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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS › ANTINEOPLASTIC AGENTS › PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS › Podophyllotoxin derivatives
etoposide
L01CB01
Forms & Strengths
- Injection: 20 mg/mL in 5 mL, 10 mL, 25 mL, 50 mL vials
- Capsule (oral): 50 mg
Adult Dosing
- Testicular cancer: 50-100 mg/m²/day IV days 1-5 or 100 mg/m²/day IV days 1, 3, and 5
- Small cell lung cancer: 35-50 mg/m²/day IV days 1-4 or 100 mg/m²/day IV days 1-3
- Oral dosing: Equivalent to twice the IV dose, rounded to nearest 50 mg (usually 100-200 mg/m²/day)
Pediatric Dosing
- Refractory acute lymphoblastic leukemia: 100-300 mg/m²/day IV for 1-5 days
- Brain tumors / solid tumors: 100-200 mg/m²/day IV for 3-5 days
Indications
- Refractory testicular tumors in combination with other agents
- Small cell lung cancer in combination with other chemotherapeutic agents
Mechanism of Action
- Inhibits topoisomerase II, causing DNA strand breaks and preventing re-ligation
- Causes cell cycle arrest in the late S and G2 phases
Contraindications
- Hypersensitivity to etoposide or any component of the formulation
- Severe baseline myelosuppression (for initial courses)
- Severe hepatic impairment (for oral use)
Adverse Reactions
- Myelosuppression (dose-limiting, nadir at 7-14 days)
- Nausea, vomiting, mucositis, and anorexia
- Alopecia (reversible)
- Hypotension during rapid intravenous infusion
- Secondary malignancies (acute leukemias)
Drug Interactions
- Cyclosporine: Increases etoposide exposure and toxicity
- Antineoplastic agents: Additive myelosuppression and immunosuppression
- CYP3A4 inducers/inhibitors: Potential alteration of clearance
- Live vaccines: Risk of disseminated infection
Curated Content: Needs Vetting Before Put to Clinical Use