Care during chemotherapy and beyond
swap names:Mol®, VePes®, Etopophos®
Alternate name:VP-16, Etoposidphosphat
Chemocare.com uses generic names in all drug descriptions. VP-16 is the trade name for etoposide. VePesid and Etopophos and Toposar or etoposide phosphate are other names for etoposide. In some cases, healthcare professionals may use the trade name VP-16 or other names VePesid or Etopophos or Toposar or Etoposide phosphate when referring to the generic drug name Etoposide.
Art des Medicaments:Etoposide is an anticancer chemotherapy ("antineoplastic" or "cytotoxic") drug. This drug is classified as a 'plant alkaloid' and 'topoisomerase II inhibitor'. (See the “How does this medicine work” section below for more details).
What is etoposide used for:
- Testicular, bladder, prostate, lung, stomach and uterine cancer. Hodgkin and non-Hodgkin lymphoma, mycosis fungoides, Kaposi's sarcoma, Wilm's tumor, rhabdomyosarcoma, Ewing's sarcoma, neuroblastoma, brain tumors.
- It can also be given as a high-dose therapy in bone marrow transplantation.
Note:Once a drug has been approved for one use, doctors can use the same drug for other problems if they think it might help.
How etoposide is given:
- In tablet form for oral use.
- As an infusion into a vein (intravenous, IV), as a short infusion or as a continuous infusion over 24 hours.
- Etoposide is considered an irritant. An irritant is a chemical that can cause inflammation of the vein through which it is administered. If the drug leaks out of the vein, tissue damage can occur. The nurse or doctor administering this medication needs careful training. If you experience pain, redness or swelling at the infusion site while being treated with etoposide, tell your doctor straight away.
- The amount of etoposide you receive and how it is given depends on many factors, including your height and weight, your general health or other health conditions, and the type of cancer or condition being treated. Your doctor will determine your dose, schedule, and route of administration.
Important notes on the side effects of etoposide:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and disappear after treatment is completed.
- There are many ways to minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the effectiveness of the drug.
- The side effects of etoposide and their severity depend on how much of the drug is given. In other words, high doses can produce more serious side effects.
The following side effects are common (more than 30%) in patients taking etoposide:
- Low white blood cell count. (This may increase your risk of infection).
- Low platelet count (This may increase your risk of bleeding).
Nadir:This means nadir is the time between chemotherapy cycles when you have low blood counts.
- Menopause (induced by chemotherapy)
- loss of fertility. That means your ability to father a child may be affected by etoposide. Discuss this issue with your doctor.
- Nausea and vomiting (especially at high doses)
- Low blood pressure (if the drug is infused too quickly)
These side effects are less common, i. H. they occur in 10-29 percent of patients receiving etoposide:
- Mouth sores (especially at high doses)
- diarrhea (especially at high doses)
- loss of appetite
- Radiation recall (see skin reactions)
Other side effects:
- Metallic taste during the infusion of the drug
- Inflammation at the injection site
- Peripheral neuropathy (numbness in fingers and toes) may occur with repeated dosing. This is a rare side effect, but it can be irreversible. Report numbness or tingling in your feet or hands to your doctor.
- Years after taking etoposide, there is a small risk of developing blood cancers, such as leukemia. Talk to your doctor about this risk.
Not all side effects are listed above, some rare side effects (occurring in less than 10% of patients) are not listed here. However, you should always let your doctor know if you notice any unusual symptoms.
When to contact your doctor or healthcare provider:
Contact your healthcare providerimmediately,Day or night if you have any of the following symptoms:
- Fever of 38°C (100.4°F) or higher, chills (possible signs of infection).
The following symptoms require medical attention but are not emergencies. Contact your healthcare providerWithin 24 hoursNotice the following:
- Nausea (interferes with ability to eat and is not relieved by prescribed medication)
- Vomiting (vomit more than 4-5 times in 24 hours)
- Diarrhea (4-6 episodes within 24 hours)
- Unusual bleeding or bruising
- Black or tarry stools or blood in stool or urine
- Extreme fatigue (unable to care for yourself)
- Mouth sores (painful redness, swelling or ulcers)
- Swelling, redness and/or pain in one leg or arm and not the other
- Numbness or tingling in your fingers or toes
- yellowing of the skin or eyes
- Pain, redness, or swelling at the infusion site
Always tell your doctor if you experience any unusual symptoms.
- Before beginning treatment with etoposide, be sure to tell your doctor about all other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin or products containing aspirin unless specifically authorized by your doctor.
