Chemotherapy Patient Resource Area

Etoposide/Vepesid^®

Drug
Etoposide (generic name) is manufactured as Vepesid^® (trade name) (Bristol-Myers Squibb, Princeton, NJ).

Action
Etoposide is a drug that stops the growth of cancer cells. It is in the class of drugs known as podophyllotoxin derivatives and is used to treat several kinds of cancer, including ovarian cancer, small cell lung cancer, Hodgkin's disease, and a type of childhood brain tumor called ependymoma.

What does the drug look like?
Etoposide is supplied in 50-mg, pink, oblong gelatin capsules (8 mm in diameter and 20 mm in length) and in larger 100-mg, pink, oblong gelatin capsules (10 mm in diameter and 24 mm in length).

How long will I take the drug?
The length of treatment varies and depends on your diagnosis and how well your body responds to treatment.

How do I take the drug?
Etoposide is taken by mouth on an empty stomach. The dose of etoposide is based on your body size and is determined by your doctor. Your doctor and pharmacist will tell you how many tablets to take each day and when to take them. Various schedules are used and, in some treatment protocols, an IV dose of etoposide is given on the first day, followed by oral doses of etoposide on subsequent days. Be sure to read the label on your medicine closely so that you take the dose you need at the time you should take it. Swallow each capsule whole; do not chew them. If you are unable to swallow the capsule, it can be pierced and the contents squeezed out into juice or other liquid. Mix thoroughly and drink. Avoid contact with the drug; wash hands before and after piercing the etoposide capsule, and only pierce the capsule if you are unable to swallow the capsule whole. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you accidentally take too many pills or someone else accidentally takes your medicine, contact your doctor or the nearest emergency room immediately.

Storage
Store this medicine at room temperature, away from excess heat and moisture (do not store on a windowsill or in a bathroom). Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Etoposide may cause nausea and vomiting. Eat small frequent meals and bland foods, and report moderate to severe vomiting to your doctor. Medications for nausea can be prescribed to help with this side effect.
• Changes in taste are common while on etoposide therapy. Experiment with spices and flavorings and different textures and temperatures of foods.
• Etoposide may cause mouth sores. If mouth sores occur, avoid spicy foods and do not use mouthwash, because it may contain alcohol and worsen mouth pain. Your healthcare providers may give you suggestions on how to care for your mouth or manage mouth sores, and these directions should be followed carefully.
• Hair may thin or become brittle while receiving etoposide treatment. Depending on the dose and schedule, moderate to complete hair loss may occur. However, hair grows back upon completion of treatment.
• Etoposide temporarily lowers the number of white blood cells in your blood, increasing your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5^oF or have chills, a cough, or painful urination.
• Etoposide also lowers the number of platelets in your blood, which are necessary for proper blood clotting. Call your doctor immediately if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. Use a soft toothbrush, and use care when flossing. Your healthcare providers may give you suggestions on how to care for your mouth, and these directions should be followed carefully.
• Etoposide may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you must use a reliable birth control method and not assume that you cannot get pregnant or get someone else pregnant. Women who are pregnant or would like to become pregnant need to discuss this with their doctors before taking this drug.

Drug interactions
Let your doctor know what medications you are taking. Taking high-dose cyclosporine with etoposide will increase etoposide blood levels. Also, if you are taking vitamins, herbs, or nutritional supplements, be sure to let your doctor know.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills, cough, or burning or pain on urination
• Moderate to severe nausea and vomiting
• Moderate to severe mouth sores or blistering
• Any bleeding, such as from your nose or gums or in your urine
• Dark-colored (black or tar-like) stools
• Unusual bruising
• Pinpoint red spots on your skin