Etoposide

Etoposide is a derivative of podophyllotoxin which inhibits DNA topoisomerase II and thereby, DNA synthesis. It is cell cycle dependent and only works on certain phases of cellular division.¹

• Brain tumours
• Small cell carcinoma of bronchus^2,3
• Lymphomas (Non-Hodgkins lymphoma, Hodgkin's lymphoma)⁴
• Testicular cancer⁵
• Acute leukaemias (acute myeloid leukaemia, acute lymphoblastic leukaemia)

Of the list etoposide is most commonly used in lung and testicular cancers. It is also used for refractory ovarian cancer.

Please see SPC for full list.⁶

• Renal impairment
• Liver impairment - contraindicated if severe liver dysfunction
• Myelosuppression
• Leucopenia
• Thrombocytopaenia
• Pregnancy, paternity and breast feeding

Please see SPC for full list.

• Increased anticoagulant effect with warfarin
• Agranulocytosis risk increased with clozapine
• Ciclosporin increases etoposide levels
• Decreases absorption of phenytoin
• Digoxin

Please see SPC for full list.
Common side-effects:

• Myelosuppression - therefore not given at intervals shorter than 3 weeks apart
• Anaphylactic-like reactions
• Fatigue, drowsiness
• Transient hypotension
• Nausea and vomiting and diarrhoea
• Reversible alopecia

• Secondary leukaemia
• Reversible loss of vision
• Bronchospasm, other lung effects
• Serious skin reactions
• Cardiovascular: arrhythmias, myocardial infarction reported⁸
• Hepatotoxicity rarely⁶
• Respiratory - apnoea can occur during infusion
• Tumour lysis syndrome - has been rarely reported with the oral formulation (Vepesid®)

• FBC
• LFTs

It can be given orally or via intravenous infusion (daily for up to 5 days).