Etoposide (Generic Name)

Other Names: VePesid®, VP-16

About This Drug

Etoposide is a drug used to treat cancer. This drug is given intravenously (IV) or orally.

Possible Side Effects (More Common)

  • Nausea and vomiting. These symptoms may occur within one to six hours after you receive the drug and may last up to 48 to 72 hours. 
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually occurs seven to 10 days after the drug is given and may increase your risk of infection, fatigue, and bleeding.
  • Decreased appetite
  • Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Fatigue
  • Blood pressure may be lowered during administration if this drug is being given intravenously.

Possible Side Effects (Less Common)

  • Diarrhea that may last for several days
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Changes in your liver function.  Your doctor will monitor your liver function as needed.
  • Effects on the nerves called peripheral neuropathy. You may feel numbness or tingling in your hands and feet. It may be difficult for you to button your clothes, open jars, or walk normally. The effect on the nerves may get worse with additional doses of the drug. These effects get better in some people after the drug is stopped but it may not get better in some people.
    • Be careful when cooking, walking, and handling sharp objects and hot liquids.
  • Rash  

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment. Asl your doctor or nurse about effective methods of birth control.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 
    • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.
    • Women may experience signs of menopause like vaginal dryness or itching.  Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • If you are receiving this drug intravenously, let your nurse know if you are feeling lightheaded or dizzy.
  • Speak with your nurse about obtaining a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good...Feel Better” program close to where you live. It is a free program where women undergoing chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and  skin and nail care.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of ½ teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Let your doctor know right away if you develop a rash while on this medication.

Food and Drug Interactions

Take etoposide pills one hour before or two to three hours after a meal. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

Allergic Reactions

Serious allergic reactions including anaphylaxis are rare. Tell your doctor or nurse immediately if you have any of the following symptoms during the time you are receiving this drug:

  • Difficulty catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat rapidly (palpitations)
  • Dizziness or lightheadedness
  • Flushing/itching/rash/hives

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Difficulty breathing, rash or itching, dizziness or lightheadedness, palpitations
  • Diarrhea of four stools a day or diarrhea with weakness or lightheadedness
  • Confusion
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than twice in one day

 

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Numbness or tingling in hands or feet
  • Difficulty walking or changes in the way you walk
  • Painful mouth or throat that makes it difficult to eat or drink
  • Rash

Revised November 2011

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