etoposide
Etoposide injection is an chemotherapy anticancer medication used in combination with other chemotherapy medications to treat testicular cancer or small cell lung cancer. It’s also known as VP-16. Etoposide injection is infused intravenously (IV), usually daily for a few days during each chemotherapy cycle. This medication can raise your risk for infections and bleeds.
What is Etoposide injection?
What is Etoposide injection used for?
Testicular cancer that's hard to treat (refractory)
Small cell lung cancer
How Etoposide injection works
Etoposide injection is a type of anticancer medication called a topoisomerase II inhibitor. It prevents cancer cells from growing by damaging the cancer cells’ genetic material.
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What are the side effects of Etoposide injection?
Common Side Effects
- Low white blood cell count (up to 91%)
- Hair loss (up to 66%)
- Low platelet count (up to 41%)
- Nausea and vomiting (up to 43%)
- Low red blood cell count (up to 33%)
Other Side Effects
- Low appetite
- Diarrhea
- Mouth sores
- Stomach pain
- Tingling or numbness in the hands and feet
Serious Side Effects
- Serious infections: headache, fevers, chills, body aches, cough, trouble breathing, severe diarrhea, vomiting, painful or frequent urination
- Serious bleeds: bleeding or bruising that doesn’t stop or go away, large amount of bleeding, blood in the urine, throwing up blood, bloody or black and tarry stools
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Etoposide injection
Pros
Can be given at a lower dose to some people with kidney problems
Infusions are given only a few days out of each chemotherapy cycle
Brand Etopophos (etoposide phosphate) can be given to those allergic to certain ingredients in the generic
Available as a lower-cost generic
Cons
Might cause fertility problems in both males and females
Infusions can last almost 4 hours
Can cause rare, but serious, skin reactions (extravasation)
High risk of side effects, such as infections and hair loss
Pharmacist tips for Etoposide injection
Ask your provider about what to expect on your etoposide injection days. Each infusion alone can take up to 3.5 hours. You also have to consider the time it takes to check-in or the time for any post-infusion observations. Please plan ahead by taking time off work or school, arriving early, and arranging for rides, if needed. Wear comfortable clothes and bring something to help you pass the time, such as music or a book.
You might experience symptoms of low blood pressure, such as dizziness and feeling light-headed, while receiving etoposide injection. If you need to stand up, do so slowly so that you don't fall. If you do feel unsteady or can’t keep your balance, let your provider know right away. This might be a sign that your infusion rate is too fast. Your provider might need to stop your infusion, treat your low blood pressure, and restart the infusion at a slower rate.
Though rare, you might experience an allergic reaction while receiving etoposide injection. If so, your healthcare team will need to stop your treatment in order to treat your reaction. Let your provider know right away if you feel your face flushing, itching, or trouble breathing.
If you feel nauseous from etoposide injection, let your provider know. They can prescribe you anti-nausea medications, such as ondansetron (Zofran), to ease your symptoms. They can also give you tips, like eating smaller meals throughout the day or eating food that's more bland, to lower your risk for nausea.
Receiving etoposide treatment can put you at higher risk for infections because it lowers your immune system. Protect yourself from infections by avoiding crowds or people who are sick. Also, wash your hands before you eat and after you use the restroom. Let your provider know right away if you have any symptoms of an infection, such as fever, sore throat, or cough.
Frequently asked questions about Etoposide injection
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What are the risks and warnings for Etoposide injection?
Etoposide injection can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood cell counts
Etoposide injection can cause your red blood cell (RBC), white blood cell (WBC), and platelet counts to drop, typically around 1 to 2 weeks after you start this medication. This is because etoposide injection is a chemotherapy agent that targets and kills fast-growing cancer cells. But as a side effect, it can kill fast-growing healthy cells as well, such as your blood cells. When your blood cell counts drop too low, you're at risk for problems such as infections, anemia, and bleeding or bruising. Your provider will order labs to check your blood cell counts before you start etoposide injection and before each chemotherapy cycle. If your blood cell counts drop too low, your provider will need to pause your treatment and possibly add another medication to help raise your blood counts. Let your provider know right away if you experience symptoms of low blood cell counts, such as:
Risk of blood cancer
Risk factors: Receiving etoposide injection for a long time
Though rare, receiving etoposide injection can put you at risk for developing blood cancers (leukemias). While researchers aren't clear why this happens, it's thought that etoposide injection can affect the genetic material of certain blood cells and change them into cancer cells. And the risk is higher if you receive etoposide injection for a longer period of time. If you've any questions or concerns about the risk of blood cancer, please discuss them with your healthcare provider.
Serious allergic reactions
Risk factors: Receiving etoposide injection at a higher dose | Receiving etoposide injection infusions too quickly
Some people have experienced serious allergic reactions from etoposide injection treatment. If you experience an allergic reaction, your provider will need to stop your etoposide infusion and provide medical care immediately. If your reaction is severe, you might not be able to continue etoposide treatment. Let your provider know right away if you experience symptoms of an allergic reaction, such as rash, hives, itching, chills, swelling of the face and throat, or trouble breathing.
Harm to unborn baby
Etoposide injection might cause harm to unborn babies if received by mothers during pregnancy. If you're able to get pregnant, you're recommended to use birth control while receiving etoposide injection and for 6 months after your treatment ends. Discuss with your provider about birth control options that are best for you. If you become pregnant while receiving this medication, please let your provider know right away.
If you're a male and have a partner who is able to become pregnant, you should also use birth control while receiving etoposide injection and for 4 months after your treatment ends. Etoposide injection might damage your sperm, which can lead to birth defects if your partner becomes pregnant.
Etoposide injection dosage forms
Typical dosing for Etoposide injection
Your provider will calculate your dose of etoposide injection using your body surface area (BSA, in units of m2), which takes into account your body weight and height.
Testicular cancer
The typical dose is 50-100 mg/m2 infused intravenously (IV) on days 1 through 5 (or on days 1, 3, and 5) of each cycle of chemotherapy. Each cycle usually lasts either 21 or 28 days.
Small cell lung cancer
The typical dose is 35-50 mg/m2 infused intravenously (IV) for 4 or 5 days.
Your provider might prescribe a different dose based on current research and updated NCCN guidelines. Ask your provider if you have any questions about your dose.
How much does Etoposide injection cost?
What are alternatives to Etoposide injection?
Testicular cancer that's hard to treat (refractory)
Small cell lung cancer
Etoposide injection images
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