Oral. Since the growth of normal body cells may also be affected by etoposide, other effects will also occur. Transient hypotension following rapid intravenous administration has been reported in 1% to 2% of patients. Total body clearance values range from 33 to 48 mL/min or 16 to 36 mL/min/m2 and, like the terminal elimination half-life, are independent of dose over a range of 100 to 600 mg/m2. In children, approximately 55% of the dose is excreted in the urine as etoposide in 24 hours. MECHANISM OF ACTION: Etoposide is a semisynthetic derivative of the podophyllotoxins, an . Etoposide does not accumulate in the plasma following daily administration of 100 mg/m2 for 4 to 5 days. Things to remember when you fill your prescription. No conclusive evidence exists Antioxidants Although this is a controversial area, many clinicians feel that antioxidants should not be taken while receiving chemotherapy and . For example, no correlation exists between the absolute oral bioavailability of Etoposide capsules and nonrenal clearance. Irreversible testicular atrophy was present in rats treated with Etoposide intravenously for 30 days at 0.5 mg/kg/day (about 1/16th of the human dose on a mg/m2 basis). 2.1 Recommended Dosage . WHO Grade III or IV leukopenia, granulocytopenia, and asthenia were more frequent among elderly patients. In the one study (Etoposide in combination with cyclophosphamide and vincristine compared with cyclophosphamide and vincristine or cyclophosphamide, vincristine, and doxorubicin) where age was a significant prognostic factor for survival, a survival benefit for elderly patients was observed for the Etoposide regimen compared with the control regimens. endstream endobj startxref DRUG NAME: Etoposide SYNONYM(S): VP-161 COMMON TRADE NAME: VEPESID®, ETOPOPHOS® (etoposide phosphate) CLASSIFICATION: topoisomerase II inhibitor. Metabolic acidosis has also been reported in patients receiving higher doses. Etoposide is teratogenic and embryocidal in rats and mice at doses of 1% to 3% of the recommended clinical dose based on body surface area. The following adverse reactions have been infrequently reported: abdominal pain, aftertaste, constipation, dysphagia, asthenia, fatigue, malaise, somnolence, transient cortical blindness, optic neuritis, interstitial pneumonitis/pulmonary fibrosis, fever, seizure (occasionally associated with allergic reactions), Stevens-Johnson syndrome, and toxic epidermal necrolysis, pigmentation, and a single report of radiation recall dermatitis. Massachusetts College of Pharmacy and Allied Health Sciences, 179 Longwood Avenue, Boston, MA 02115. Etoposide, therefore, is cleared by both renal and nonrenal processes, ie, metabolism and biliary excretion. Patients with severe myelosuppression. When advanced age was determined to be a prognostic factor for response or survival in these studies, comparisons between treatment groups were performed for the elderly subset. a type of cancer of the lymph nodes called Hodgkin's lymphoma, neuroendocrine cancer of the prostate gland, acute myeloid leukemia, a type of blood cancer, low amount of albumin proteins in the blood, a significant decrease in certain blood clotting cells called platelets, low levels of a type of white blood cell called neutrophils, a type of inflammation of the lung called interstitial pneumonitis, a condition where there is formation of fibrous tissue in the lung called pulmonary fibrosis, a mother who is producing milk and breastfeeding, a significant drop in a certain type of white blood cell called a neutrophil. In medical practice, the drug is usually used as an anticancer agent. Found inside – Page 652CONTRAINDICATIONS: Thrombophlebitis, cardiovascular disease, breast or reproductive ... pain on injection, and involuntary muscle movements. etoposide, ... The effect of renal disease on plasma Etoposide clearance is not known. Etoposide provides zitotoksicescoe due to DNA damage. CONTRAINDICATIONS Etoposide is contraindicated in patients who have demonstrated a previous hypersensitivity to etoposide or any component of the