Etoposide (VEPESID)

Breast cancer, lung cancer, prostate cancer, lymphoma, many other uses

Breast cancer, lung cancer, prostate cancer, lymphoma, many other uses

• Oral: Many dosing regimens, please refer to specific chemotherapy protocol
• Given as monotherapy or in combination with other chemotherapy agents

Available as 50 mg liquid filled soft gelatin capsules. Capsules should NOT be opened. An oral solution can be prepared using the IV formulation for patients unable to swallow the capsules, please discuss with your pharmacy team. Store at room temperature.

Topoisomerase II Inhibitor

Take on an empty stomach (preferred, may take with food if necessary)

Once daily dosing: If a dose is missed, patients should be instructed to take it as soon as they can if it is within 12 hours of the missed dose. If it is over 12 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.

Twice daily dosing: If a dose is missed, patients should be instructed to take it as soon as they can if it is within 6 hours of the missed dose. If it is over 6 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.

Common: Myelosuppression, Nausea, Vomiting, Mucositis, Alopecia, Fatigue, Constipation.

‍Less Common: Allergic or hypersensitivity reactions (are rare but can be life threatening), Anorexia, Taste alteration, Stomatitis, Diarrhea, Acute leukemia.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential at baseline, bilirubin, ALT, AST, albumin, renal function tests. ‍

During treatment: CBC & differential at baseline, bilirubin, ALT, AST, albumin, renal function tests, signs of hypersensitivity reaction.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Adverse GI effects are common with oral etoposide, educate patient on how to prevent, and how to manage if they occur.

BC Cancer. BC Cancer Drug Manual. Etoposide. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Etoposide_monograph.pdf.  Updated March 1, 2020. Accessed January 22, 2024.

Lexicomp. Etoposide Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/6884?cesid=7Ag6Wss3ksD&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Detoposide%26t%3Dname%26acs%3Dtrue%26acq%3Detoposide. Updated December 11, 2023. Accessed January 31, 2024.

Cancer Care Ontario. Etoposide Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/43711. Updated July 2022. Accessed January 22, 2024

Bristol Laboratories of Canada. VEPESID® Product Monograph. Montreal, Quebec. Updated March 3, 2015.