Etoposide interactions

Conditions

Conditions in which Etoposide needs care, as documented in this source.

• Bone Marrow Failure Disorders

  Major

  Etoposide induces dose-related myelosuppression. Leukopenia, thrombocytopenia, and anemia have been reported during etoposide therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Therapy should be administered cautiously in patients whose bone marrow reserve may be severely depressed and should be withheld if an absolute neutrophil counts fall below 500/mm3 and/or platelet counts fall below 50,000/mm3. Clinical monitoring of hematopoetic function is recommended. Periodic complete blood counts should be done during the course of etoposide treatment and it should be performed prior to each cycle of therapy and at appropriate intervals during and after therapy. At least one determination should be done prior to each dose.

  5 sources

  1. Niederle N Ostermann J Achterrath W Lenaz L Schmidt CG "Etoposide in patients with previously untreated non-small-cell lung cancer: a phase I study." Cancer Chemother Pharmacol 28 (1991): 59-62
  2. Lokich J Corkery J "Phase I study of VP-16-213 (Etoposide) administered as a continuous 5- day infusion." Cancer Treat Rep 65 (1981): 887-9
  3. DeVore R, Higa G, Robbins A, Sarkar M "Protracted infusion of low-dose etoposide (E): preliminary results of a Phase I/II pharmacokinetic (PK) study (Meeting abstract)." Proc Annu Meet Am Soc Clin Oncol 12 (1993): a4491993
  4. Kobayashi K, Ratain MJ "Pharmacodynamics and long-term toxicity of etoposide." Cancer Chemother Pharmacol 34 Suppl (1994): s64-8
  5. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb (2001):

• Infections

  Major

  Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

  39 sources

  1. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  2. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories (2002):
  3. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb (2001):
  4. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb (2001):
  5. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation (2001):
  6. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb (2001):
  7. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb (2001):
  8. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation) (2001):

  Show all 39 sourcesShow fewer sources

  9. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  10. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  11. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  12. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  13. "Product Information. Fludara (fludarabine)." Berlex Laboratories (2001):
  14. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn (2001):
  15. "Product Information. Matulane (procarbazine)." Roche Laboratories (2001):
  16. "Product Information. DTIC-Dome (dacarbazine)." Bayer (2001):
  17. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn (2001):
  18. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc (2001):
  19. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company (2001):
  20. "Product Information. Hycamtin (topotecan)." SmithKline Beecham (2001):
  21. "Product Information. Taxotere (docetaxel)." Rhone Poulenc Rorer (2001):
  22. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb (2001):
  23. "Product Information. Nipent (pentostatin)." Hospira Inc (2001):
  24. "Product Information. Tabloid (thioguanine)." Prasco Laboratories (2001):
  25. "Product Information. Xeloda (capecitabine)." Roche Laboratories (2001):
  26. "Product Information. Alkeran (melphalan)." Glaxo Wellcome (2022):
  27. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome (2001):
  28. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  29. "Product Information. Doxil (doxorubicin liposomal)." Sequus Pharmaceuticals Inc (2001):
  30. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn (2001):
  31. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation (2001):
  32. "Product Information. Jevtana (cabazitaxel)." sanofi-aventis (2010):
  33. "Product Information. Halaven (eribulin)." Eisai Inc (2010):
  34. "Product Information. Keytruda (pembrolizumab)." Merck & Co., Inc (2014):
  35. "Product Information. Blincyto (blinatumomab)." Amgen USA (2014):
  36. "Product Information. Opdivo (nivolumab)." Bristol-Myers Squibb (2014):
  37. "Product Information. Unituxin (dinutuximab)." United Therapeutics Corporation (2015):
  38. "Product Information. Empliciti (elotuzumab)." Bristol-Myers Squibb (2015):
  39. "Product Information. Pepaxto (melphalan flufenamide)." Oncopeptides Inc. (2021):

• Kidney Diseases

  Moderate

  Etoposide is primarily eliminated by the kidney. Less than 50% is eliminated as unchanged drug in the urine. Reduced clearance, increased AUC, and decreased volume of distribution have been noted in patients with impaired renal function. Therapy should be administered cautiously and dosages reduced in patients with compromised renal function. Patients with a creatinine clearance between 15 to 50 mL/min should receive 75% of the recommended dosage of etoposide. Data are not available in patients with creatinine clearances <15 mL/min and further dosage reductions are recommended. Clinical monitoring of renal function is recommended.

  1 source

  1. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb (2001):