etoposide at a glance
Medicine class
Podophyllotoxin-derived cytotoxic chemotherapy and topoisomerase II inhibitor.
Licensed roles
Selected adult lung, testicular, ovarian, lymphoma and acute myeloid leukaemia settings.
Oral administration
Take capsules on an empty stomach and swallow them whole with water.
Monitoring
Regular blood tests are essential because etoposide can suppress bone-marrow function.
What is etoposide used for?
The oral capsule is licensed in adults for:
Recurrent or treatment-resistant testicular cancer, with other chemotherapy.
Small-cell lung cancer, with other chemotherapy.
Second-line treatment of Hodgkin lymphoma, with other chemotherapy.
Relapsed or treatment-resistant non-Hodgkin lymphoma, with other chemotherapy.
Relapsed or treatment-resistant acute myeloid leukaemia, with other chemotherapy.
Non-epithelial ovarian cancer, with other chemotherapy.
Platinum-resistant or platinum-refractory epithelial ovarian cancer.
How does etoposide work?
Etoposide traps topoisomerase II, an enzyme cells use to cut and rejoin DNA during replication. This leaves double-strand DNA breaks, which can stop cancer-cell growth and cause cell death.
etoposide preparations and strengths
Capsule
Route: Oral
Strengths: 50 mg, 100 mg
How to take etoposide
Follow the specialist cancer team's written instructions exactly. Take oral capsules on an empty stomach, swallow them whole with water and do not open, crush or chew them.
Contact the cancer team if instructions are unclear.
If you vomit soon after taking a capsule, contact the cancer team rather than taking another.
Do not use a blister containing a leaking capsule. Avoid direct contact and follow the cancer pharmacy's disposal advice.
etoposide side effects
Common or expected effects
- Reduced white cells, red cells or platelets
- Nausea or vomiting
- Temporary hair loss
- Reduced appetite
- Tiredness, weakness or feeling unwell
- Abdominal pain or constipation
- Diarrhoea or a sore mouth
- Dizziness
- Skin pigmentation, rash or itching
- Liver injury or abnormal liver tests
Get urgent medical advice
- Fever, chills or other infection symptoms caused by low white-cell counts
- Unexpected or persistent bleeding, or marked bruising
- Severe allergic reaction with wheezing, breathlessness, swelling or collapse
- Chest pain, a significant heartbeat disturbance or sudden breathlessness
- Seizure or sudden visual loss
- Possible tumour lysis syndrome, including rapidly worsening illness, reduced urine or confusion
etoposide in pregnancy
Etoposide can harm an unborn baby and is generally avoided during pregnancy unless specialist treatment is clinically necessary. Tell the cancer team immediately about pregnancy or plans for pregnancy. Effective contraception is required for patients who could become pregnant or cause a pregnancy during treatment and for six months afterwards. Discuss fertility preservation before treatment where relevant.
etoposide while breastfeeding
Breastfeeding is contraindicated with the oral capsule because etoposide enters human milk and could seriously harm the infant. Ask the oncology and maternity teams when breastfeeding may safely restart after all cancer treatment has finished.
etoposide interactions
The oncology team should review all prescribed, non-prescription and complementary products before treatment.
Yellow fever and other live vaccines
Live vaccines can cause serious systemic infection in immunosuppressed patients and are contraindicated in this setting.
Ciclosporin
High ciclosporin exposure can markedly increase etoposide exposure and toxicity.
Phenytoin and other enzyme-inducing antiepileptics
These may reduce etoposide exposure and effectiveness, while seizure control may also deteriorate.
Common questions about etoposide
Answers are fully visible for fast scanning and source review.
Why are blood tests needed?
Etoposide can substantially lower white cells, red cells and platelets, increasing infection, anaemia and bleeding risks.
Should the capsules be taken with food?
No. Take the capsules on an empty stomach according to the cancer team's instructions.
Can the capsules be opened or chewed?
No. Swallow them whole with water; opening or crushing them can expose the patient or carer to cytotoxic contents.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.