- Do not get immunized or vaccinated while taking etoposide without your doctor's approval.
- Tell your doctor if you are or might be pregnant before starting this treatment.
- For both men and women: Do not conceive (do not become pregnant) while taking etoposide. Barrier birth control methods, such as condoms, are recommended. Discuss with your doctor when it is safe for you to become pregnant or conceive a child after therapy.
- Do not breast-feed while taking this medication.
Self Care Tips:
- Apply warm compresses if you experience pain, redness, or swelling at the infusion site and notify your doctor.
- Drink at least two to three liters of fluids every 24 hours unless instructed otherwise.
- You could be at risk of infection, so avoid crowds or people with colds and report any fever or other signs of infection to your doctor right away.
- Wash your hands often.
- To treat/prevent mouth sores, use a soft-bristled toothbrush and rinse with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water three times a day.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications prescribed by your doctor and eat small meals frequently.
- Avoid sun exposure. Wear sunscreen with SPF 15 (or higher) and protective clothing.
- In general, the consumption of alcoholic beverages should be kept to a minimum or avoided altogether. You should discuss this with your doctor.
- Get plenty of rest.
- Eat a good diet.
- If you notice any symptoms or side effects, be sure to discuss them with your healthcare team. They can prescribe medication and/or make other suggestions that are effective in managing such issues.
Monitoring and testing:
You will be checked regularly by your doctor while you are taking etoposide to monitor side effects and to check your response to therapy. Regular blood tests to monitor your complete blood count (CBC) and the function of other organs (e.g. your kidneys and liver) will also be ordered by your doctor.
How etoposide works:
Cancerous tumors are characterized by cell division that is no longer controlled as in normal tissue. "Normal" cells stop dividing when they come into contact with similar cells, a mechanism known as contact inhibition. Cancer cells lose this ability. Cancer cells no longer have the normal control mechanisms that control and limit cell division. The process of cell division, whether normal or cancerous, occurs through the cell cycle. The cell cycle goes from the resting phase through active growth phases to mitosis (division).
Chemotherapy's ability to kill cancer cells depends on its ability to stop cells from dividing. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself when it divides. If the cells cannot divide, they die. The faster the cells divide, the more likely it is that the chemotherapy will kill the cells and the tumor will shrink. They also induce cell suicide (suicidal or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell cycle specific. Chemotherapy drugs that affect cells at rest are called cell cycle nonspecific. Chemotherapy planning is based on the type of cells, the rate at which they are dividing, and when a particular drug is likely to be effective. For this reason, chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that divide rapidly. Unfortunately, chemotherapy does not know the difference between cancer cells and normal cells. The "normal" cells will grow back and be healthy, but in the meantime side effects will occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and intestines, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea and/or hair loss. Different drugs can affect different parts of the body.
Etoposide belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are obtained from the evergreen plant (Catharanthus rosea). The taxanes are made from the bark of the Pacific yew tree (Taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are obtained from the May apple plant. Camptothecan analogues come from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell cycle specific. That is, they attack cells at different stages of division.
- Vinca-Alkaloid:vincristine, vinblastine and vinorelbine
- Taxane:paclitaxel and docetaxel
- Podophyllotoxine:Etopos and Tenisops
- Camptothecan-Analoga:Irinotecan und Topotecan
Topoisomerase inhibitors (such as etoposide) are drugs that interfere with the action of topoisomerase enzymes (topoisomerase I and II). Topoisomerase enzymes control the manipulation of DNA structure necessary for replication.
- Topoisomerase-I-Hemmer:Ironotecan, Topotecan
- Topoisomerase-II-Inhibitoren:Amsacrin, Etoposid, Etoposidphosphat, Teniposid
Note:We strongly encourage you to speak to your doctor about your specific medical condition and treatments. The information contained on this website is intended to be helpful and educational, but does not replace medical advice.
Chemocare.com is designed to provide patients and their families, carers and friends with the latest information about chemotherapy. Information on the 4th Engel Mentoring Program can be found atwww.4thangel.org
Is etoposide a strong chemo? ›
Etoposide is a strong chemotherapeutic agent that has a proven record of working against various human malignancies.What type of cancer does etoposide treat? ›
Use in Cancer
Etoposide is approved to be used with other drugs to treat: Small cell lung cancer. It is used with other chemotherapy as first-line treatment. Testicular cancer.
