Etoposide: High Dose for SCT (Generic Name)

Other Names: VePesid®, VP-16

About this drug

Etoposide is used to treat cancer. It may be used in pre-transplant chemotherapy. This drug is given intravenously (IV).

Possible side effects (More Common)

  • Nausea and vomiting. These symptoms may occur within three to eight hours after you receive the drug and may last up to eight to 10 hours.
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression occurs five to seven days after the drug is given and may increase your risk of infection, fatigue, and bleeding. Transfusions of blood products may be required.
  • Decreased appetite
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Rash
  • Hair loss. Most patients experience scalp and body hair loss. You may notice hair thinning five to seven days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Fatigue or tiredness
  • Changes in your liver function. Your doctor will monitor your liver function as needed.

Possible side effects (Less Common)

  • Diarrhea that may last for several days
  • Confusion
  • Blood pressure may be lowered during administration of this drug.

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. Women may experience signs of menopause like vaginal dryness or itching.
    • 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.
    • 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.
    • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • Ask your doctor or nurse about medication that is available to help prevent or lessen nausea or vomiting.
  • 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.
  • 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.
  • 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.
  • Mouth care is very important. Your mouth care should consist of gently brushing with a very soft tooth brush and rinsing your mouth with a mixture of ½ teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth.

Food and drug interactions

There are no known interactions of Etoposide with food. This drug may interact with other medication. Tell your doctor and pharmacist about all of 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:

  • Shortness of breath
  • Fever of 100.5 F (38 C) or above; chills
  • Unusual bleeding or bruising
  • Rash or itching
  • Dizziness or lightheadedness
  • Palpitations
  • Confusion
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than twice in one day

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

  • Painful mouth or throat that makes it difficult to eat or drink
  • Diarrhea of three stools in a day or diarrhea with weakness or lightheadedness
  • Rash

Revised November 2011

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