How should I store etoposide oral?

Store etoposide oral in the refrigerator at 36° to 46°F (2° to 8°C). Don't freeze it. Keep it stored in the [bottle it came in](https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/oral-chemotherapy.html). If you're planning to travel, make sure to store your medication in a cooler bag with ice, so that it's at the right temperature. Talk with your provider or pharmacist if you have questions about storage or traveling with etoposide oral.

etoposide

Generic Vepesid

Used for Lung Cancer, Testicular Cancer

Etoposide oral is an anticancer medication used in combination with other chemotherapy medications to treat small cell lung cancer. It’s also commonly known as VP-16. Etoposide oral is taken by mouth, usually daily for a few days during each chemotherapy cycle. This medication can raise your risk for infections and bleeds.

Reviewed by:

Jenny Zhang, PharmD, BCOP

Connie Zheng, PharmD

Last reviewed on October 12, 2022

What is Etoposide oral?

What is Etoposide oral used for?

Small cell lung cancer

How Etoposide oral works

Etoposide oral is a type of anticancer medication called a topoisomerase II inhibitor. It prevents cancer cells from growing by damaging the cancer cells’ genetic material.

Are you looking for information on etoposide (Etopophos) injection, topotecan (Hycamtin) instead?

Drug facts

Common Brands	VePesid(brand no longer available)
Drug Class	Anticancer agent
Controlled Substance Classification	Not a controlled medication
Generic Status	Lower-cost generic available
Availability	Prescription only

Common Brands

VePesid(brand no longer available)

Drug Class

Anticancer agent

Controlled Substance Classification

Not a controlled medication

Generic Status

Lower-cost generic available

Availability

Prescription only

Side effects of Etoposide oral

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Low white blood cell count (60-91%)
Hair loss (8-66%)
Nausea and vomiting (31-43%)
Low platelet count (22-41%)
Low red blood cell count (up to 33%)

Please note: Reports of these side effects were gathered from people who took etoposide oral only, either by mouth or through IV.

Less Common Side Effects

Stomach pain
Lack of appetite
Diarrhea
Mouth or throat sores

Etoposide oral serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Infections: fevers, chills, 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 stool
Serious skin problems: mouth sores, redness of the eyes, rash, blisters, fever, cough, tiredness

Source: DailyMed

The following Etoposide oral 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):

Diarrhea
Fatigue
Hair loss
Loss of appetite
Nausea
Pain, redness, or swelling with sores inside the mouth or throat
Vomiting

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Avg retail price

$1519.49(Save 78.64%)

$324.59

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Pros and cons of Etoposide oral

Pros

Taken by mouth
Available as a lower-cost generic
Recommended treatment option for small cell lung cancer, in combination with other anticancer medications

Cons

Raises your risk for infections, bleeding, or bruising
Slightly more nausea and vomiting compared to etoposide injection
Can cause hair loss

Pharmacist tips for Etoposide oral

Swallow etoposide oral capsules whole. Don’t open, dissolve, or chew the capsules.
Store etoposide oral capsules in the refrigerator at 36° to 46°F (2° to 8°C), in its original container. If you live with other people, make sure they're aware of where your medication is stored and don't accidentally take it or touch it. Ask your provider or pharmacist if there are any other storage safety instructions for etoposide oral.
You’ll need to get labs done regularly during etoposide treatment. This is so your provider can monitor your blood cell counts and liver health. Etoposide oral can lower your blood cell counts and put you at risk for bleeding or developing infections. Liver problems can also put you at higher risk of the medication’s side effects. Follow the lab schedule your provider gives you. Tell your care team if you develop a fever.
Etoposide oral can cause hair loss. Talk to your provider if this is a concern and ask about ways to manage it.
Etoposide oral can cause harm to an unborn baby. If you’re a female who can get pregnant, use birth control while taking this medication. Discuss with your provider to see which birth control option is best for you.
Tell your provider if you are taking a medication called cyclosporine modified (Neoral). Depending on your dose, it can interact with etoposide oral and change the levels of etoposide oral in your body and raise your risk of side effects. Tell your provider and pharmacist about all the medications you take, including supplements and over-the-counter medications. Before starting any new medications, make sure your provider knows you're taking etoposide oral.
Ask your provider or pharmacist about the best way to handle and throw away etoposide oral safely. You or your caregiver should wear gloves when handling this medication. Make sure to wash hands before and after handling. Anticancer medications can be very harmful to people who handle or come into contact with them.

