etoposide phosphate at a glance
Medicine class
Cytotoxic chemotherapy; a podophyllotoxin derivative targeting topoisomerase II.
How it is given
A specialist cancer team gives it into a vein as a slow infusion.
Key monitoring
Blood counts and kidney function require close review because bone-marrow suppression is the main limiting toxicity and renal impairment reduces clearance.
What is etoposide phosphate used for?
The selected product is licensed for the following cancers, generally with other approved chemotherapy:
Testicular cancer and small-cell lung cancer in adults.
Hodgkin lymphoma, non-Hodgkin lymphoma and acute myeloid leukaemia in adults and children.
High-risk gestational trophoblastic neoplasia in adults.
Non-epithelial ovarian cancer in adults.
Platinum-resistant or refractory epithelial ovarian cancer in adults.
How does etoposide phosphate work?
The phosphate form is converted in the body to active etoposide. Etoposide interferes with topoisomerase II, an enzyme involved in managing DNA during cell division. This promotes DNA double-strand breaks and prevents susceptible cancer cells from dividing normally.
How to take etoposide phosphate
This formulation is not swallowed. Trained staff prepare the powder and administer it into a vein as a slow infusion while monitoring for hypersensitivity, blood-pressure changes and infusion-site reactions.
Tell staff immediately if the infusion site becomes painful, swollen or red.
Report flushing, rash, dizziness or breathing difficulty during administration immediately.
Food does not affect administration of this intravenous formulation.
etoposide phosphate side effects
Common or expected effects
- Reduced white cells, red cells or platelets, increasing susceptibility to infection, tiredness, breathlessness, bruising or bleeding.
- Nausea, vomiting, reduced appetite, abdominal discomfort and constipation.
- Hair loss, weakness or general malaise.
- Diarrhoea or inflammation of the mouth and digestive tract.
- Abnormal liver blood tests.
- Dizziness, rash, itching or irritation of the infused vein.
Get urgent medical advice
- Severe infection or bone-marrow suppression.
- Anaphylaxis, bronchospasm or angioedema, particularly during an infusion.
- Severe bleeding, chest pain or abnormal heart rhythm.
- Severe skin reactions with blistering or peeling.
- Tissue injury following leakage outside the vein.
- Tumour lysis syndrome or acute kidney failure.
- Rare secondary acute leukaemia.
etoposide phosphate in pregnancy
Etoposide can harm an unborn baby and should be used during pregnancy only when clinically required. Discuss pregnancy urgently with the oncology team. 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 phosphate while breastfeeding
Breastfeeding is contraindicated during treatment because etoposide enters human milk and could seriously affect the infant. Discuss feeding options with the oncology and maternity teams.
etoposide phosphate interactions
The cancer team should review all prescribed, non-prescribed and complementary products before treatment.
Live vaccines, including yellow fever vaccine
They can cause serious vaccine-related infection in an immunosuppressed patient and are contraindicated in this setting.
Ciclosporin
High systemic exposure can markedly increase etoposide exposure and toxicity risk.
Phenytoin and other enzyme-inducing antiseizure medicines
They may increase etoposide clearance, reduce anticancer effect and contribute to poorer seizure control.
Common questions about etoposide phosphate
Answers are fully visible for fast scanning and source review.
Is etoposide phosphate the same as etoposide?
Etoposide phosphate is a prodrug converted in the body to active etoposide, so its anticancer mechanism is considered the same.
Can etoposide phosphate be taken by mouth?
The selected formulation is a powder prepared for intravenous infusion, not an oral product.
Why are blood tests needed?
Treatment can substantially reduce white cells, red cells and platelets, so testing helps identify infection, anaemia and bleeding risks.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.