Etoposide is used in combination with other medications to treat a certain type of lung cancer (small cell lung cancer; SCLC). Etoposide is in a class of medications known as podophyllotoxin derivatives. It works by slowing or stopping the growth of cancer cells in your body.Will I lose my hair on etoposide? ›
This medicine often causes a temporary loss of hair. After treatment with etoposide has ended, normal hair growth should return.How long is a cycle of etoposide? ›
You have carboplatin and etoposide as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover. Each cycle of treatment lasts 3 weeks (21 days).What is the most life threatening side effect of chemotherapy? ›
Infections. Chemotherapy can reduce your body's ability to fight infection. This makes you more likely to get infections that could make you seriously ill.What are the toxicities of etoposide? ›
Etoposide is relatively cell cycle specific, and it affects cells in the S and G2 phases of cell division. The dose-limiting toxicity is myelosuppression, with neutropenia the principal form of hematologic toxicity. Mild thrombocytopenia, mucositis, nausea, alopecia, and emesis are common.Does etoposide affect the heart? ›
Other agents that may induce a cardiac event include paclitaxel, etoposide, teniposide, the vinca alkaloids, fluorouracil, cytarabine, amsacrine, cladribine, asparaginase, tretinoin and pentostatin.Does etoposide cause memory loss? ›
Effects on the nervous system
This treatment can affect the nervous system. Very rarely, it can cause a condition called RPLS (reversible posterior leukoencephalopathy syndrome). Symptoms include: memory loss.
Etoposide works by blocking the action of an enzyme in cells called topoisomerase, which is necessary for cell replication and tumor growth. Cells need this enzyme to keep their DNA in the proper shape when they are dividing. Blocking this enzyme leads to breaks in the DNA, which leads to cancer cell death.
How much does etoposide cost? ›
Etoposide is a generic prescription medication used, in combination with other medications, to treat small cell lung cancer. It comes in the form of an oral capsule and injection. The brand-name version of this drug is VePesid. The average retail price of Etoposide is about $73.22.How long after taking etoposide can you eat? ›
Take this medication on an empty stomach (at least 1 hour before or 2 hours after food). Swallow each capsule whole; do not crush or chew them. If you are unable to swallow the tablet, the pharmacist will give you specific instructions. If you miss a dose, take it as soon as possible.Is etoposide still used? ›
Etoposide is still being used and is still being made from podophyllotoxin. But the main source, the Himalayan mayapple (Podophyllum hexandrum), is difficult to grow; so Elizabeth S.Can etoposide cause liver damage? ›
Both etoposide and teniposide are associated with an appreciable rate of serum enzyme elevations during therapy, and high doses have been implicated in causing clinically apparent acute liver injury including sinusoidal obstruction syndrome.Can etoposide lower blood pressure? ›
Things that may occur during or within hours of treatment
Your blood pressure may drop or your heart rate slow down while you are getting this drug. This usually goes back to normal on its own. Your blood pressure and heart rate may be checked during the infusion.
Tell your doctor right away if you notice swelling, pain, or redness at the injection site. This medicine may cause leukemia (cancer of the blood or bone marrow) in rare cases. Talk with your doctor about any concerns you have about this.What chemo drug causes the most hair loss? ›
Combination chemotherapy regimens, particularly ones that include doxorubicin, docetaxel, paclitaxel, or etoposide are more likely to cause hair loss than chemotherapy with a single drug.Should you take etoposide with food? ›
Make sure you understand the directions. Etoposide is preferably taken on an empty stomach with a glass of water; it may be taken with food if needed. Avoid grapefruit and grapefruit juice starting 3 days before and ending 1 day after your etoposide dose, as these may interact with etoposide.What is the average rounds of chemo? ›
During a course of treatment, you usually have around 4 to 8 cycles of treatment. A cycle is the time between one round of treatment until the start of the next. After each round of treatment you have a break, to allow your body to recover.When should I take etoposide? ›
Oral etoposide is given by mouth, in the form of a capsule. The capsule(s) should be swallowed whole, on an empty stomach (1 hour before or 2 hours after eating).
What organ is most affected by chemotherapy? ›
- Blood-forming cells in the bone marrow.
- Hair follicles.
- Cells in the mouth, digestive tract, and reproductive system.