Common questions about Etoposide

Etoposide can weaken your immune system and make it harder for your body to fight off an infection. If you do get an infection, you might become seriously sick. There are things you can do to protect yourself from an infection. For example, you can wash your hands often, especially after you use the restroom and before you eat. If possible, try to avoid crowded places and people who are sick. To prevent getting sick from tainted foods, please wash raw fruits and vegetables before you eat, and cook your food thoroughly. If you do feel sick with symptoms such as fever, cough, sore throat, fatigue, or chills, let your provider know right away.

Let your provider know if you have problems with your kidney. Depending on how severe your kidney problem is, your provider might need to lower your dose of Etoposide. This is because your kidneys help remove this medication from your body. But if your kidneys damaged, then etoposide stays around longer and can build up in your body. This might lead to problems, such as higher risk of side effects from etoposide.

Etoposide isn’t recommended during pregnancy. Based on animal studies, it can cause harm to your unborn baby. Let your provider know right away if you become pregnant during etoposide treatment, or if you have any questions about pregnancy while receiving the medication.

Etoposide isn’t recommended if you’re breastfeeding. Researchers don’t know if this medication can pass into breast milk. But if it does, it can cause serious harm to nursing infants. Talk with your provider if you’re breastfeeding or considering breastfeeding.

Store Etoposide in the refrigerator at 36° to 46°F (2° to 8°C). Don't freeze it. Keep it stored in the bottle it came in. If you're planning to travel, make sure to store your medication in a cooler bag with ice, so that it's at the right temperature. Talk with your provider or pharmacist if you have questions about storage or traveling with Etoposide.

Risks and warnings for Etoposide oral

Etoposide oral 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.

Must be given by a trained healthcare provider

Warning Icon Etoposide oral must be given by or under the supervision of your healthcare provider who's trained in caring for people taking chemotherapy medications.

Low blood cell counts

Warning Icon Etoposide oral can cause your white blood cell, red blood cell, and platelet counts to drop. This can happen within a couple of weeks after you start this medication. When the number of these cells are lower than normal, you’re at risk of developing infections, anemia, and bleeding or bruising. Your provider will closely monitor your blood counts through regular lab work while you're taking etoposide oral. If your blood counts are low, your dose might need to be lowered or you might stop taking the medication altogether. Typically, your blood cell counts should recover about 3 weeks after you stop this medication. Let your provider know as soon as possible if you experience fevers, chills, or bleeding and bruising that doesn’t stop or go away, because you might need to stop this medication.

Nausea, vomiting, and mouth sores

Etoposide oral can cause you to experience mild to moderate nausea and vomiting. Let your provider know if you do have these side effects because they can prescribe anti-nausea medications to ease those symptoms.

Etoposide oral can sometimes cause mouth sores. These sores can be painful and make it difficult for you to eat and drink. Make sure to brush your teeth and floss gently to protect your oral health. Let your provider know if you develop mouth sores, they might be able to recommend a mouthwash or other methods to ease your symptoms.

Harm to unborn baby

You’re recommended to avoid etoposide oral during pregnancy. Based on animal studies, etoposide oral can cause harm to an unborn baby. Because of these risks, you should use birth control during treatment with etoposide oral to prevent pregnancy. Let your provider know right away if you or your partner becomes pregnant during this time.

Etoposide oral dosage

The average cost for 14 capsules of 50mg of Etoposide oral is $324.59 with a free GoodRx coupon. This is 78.64% off the average retail price of $1,519.49.

Capsule

Dosage	Quantity	Price as low as	Price per unit
50mg	14 capsules	$324.59	$23.19

Typical dosage for Etoposide oral

Your provider will calculate your dose of etoposide oral using your body surface area (BSA, in units of m²), which takes into account your body weight and height. Your dose of etoposide oral will be rounded to the nearest 50 mg.

Typically, the dose of oral etoposide oral is twice the dose of the intravenous (IV) etoposide injection that you’ve been receiving. The dosing can differ depending on the treatment regimen.