Etoposide: High Dose for Stem Cell Transplant (Generic Name)
Other Names: VePesid®, VP-16
About This Drug
Etoposide is used to treat cancer. It may be used before you get a stem cell transplant. This drug is given in the vein (IV).
Possible Side Effects (More Common)
- Nausea and throwing up (vomiting). These symptoms may happen within one to six hours after getting this drug and may last up to 72 hours. Medicines are available to stop or lessen these side effects.
- Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
- Decreased appetite (decreased hunger)
- Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
- Hair loss. Most patients lost hair on their scalp and body. You may notice hair thinning five to seven days after getting this drug. Often hair loss is temporary; your hair should grow back when treatment is done.
- Fatigue or feeling tired
- Increased total bilirubin in your blood. This may mean that you have changes in your liver function. Your blood work will be checked by your doctor.
Possible Side Effects (Less Common)
- Loose bowel movements (diarrhea) that may last for several days
- Feeling confused
- Low blood pressure while you are getting this drug
- Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.
Serious allergic reactions including anaphylaxis are rare. While you are getting this drug in your vein IV, tell your nurse right away if you have any of these symptoms of an allergic reaction:
- trouble catching your breath
- feeling like your tongue or throat are swelling
- feeling your heart beat quickly or in a not normal way (palpitations)
- feeling dizzy or lightheaded
- flushing, itching, rash, and/or hives
Treating Side Effects
- Ask your doctor or nurse about medicine that is available to help stop or lessen nausea or vomiting.
- Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
- Talk with your nurse about getting 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 getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
- If you get a rash do not put anything on it 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 get a rash while on this medicine.
- 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. Also avoid alcohol and smoking because they can bother your mouth.
- Be careful when cooking, walking, and handling sharp objects and hot liquids.
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 the medication and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might 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 help.
When to call the doctor
Call your doctor or nurse right away if you have any of these symptoms:
- Trouble breathing or feeling short of breath
- Fever of 100.5 F (38 C) or higher
- Easy bleeding or bruising
- Rash or itching
- Feeling dizzy or lightheaded
- Feeling that your heart is beating in a fast or not normal way (palpitations)
- Feeling confused
- Nausea that stops you from eating or drinking
- Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
- Throwing up more than 3 times a day
Call your doctor or nurse as soon as possible if you have any of these symptoms:
- Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
- Trouble walking or changes in the way you walk
- Pain in your mouth or throat that makes it hard to eat or drink
Sexual Problems and Reproduction Concerns
- Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
- 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 getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
- Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
- Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
- 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. Ask your doctor or nurse about effective methods of birth control.
- Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.
Revised August 2014