Pharm

Etoposide

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Etoposide, Toposar

  • 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