A topoisomerase inhibitor semisynthetic derivative of epipodophyllotoxin.

Activity in lymphomas, lung, stomach, testicular, head and neck and ovarian cancers

Considered a potential carcinogen in humans.

Secondary acute leukemia develops in fewer than 0.5% of patients treated with less than 2000 mg/M2 of drug and in as many as 6% of patients treated with greater than 3000 mg/M2 of VP-16 chemotherapy.

Patients with low serum albumin may be at an increased risk for etoposide associated toxicities.

A 25% dose reduction for patients with 15 to 50 mL/min creatinine clearance.

Elderly patients have more anorexia, mucositis, dehydration, somnolence, leukopenia, granulocytopenia and asthenia, myelosuppression, gastrointestinal effects, infectious complications and alopecia. elevated BUN levels than younger patients.

Etoposide and its metabolites are significantly excreted by the kidney, and the risk of adverse reactions are greater in patients with impaired renal function.

Myelosuppression is dose related, with granulocyte nadirs occurring 7 to 14 days after drug administration and platelet nadirs occurring 9 to 16 days after drug administration.

Nausea and vomiting are the major gastrointestinal toxicities.

Mild to severe mucositis may occur.

Gastrointestinal toxicities are slightly more frequent after oral administration than after intravenous infusion.

Anaphylactic-like reactions occur in less than 1% of the patients treated with the oral capsules.

Alopecia is observed in up to 66% of patients.

Hepatic toxicity may occur in patients receiving higher doses of the drug than those recommended.

Metabolic acidosis has also been reported in patients receiving higher doses.

ETOPOSIDE Capsules 50 mg as first-line in combination with other approved chemotherapeutic agents for patients with small cell lung cancer.

Recommended dose of etoposide capsules is 2 times the IV dose rounded to the nearest 50 mg (i.e., 2 times 35 mg/m2/day for 4 days to 50 mg/m2/day for 5 days) for SCCL.

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