Etoposide chemical structure
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Etoposide

Etoposide phosphate (Eposin®, Etopophos®, Vepesid®, VP-16®) is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme. It is often given in combination with other drugs. more...

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Chemically it derives from podophyllotoxin, a toxin found in the American Mayapple.

It is given intravenously or by mouth in capsule form. If the drug is given by IV it must be done slowly over a 30 to 60 minute period because it can lower blood pressure as it is being administered. Blood pressure is checked often during infusing. The physician may lengthen or shorten the time depending on circumstances.

Side Effects

Common are:

  1. low blood pressure
  2. hair loss
  3. pain and or burning at the IV site
  4. constipation or diarrhea
  5. metallic food taste
  6. Bone marrow suppression, leading to
    1. decreased white blood cell counts (leading to increased susceptibility to infections)
    2. low red blood cell counts (anemia)
    3. low platelet counts (leading to easy bruising and bleeding)

Less common are:

  1. nausea and vomiting
  2. allergic type reactions
  3. rash
  4. fever, often occurring shortly after IV administration and not due to infection
  5. mouth sores

Instruction

Patients are generally advised to call their doctor in case of fever, symptoms of infection or painful injection sites, as these may progress severely without adequate medical attention.

It is advised to drink lots of fluids after treatment to prevent damage to the bladder and kidneys, typically 1.5 to 3.5 litres of water on the day of treatment and for several days after.

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Advise Birth Control For at Least 100 Days After Etoposide
From Family Pratice News, 1/15/01 by Timothy F. Kirn

SACRAMENTO -- Testicular cancer patients would be well advised to wait at least 100 days after completing etoposide therapy before trying to conceive a child, Francesco Marchetti, Ph.D., said at a cancer symposium sponsored by the University of California, Davis, Cancer Center.

Results of Dr. Marchetti's studies in mice indicated that etoposide induces structural chromosomal damage in germ cells during spermatogenesis. These abnormalities can be transmitted to offspring.

At 64 hours after treatment, 30% of murine sperm cells had structural abnormalities. Although most of the damage proved to be lethal to the cells, aneuploidy was detected in 7% of live spermatocytes and in 2% of the zygotes produced by mating.

Testicular cancer is the most common form of cancer in men aged 15-35 years.

Many oncologists tell patients to use condoms or some form of birth control during treatment, which can last about 9-12 weeks, depending on the number of chemotherapy cycles. There is less consensus regarding how long contraception should be continued after active treatment.

Spermatogenesis in humans takes about 44 days, but a 100-day wait before attempting conception would be more prudent, said Dr. Marchetti, a biomedical scientist at the Lawrence Livermore National Laboratory, Livermore, Calif. Moreover, nonsurgical treatment of testicular cancer often involves exposure to radiation and other chemotherapy agents in addition to etoposide.

COPYRIGHT 2001 International Medical News Group
COPYRIGHT 2001 Gale Group

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