formulation. endstream endobj 143 0 obj <> endobj 144 0 obj <> endobj 145 0 obj <>stream (1) It is 4'-demethylepipodophyllotoxin 9-[4,6-0-(R)-ethylidene-β-D-glucopyranoside]. WebMD provides common contraindications for etoposide oral. CONTRAINDICATIONS Etoposide should not be given to individuals who have demonstrated a previous hypersensitivity to it or any component of the formulation. Initial U.S. Approval: 1983 -----INDICATIONS AND USAGE----- ETOPOPHOS is a topoisomerase inhibitor indicated for the treatmentof patients with: • Refractory testicular tumors, in combination with other chemotherapeutic drugs. Note: Plastic devices made of acrylic or ABS (a polymer composed of acrylonitrile, butadiene, and styrene) have been reported to crack and leak when used with undiluted Etoposide Injection. After intravenous infusion, the Cmax and AUC values exhibit marked intra- and inter-subject variability. Patients then receive sodium thiosulfate IV over 15 minutes at 4 and 8 hours after carboplatin. Procedures for proper handling and disposal of anticancer drugs should be considered. Herb and Supplement Interactions with Cancer Treatment Kim DeRhodes, RPh N-acetyl cysteine Do not take while taking cisplatin Alpha lipoic acid Theoretically, may interfere with chemotherapy as it acts as an antioxidant. Found inside – Page 415Injection : Single - dose vial containing etoposide phosphate that is equivalent to 100 mg etopo- Contraindications and precautions side ( 20 mg etoposide ... Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. The dosage should be modified to take into account the myelosuppressive effects of other drugs in the combination or the effects of prior x-ray therapy or chemotherapy which may have compromised bone marrow reserve. Carboplatin + Etoposide 5-8. Etoposide binding ratio correlates directly with serum albumin in patients with cancer and in normal volunteers. CA–A Cancer J for Clin. For recommended dosing adjustments in patients with renal impairment see PRECAUTIONS. Vials diluted as recommended to a concentration of 0.2 or 0.4 mg/mL are stable for 96 and 24 hours, respectively, at room temperature (25°C) under normal room fluorescent light in both glass and plastic containers. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts, Health News and Information, Delivered to Your Inbox, Metastatic NSCLC: Know Your Treatment Options, Metastatic NSCLC: Getting The Medical Team You Need, Self-Care Tips for Living With Metastatic NSCLC. Found insideLook no further than the new 5th edition of the best-selling Manual for Pharmacy Technicians to master the practical skills and gain the foundational knowledge all technicians need to be successful. In comparison, the median PRDFS was only 7 months in the etoposide group, where all patients relapsed (hazard ratio HR 0.287, 95% KI: 0.076-0.884, p = 0.03). ASHP technical assistance bulletin on handling cytotoxic and hazardous drugs. Etoposide Injection must be diluted prior to use with either 5% Dextrose Injection, or 0.9% Sodium Chloride Injection, to give a final concentration of 0.2 to 0.4 mg/mL. To report SUSPECTED ADVERSE REACTIONS, contact Hikm Pharmaceuticals USA Inc. at 1-877-845-0689, or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. The usual dose of Vepesid is 100 to 200 mg per m2of body surface area for 5 days in a row or 200 mg/m2/day on days 1, 3 and 5 every 3 to 4 weeks. After intravenous administration of 14C-Etoposide (100 to 124 mg/m2), mean recovery of radioactivity in the urine was 56% of the dose at 120 hours, 45% of which was excreted as Etoposide: fecal recovery of radioactivity was 44% of the dose at 120 hours. Etoposide (50 mg) 50mg - 8 Capsules Capsule (Etoposide) drug information. No differences in myelosuppression were seen between elderly and younger patients in these studies except for an increased frequency of WHO Grade III or IV leukopenia among elderly patients in a study of Etoposide phosphate or Etoposide in combination with cisplatin. Contraindications. (Contraindications) Hypersensitivity. 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