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Drug Formulary
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etoposide

( e-TOE-poe-side )
Other Name(s): Vepesid®
Appearance: Injectable - clear, pale yellow solution, mixed into larger bags of fluids; Oral - pink capsules
pdf download oral patient.pdf
pdf download toposide pour le patient.pdf

Medication Information Sheet
etoposide (e-TOE-poe-side)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Vepesid®

Appearance:
Injectable - clear, pale yellow solution, mixed into larger bags of fluids; Oral - pink capsules

What is this medication for?
  • For treating cancers of the lung, testicles, lymphoma, leukemia or many other types of cancer.
What should I do before I have this medication?
  • Tell your doctor and pharmacist if you have / had significant medical condition(s), especially if you have / had infections, kidney disease or liver disease, radiation treatment, or have any allergies.
  • Etoposide may harm the unborn baby.
  • Let your doctor know if you are breastfeeding, pregnant or plan to become pregnant
  • People who have cancer/leukemia are at a higher risk of developing other cancers/leukemias. Also, some cancer medications, such as etoposide, may increase this risk. You should discuss this with your doctor.
How will this medication affect sex, pregnancy and breastfeeding?
  • Do not use this drug if you are pregnant. If there is ANY chance that you or your partner may become pregnant, you and your partner together must:► Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
  • Tell your doctor right away if you or your partner becomes pregnant.
  • Do not breastfeed while taking this drug.
  • Effects on Fertility: Probable
  • Effects on Fertility: Probable
How is this medication given?

Etoposide injection:

  • Given by injection into a vein.

 

Oral capsules:

  • Take the oral capsules exactly as directed by your doctor. Make sure you understand the instructions.
  • Swallow the capsules whole with a glass of water on an empty stomach, one hour before or two hours after food or other medications.
What else do I need to know while on this medication?

  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • Do not have any grapefruit, starfruit, Seville oranges or their juices/products while on this treatment, since this may interact with etoposide.
How should I safely store this medication?

  • Oral capsules:

  • Store in original packaging at room temperature, away from heat, light or moisture. Keep out of reach of children and pets.
  • Do not throw out any unused drugs at home. Bring them to your pharmacy for safe disposal.

What are the side effects of this medication?

The following side effects are common or severe. You may not have all of the side effects. Other side effects may occur. If you have any unusual or bothersome symptoms, discuss with your doctor.
 

Side effects and what to do When to contact doctor?
More Common Side Effects

Hair thinning or loss

  • Use a gentle soft brush; care should be taken with hair sprays, bleaches, dyes and perms.
  • Your hair usually grows back after your treatment ends, but the texture or colour may change.

 

 -

Poor appetite; do not feel like eating; weight loss

  • Eat foods that you like and try to eat regular small meals.
  • Use meal supplements if possible. See a dietitian.
 Contact your health care team if no improvement or if severe

Diarrhea

  • Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine, orange or prune juice.
  • Try a low-fiber BRAT diet (Bananas, white Rice, Apple sauce, Toast made with white bread).
  • Take anti-diarrhea drug(s) if given to you by your doctor.
  • Also see Diarrhea pamphlet.*
 Contact your health care team if no improvement or if severe

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

 Get emergency medical help right away

Nausea and vomiting

  • Drink clear fluids and avoid large meals. Get fresh air and rest.
  • Limit spicy, fried foods or foods with a strong smell.
  • Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
  • Contact your doctor if nausea lasts more than 1 day or if any vomiting occurs.
  • Also see Nausea & Vomiting pamphlet.*
 Contact your health care team if no improvement or if severe

Unusual bleeding or bruising (black stools, coughing up blood, purple or red dots on skin, bleeding that will not stop)

  • May occur in days to weeks after your dose is given/ after treatment starts
  • May be due to low platelets, but may occur even with normal platelets
  • Use a soft toothbrush. Be careful not to cut or bruise yourself.
  • Check with your doctor before any surgery or dental work.
  • Use acetaminophen (Tylenol®) for fever, mild headache, aches or pains.
  • Talk to your doctor first before using other drugs such as ibuprofen (Advil®) or naproxen (Aleve®) or aspirin, since they may increase bleeding risk. If taking aspirin regularly, such as for heart conditions, talk to your doctor.
  • Also see Low Platelets pamphlet.*
 Get emergency medical help right away

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe

Liver problems (yellow skin or eyes, dark urine)

 Get emergency medical help right away

Allergic reaction (fever, severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness)

  • May occur during or shortly after the drug is given.
 Get emergency medical help right away

Low blood pressure; dizziness

  • Try to get up and move slowly.
  • Do not drive a motor vehicle or operate machinery if dizzy.
 Contact your health care team if no improvement or if severe

Central Nervous System (CNS) effects, including blindness

 Get emergency medical help right away

Lung problems (increased cough, breathing problems, chest pain, coughing blood)

 Get emergency medical help right away

Redness/rash in areas where you’ve previously received radiation

 Contact your health care team as soon as possible (office hours)

Serious skin rash (may include blisters or skin peeling)

 Get emergency medical help right away

For more links on how to manage your symptoms go to https://www.cancercareontario.ca/en/symptom-management.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Funding & Reimbursement

Several payment sources exist for cancer drugs in Ontario, depending on the drug, disease indication, and how and where it is delivered.

View Funding & Reimbursement

Symptom Management

Many people living with cancer experience nausea, diarrhea and other symptoms from their treatment or disease.

View Symptom Management

Drug Safety and Administration

Find documents on drug safety and administration for healthcare providers, including calculations and recommendations.

View Drug Safety and Administration