Some people find they can lead an almost normal life during chemotherapy. But others find everyday life more difficult. You may feel unwell during and shortly after each treatment but recover quickly between treatments. You may be able to get back to your usual activities as you begin to feel better.Which cancers are most likely to recur? ›
Some cancers are difficult to treat and have high rates of recurrence. Glioblastoma, for example, recurs in nearly all patients, despite treatment. The rate of recurrence among patients with ovarian cancer is also high at 85%.Does etoposide cause neuropathy? ›
We conclude that peripheral neuropathy of moderate severity is a potential complication of high-dose etoposide therapy but appears to be self-limited.What is the original use of etoposide? ›
Etoposide is a podophyllotoxin derivative used to treat testicular and small cell lung tumors. A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA.How can I protect my heart from chemo? ›
Being as fit and as well as possible before you start chemo is important. You can help yourself by eating well, being active, and making sure your blood pressure and cholesterol are well controlled, as well as diabetes if you have it. For most people, that means taking your medicines as prescribed.Does etoposide cause shortness of breath? ›
In 100 people receiving Etoposide, Ifosfamide, 3 or fewer may have: Damage to the heart or heart failure which may cause tiredness, shortness of breath, or swelling of ankles. Damage to the lungs or scarring of the lungs which may cause shortness of breath.Which chemo drugs cause chemo brain? ›
The chemotherapy drug cisplatin is commonly linked to chemo brain. In a new study, a research team identified what they believe may be a key biological change responsible for chemo brain in people treated with cisplatin.What percentage of chemo patients get chemo brain? ›
Chemo brain is extremely common, says Dr. Arash Asher, director of Cancer Rehabilitation and Survivorship at Cedars-Sinai. "As many as 75% of cancer patients have experienced it during their treatment," says Dr. Asher.What are the side effects of long term use of hydroxyurea? ›
Long-term treatment with hydroxyurea is associated with painful skin ulcers, aphthous ulcers, non-ulcerative toxicity with erythema, and skin infiltration.  Rarely, long-term therapy with hydroxyurea is associated with gangrene of the toes and digits.
Is etoposide chemotherapy or immunotherapy? ›
Chemotherapy drugs, such as cisplatin, carboplatin, etoposide, paclitaxel and pemetrexed, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.What plant does etoposide come from? ›
Etoposide is a semisynthetic derivative of podophyllotoxin, a substance found naturally in the mandrake plant. Also known as VP-16, this epipodophyllotoxin is used in SCLC and NSCLC, among many others.How much does a round of chemo cost in USA? ›
Common and Costly Chemotherapy Drugs
Depending on the drug and type of cancer it treats, the average monthly cost of chemo drugs can range from $1,000 to $12,000. If a cancer patient requires four chemo sessions a year, it could cost them up to $48,000 total, which is beyond the average annual income.
However, taking the pill or liquid exactly as directed is essential to kill the cancer. While this method is more convenient for patients, it is also more expensive. Your health insurance company may require you to pay a higher deductible or co-payment than you would have to for intravenous chemotherapy.What helps your stomach heal after chemo? ›
Foods that naturally contain healthy, living bacteria (probiotics) are yogurt, kefir, buttermilk, kombucha tea, sauerkraut, kimichi, and tempeh. Choosing prebiotic and probiotic foods daily during and after cancer treatment can promote a healthy digestive tract.What should you not do after chemo? ›
Contact with body fluids after treatment
Because chemotherapy drugs can affect healthy cells, coming into contact with them in various body fluids can be potentially harmful to yourself or others. That's why it's a good idea to avoid contact with body fluids that may contain them.
2-3 servings of whole grain bread, pastas, rice, etc. every day. Limit fat intake to 30% of calories (preferably less than or equal to 20% of calories) every day. Limit intake of simple sugars.What is another name for etoposide? ›
Etoposide is a chemotherapy drug and is also known by its brand name Etopophos or Vepesid. You might have it as a treatment for a number of different types of cancer.What strength is etoposide? ›
Etoposide Injection contains 30.5% alcohol (ethanol), which corresponds to 240.64 mg of ethanol per ml of concentrate i.e up to 1.2 gm of ethanol per 5 ml vial, equivalent to 30 ml of beer or 12.55 ml of wine and up to 3 gm of ethanol per 12.5 ml vial, equivalent to 75 ml of bear or 31.4 ml of wine.What is the most effective chemotherapy? ›
Doxorubicin is considered one of the strongest chemotherapy drugs for breast cancer ever invented. It can kill cancer cells at every point in their life cycle, and it's used to treat a wide variety of cancers, not just breast cancer. Doxorubicin is also known as “The Red Devil” because it is a clear bright red color.