Etoposide VP 16

Etoposide VP 16 Brand Names- Etopophos | Toposar | VePesid

What is Etoposide VP 16

Etoposide is available as an injectable or a liquid-filled, soft gelatin capsule formulation.

Etopophos (etoposide phosphate) is an IV prodrug that is converted to etoposide by dephosphorylation.

Etoposide works by causing induction of DNA strand breaks by an interaction with DNA-topoisomerase II or the formation of free radicals.

These actions lead to cell cycle arrest, mostly at the G2 stage of the cell cycle, and cell death. Etoposide capsules are indicated for the first-line treatment of small-cell lung cancer (SCLC) in combination with other chemotherapeutic agents.

IV etoposide and etoposide phosphate are indicated for the first-line treatment of SCLC in combination with other chemotherapeutic agents and for the treatment of refractory testicular tumors as part of combination therapy.

Etoposide was approved by the FDA in 1983.

Indications

1. acute lymphocytic leukemia (ALL)
2. acute myelogenous leukemia (AML)
3. bone marrow ablation
4. desmoid tumor
5. Ewing’s sarcoma
6. Hodgkin lymphoma
7. neuroblastoma
8. non-Hodgkin’s lymphoma (NHL)
9. non-small cell lung cancer (NSCLC)
10. small cell lung cancer (SCLC)
11. stem cell transplant preparation
12. testicular cancer
13. thymic carcinoma
14. thymoma
15. trophoblastic disease
16. Wilms’ tumor

For the treatment of non-small cell lung cancer (NSCLC)

for the adjuvant treatment of resected stage IB to stage III non-small cell lung cancer (NSCLC) in combination with cisplatin

Side Effects

1. abdominal pain
2. alopecia
3. anaphylactoid reactions
4. anemia
5. angioedema
6. anorexia
7. apnea
8. asthenia
9. back pain
10. bone marrow suppression
11. bronchospasm
12. chills
13. constipation
14. cough
15. cyanosis
16. diaphoresis
17. diarrhea
18. drowsiness
19. dysgeusia
20. dysphagia
21. dyspnea
22. esophagitis
23. fatigue
24. fever
25. flushing
26. hepatotoxicity
27. hypertension
28. hypotension
29. infection
30. injection site reaction
31. laryngospasm
32. leukopenia
33. leukopenia
34. maculopapular rash
35. malaise
36. metabolic acidosis
37. nausea
38. neutropenia
39. new primary malignancy
40. optic neuritis
41. peripheral neuropathy
42. pneumonitis
43. pruritus
44. pulmonary fibrosis
45. radiation recall reaction
46. rash
47. renal failure (unspecified)
48. seizures
49. sinus tachycardia
50. skin hyperpigmentation
51. skin necrosis
52. Stevens-Johnson syndrome
53. stomatitis
54. throat irritation
55. thrombocytopenia
56. thrombocytopenia
57. toxic epidermal necrolysis
58. urticaria
59. vasculitis
60. vomiting

Monitoring Parameters

• CBC with differential
• LFTs
• serum creatinine/BUN

Contraindications

• bleeding
• bone marrow suppression
• breast-feeding
• children
• contraception requirements
• extravasation
• geriatric
• hypoalbuminemia
• infants
• infection
• infertility
• infusion-related reactions
• male-mediated teratogenicity
• neutropenia
• new primary malignancy
• pregnancy
• reproductive risk
• requires an experienced clinician
• thrombocytopenia

Interactions

• Cyclosporine
• Dichlorphenamide
• Gadobenate Dimeglumine
• grapefruit juice
• Palifermin
• Penicillamine
• Tuberculin Purified Protein Derivative, PPD
• Warfarin