Etoposide is used to treat small cell lung cancer. It is usually given in combination with other cancer medicines.

Etoposide may also be used for purposes not listed in this medication guide.

Etoposide can increase your risk of bleeding or infection. Call your doctor if you have unusual bruising or bleeding, or new signs of infection (fever, sore throat, trouble breathing).

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Do not break or open the etoposide capsule. Do not use a pill that has been accidentally broken.

The medicine from a broken capsule can be dangerous if it gets in your eyes, mouth, or nose, or on your skin. If this occurs, wash your skin with soap and water or rinse your eyes with water. Wear disposable rubber gloves when you handle a etoposide capsule. Throw the gloves away after one use.

Etoposide can increase your risk of bleeding or infection. You will need frequent medical tests. Your cancer treatments may be delayed based on the results.

Store etoposide capsules in the refrigerator, do not freeze.

Usual Adult Dose for Testicular Cancer:

In combination with other approved chemotherapeutic agents:
50 to 100 mg/m2 IV over 30 to 60 minutes once a day on days 1 through 5 every 3 to 4 weeks to 100 mg/m2 IV over 30 to 60 minutes once a day on days 1, 3, and 5 every 3 to 4 weeks

Comments:
-A longer duration of IV administration may be used if the volume of fluid to be infused is a concern.
-The dosage should be modified to consider the myelosuppressive effects of other drugs in the combination or the effects of prior x-ray therapy or chemotherapy which may have compromised bone marrow reserve.

Use: In combination therapy with other approved chemotherapeutic agents in patients with refractory testicular tumors who have already received appropriate surgical, chemotherapeutic, and radiotherapeutic therapy

Usual Adult Dose for Small Cell Lung Cancer:

IV:
In combination with other approved chemotherapeutic agents:
35 mg/m2 IV over 30 to 60 minutes once a day for 4 days to 50 mg/m2 IV over 30 to 60 minutes once a day for 5 days every 3 to 4 weeks

Oral:
In combination with other approved chemotherapeutic agents:
The recommended dose is 2 times the IV dose rounded to the nearest 50 mg (i.e., 2 times 35 mg/m2 IV once a day for 4 days to 50 mg/m2 IV once a day for 5 days equaling 70 mg/m2 orally once a day for 4 days to 100 mg/m2 orally once a day for 5 days)

Comments:
-A longer duration of IV administration may be used if the volume of fluid to be infused is a concern.
-The dosage should be modified to consider the myelosuppressive effects of other drugs in the combination or the effects of prior x-ray therapy or chemotherapy which may have compromised bone marrow reserve.

Use: In combination with other approved chemotherapeutic agents as first line treatment in patients with small cell lung cancer

You should not use etoposide if you are allergic to it.

Tell your doctor if you have ever had kidney disease.

Using etoposide may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.

Do not use etoposide if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant during treatment.

You should not breastfeed while you are using etoposide.

Call your doctor for instructions if you miss a dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the container it came in, in the refrigerator, tightly closed, and out of reach of children. Do not freeze.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Do not receive a "live" vaccine while using etoposide. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Etoposide may cause serious side effects. Call your doctor at once if you have:

• sudden chest pain or discomfort, wheezing, dry cough or hack;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

• vision problems;

• seizure (convulsions);

• liver problems--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or

• low white blood cell counts--fever, mouth sores, skin sores, sore throat, cough, trouble breathing.

Common side effects of etoposide may include:

• sores or white patches in or around your mouth, trouble swallowing or talking, dry mouth, bad breath, altered sense of taste;

• nausea, vomiting; or

• temporary hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may affect etoposide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to etoposide.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.