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Etoposide

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Etoposide, Toposar

  • See Also
  1. Mitotic Inhibitor Chemotherapy
  2. Chemotherapy
  • Indications
  1. FDA Approved (often combined with other agents)
    1. Testicular Cancer
    2. Small Cell Lung Cancer
  2. Off-Label
    1. Acute Myelogenous Leukemia (AML)
    2. Acute Lymphocytic Leukemia (ALL)
    3. Breast Cancer
    4. Choriocarcinoma
    5. Endometrial Cancer
    6. Epithelial Ovarian Cancer
    7. Gastric Cancer
    8. Hepatocellular Carcinoma
    9. Kaposi Sarcoma
    10. Lymphoma (Non-Hodgkin Lymphoma, Hodgkin Lymphoma)
    11. Neuroblastoma
    12. Non-Small Cell Lung Cancer
    13. Rhabdomyosarcoma
    14. Soft Tissue Sarcoma
  • Mechanism
  1. See Mitotic Inhibitor Chemotherapy
  2. Etoposide is a semisynthetic derivative of Podophyllotoxin with antineoplastic activity
    1. Podophyllotoxin extracted from the mandrake root (Podophyllum peltatum)
  3. Etoposide is a Topoisomerase Inhibitor
    1. Binds to topoisomerase 2, inhibiting DNA ligation
    2. DNA breaks accumulate
    3. Inhibits DNA Replication and transcription
    4. Arrests Cell Cycle in G2 and S phases
    5. Results in cell apoptosis and death
  • Medications
  1. IV Solution: 5, 25 and 50 ml vials
  2. Oral Capsules: 50 mg
  • Dosing
  1. See other references for disease specific dosing protocols
  • Adverse Effects
  1. Alopecia
  2. Anaphylaxis
  3. Hypotension
  4. Myelosuppression
  5. Nephrotoxicity
  6. Secondary Malignancy (esp. Acute Myelogenous Leukemia)
  7. Somnolence
  • Safety
  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Renal Function Tests
  • Drug Interactions
  1. Warfarin
    1. Etoposide may increase INR
  • Resources
  1. Etoposide Injection (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4f850eb2-3542-43a0-90e8-bb37fa05cf15
  2. Etoposide Capsule (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=508a418e-985f-4208-9324-2230655bb5c2
  3. Etoposide (StatPearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK557864/