Etoposide is used to treat cancer of the lung or testicles. It is usually given with other cancer medicines in a combination chemotherapy.

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).

Etoposide is given as an infusion into a vein. A healthcare provider will give you this injection.

Etoposide is usually given as part of a 4-day or 5-day treatment cycle every 3 or 4 weeks. Follow your doctor's dosing instructions very carefully.

Etoposide can be harmful if it gets on your skin. If skin contact occurs, wash the area with soap and water.

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.

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 be treated with 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.

Etoposide can harm an unborn baby if the mother or the father is using etoposide.

• If you are a woman, do not use etoposide if you are pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose.

• If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 4 months after your last dose.

• Tell your doctor right away if a pregnancy occurs while either the mother or the father is using etoposide.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because etoposide can harm an unborn baby.

You should not breastfeed while you are using etoposide.

Call your doctor for instructions if you miss an appointment for your etoposide injection.

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

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), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

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.

Get emergency medical help if you have signs of an allergic reaction (fever, chills, sweating, hives, fast heartbeats, feeling light-headed, 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:

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

• easy bruising, unusual bleeding, purple or red spots under your skin;

• severe ongoing nausea or vomiting;

• sudden chest pain, wheezing, dry cough, feeling short of breath;

• upper stomach pain, loss of appetite;

• vision problems; or

• a seizure (convulsions).

Common side effects of etoposide may include:

• low white blood cell counts.

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.

Tell your doctor about all your other medicines, especially:

• aspirin;

• warfarin (Coumadin, Jantoven); or

• seizure mediation.

This list is not complete. Other drugs may affect etoposide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.