Etoposide phosphate

What is Etoposide phosphate?

• Etoposide phosphate (Etopophos; Toposar) is a topoisomerase inhibitor used with other drugs to treat Small cell lung cancer and Testicular cancer.

Etoposide

Etoposide ball-and-stick

What are the uses of this medicine?

Etoposide phosphate (Etopophos; Toposar) is used for the treatment of patients with:

• Refractory testicular tumors, in combination with other chemotherapeutic drugs.
• Small cell lung cancer, in combination with cisplatin, as first-line treatment.

How does this medicine work?

Etoposide mechanism

• Etoposide phosphate is a prodrug that is converted to its active moiety, etoposide, by dephosphorylation.
• Etoposide causes the induction of DNA strand breaks by an interaction with DNA-topoisomerase II or the formation of free radicals, leading to cell cycle arrest, primarily at the G2 stage of the cell cycle, and cell death.

Who Should Not Use this medicine ?

This medicine cannot be used in patients:

• with a history of a severe hypersensitivity reaction to etoposide products.

What drug interactions can this medicine cause?

• Co-administration of Etopophos with warfarin is not recommended.

Is this medicine FDA approved?

• Etoposide was approved for medical use in the United States in 1983.

How should this medicine be used?

Recommended dosage: Refractory testicular tumors:

• 50 to 100 mg/m2 per day administered intravenously over 5 minutes to 3.5 hours on days 1 through 5, or 100 mg/m2 administered intravenously over 5 minutes to 3.5 hours on days 1, 3, and 5.

Small cell lung cancer:

• 35 mg/m2 per day administered intravenously over 5 minutes to 3.5 hours for 4 days or 50 mg/m2 per day administered intravenously over 5 minutes to 3.5 hours for 5 days.

Renal impairment:

• Reduce the recommended dose to 75% in patients with creatinine clearance 15 to 50 mL/min.

Administration:

• Etoposide injection comes as a comes as a solution (liquid) or as a powder to be mixed with liquid to be slowly injected intravenously (into a vein) by a doctor or nurse in a medical facility.
• DO NOT GIVE Etopophos BY BOLUS INTRAVENOUS INJECTION.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As injection: 114 mg etoposide phosphate (equivalent to 100 mg etoposide), white to off-white, lyophilized powder in single-dose vial for reconstitution.

This medicine is available in fallowing brand namesː

• Etopophos; Toposar; Vepesid

What side effects can this medication cause?

The most common side effects of this medicine include:

• neutropenia
• swelling, pain, redness, or burning at the injection site
• nausea
• vomiting
• sores in the mouth and throat
• stomach pain
• diarrhea
• constipation
• loss of appetite or weight
• unusual tiredness or weakness
• pale skin
• fainting
• dizziness
• hair loss
• pain, burning, or tingling in the hands or feet
• eye pain

What special precautions should I follow?

• Etopophos causes myelosuppression that results in thrombocytopenia and neutropenia. Obtain complete blood counts prior to each cycle and more frequently as clinically indicated.
• Secondary leukemias can occur with long-term use.
• Etopophos can cause hypersensitivity reactions, including rash, urticaria, pruritus, and anaphylaxis. Permanently discontinue Etopophos in patients who experience a severe hypersensitivity reaction.
• Etopophos can cause fetal harm. Advise females of potential risk to the fetus and to use effective contraception during treatment with Etopophos and for 6 months after final dose. Advise males to use effective contraception for 4 months, after the last dose of Etopophos.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• neurotoxicity

Management of overdosage:

• Patients suspected of receiving an overdose should be monitored, and supportive treatment should be administered.
• No antidote has been established for Etopophos overdosage.

Can this medicine be used in pregnancy?

• Based on animal data and its mechanism of action, Etopophos can cause fetal harm when administered to a pregnant woman.
• Advise pregnant women of the potential hazard to a fetus.
• Advise women of childbearing potential to avoid becoming pregnant.

Can this medicine be used in children?

• Safety and effectiveness in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• etoposide phosphate

Inactive ingredients:

• sodium citrate, unspecified form
• dextran 40

Who manufactures and distributes this medicine?

Licensed by:

• Cheplapharm Arzneimittel Gmbh
• Greifswald, Germany

Distributed by:

• H2-Pharma, LLC
• Montgomery, AL

What should I know about storage and disposal of this medication?

• Store unopened vials at 2° to 8°C (36°-46°F).
• Keep vial in outer carton to protect from light.
• Etopophos is a cytotoxic drug.
• Follow applicable special handling and disposal procedures.

• Dailymed label info on Etoposide phosphate
• FDA Etoposide phosphate

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