
	Ciprofloxacin
	Clarithromycin
	Cobicistat
	Conivaptan
	Cordarone
	Covera-HS
	Crixivan
	Cyclosporine
	Dabrafenib
	Darunavir
	Delavirdine
	Diflucan
	Dilacor XR
	Dilantin
	Dilantin Infatabs
	Dilantin-125
	Dilt-CD
	Diltiazem
	Diltzac
	Dronedarone
	E-Mycin
	E.E.S.
	Efavirenz
	Epitol
	Equetro
	Ery-Tab
	Eryc
	Erygel
	Eryped
	Erythra-Derm
	Erythro-statin
	Erythrocin
	Erythromycin
	Etravirine
	Extina
	Fluconazole
	Fluvoxamine
	Gengraf
	Gleevec
	Grapefruit
	Imatinib
	Incivek
	Indinavir
	INH
	Intelence
	Invirase
	Isoniazid
	Isoptin
	Isoptin SR
	Itraconazole
	Juxtapid
	Ketek
	Ketoconazole
	Korlym
	Lapatinib
	Lomitapide
	Lumacaftor
	Luvox
	Luvox CR
	Mifepristone
	Multaq
	Mycobutin
	Mysoline
	Nefazodone
	Nelfinavir
	Neoral
	Nevirapine
	Nexterone
	Nizoral
	Nizoral A-D Shampoo
	Nizoral Shampoo
	Norvir
	Noxafil
	Onmel
	Orkambi
	Oxcarbazepine
	Oxtellar XR
	Pacerone
	PCE
	Pediamycin
	Phenytek
	Phenytoin
	Posaconazole
	Prezista
	Priftin
	Primidone
	Proquin XR
	Quinupristin
	Rescriptor
	Restasis
	Reyataz
	Rifabutin
	Rifadin
	Rifampin
	Rifapentine
	Rimactane
	Ritonavir
	Sandimmune
	Saquinavir
	Sporanox
	St. John's wort
	Stribild
	Sustiva
	Synercid
	Tafinlar
	TAO
	Taztia XT
	Tegretol
	Tegretol XR
	Telaprevir
	Telithromycin
	Teril
	Tiazac
	Tracleer
	Trileptal
	Troleandomycin
	Tykerb
	Vaprisol
	Veralan
	Verapamil
	Verelan PM
	Vfend
	Victrelis
	Viracept
	Viramune
	Viramune XR
	Voriconazole
	Xolegel
	Zykadia

Pregnancy Category:D

Breastfeeding: Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug use. May 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). According to the manufacturer's data, due to the potential for serious adverse reactions in breastfed infants, a decision should be made whether to discontinue nursing or the drug, analyzing the importance of the drug to the mother.

• CV: Hypotension, hypertension
• CNS: Seizures, asthenia, malaise, dizziness
• NEURO: Peripheral neurotoxicity
• GI: Nausea, vomiting, mucositis, stomatitis, constipation, abdominal pain, diarrhea, taste changes, anorexia, esophagitis
• HEMA: Myelosuppression, leukopenia, neutropenia, anemia, thrombocytopenia
• DERM: Alopecia, facial flushing, rash
• EENT: Transient cortical blindness, optic neuritis
• RESP: Interstitial pneumonitis, pulmonary fibrosis
• HEPA: Hepatotoxicity
• MISC: Fever, chills
• HYPERSENSITIVITY: Anaphylactic reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis

• Antineoplastic agent; inhibits DNA topoisomerase II, thereby inhibiting DNA synthesis. It mainly affects the S and G2 phases of cell division; at higher concentrations (10 mcg/mL or more), lysis of cells entering mitosis occurs and at lower concentrations (0.3 to 10 mcg/mL), cells are inhibited from entering prophase
• Metabolized by liver; CYP450: 3A4 substrate
• Excreted in urine (56%), and feces (44%)
• Half-life: 4-11 hrs

US Trade Name(s)

• Only generic available

US Availability

etoposide (generic)

• CAPS: 50 mg

Canadian Trade Name(s)

• Vepesid

Canadian Availability

Vepesid

• CAPS: 50 mg

UK Trade Name(s)

• Vepesid

UK Availability

Vepesid

• CAPS: 50, 100 mg

Australian Trade Name(s)

• Vepesid

Australian Availability

Vepesid

• CAPS: 50, 100 mg

[Outline]

Hematology/Oncology

Antineoplastics

Mitotic Inhibitors

Drug Name: Etoposide 50 MG Oral Capsule

Ingredient(s): Etoposide

Imprint: E50

Color(s): Pink

Shape: Capsule

Size (mm): 23.00

Score: 1

Inactive Ingredient(s): anhydrous citric acid / gelatin / glycerin / hypromellose / ferric oxide red / polyethylene glycol / propylene glycol / water / ferrosoferric oxide / titanium dioxide

Drug Label Author:
Mylan Pharmaceuticals Inc.

DEA Schedule:
Non-Scheduled