Etoposide | Side Effects, Dosage, Uses & More
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Generic Name:

etoposide, Oral capsule

All Brands

  • VePesid (Discontinued)
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
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Highlights for etoposide

Oral capsule
1

Etoposide is used to treat small cell lung cancer. In many cases, it’s one of the first drugs used to manage this type of cancer.

2

This drug comes in the form of a capsule you take by mouth. It’s also available as an intravenous (IV) injection. The injectable form is only given by a healthcare provider. You’ll only take the oral form of etoposide after you’ve received the drug as an IV injection.

3

The etoposide capsule is only available as a generic drug.

4

The more common side effects of this drug include nausea, vomiting, loss of appetite, hair loss leading to total baldness, or mouth sores.

5

In some cases, etoposide can cause serious side effects. These can include low levels of white blood cells, red blood cells, or platelets. Having low blood cell counts can lead to infection, extreme tiredness, or unusual bleeding. It may even be fatal (cause death).

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Bone marrow suppression warning. Red blood cells deliver oxygen throughout your body, white blood cells help fight off infections, and platelets help clot your blood. This drug may cause a severe reduction in these cells. This is called myelosuppression or bone marrow suppression. This effect raises your risk of developing a serious infection or bleeding. This can be fatal. Your doctor will monitor your blood cell levels closely during treatment.

Pregnancy

You shouldn’t take this drug if you’re pregnant or plan to become pregnant. This drug can seriously harm or end a pregnancy. If you get pregnant while taking this drug, tell your doctor right away.

Infertility

This drug may cause a permanent loss of fertility (ability to get pregnant) in men and women.

  • Men: Men may have low or no sperm count. Their sperm count may return to normal, but it may take several years after the end of treatment. This drug can also harm sperm or testicular tissue, which can lead to birth defects. Men should use a condom during treatment with this drug and for at least 4 months after their last dose.
  • Women: This drug may cause women to stop having their menstrual period or enter early menopause. Women should use effective birth control during treatment and for at least 6 months after their last dose.

What is etoposide?

Etoposide is a prescription drug. It’s available as an oral capsule. It’s also available in an intravenous (IV) form, which is only given by a healthcare provider. You’ll only take this drug under the care of a doctor who has experience with chemotherapy drugs.

The capsule is only available as a generic drug.

This drug is used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Etoposide is used to treat a type of lung cancer called small cell lung cancer. It’s usually one of the first drugs used to manage this type of cancer.

How it works

Etoposide belongs to a class of drugs called antineoplastics. A class of drugs is a group of medications that work in a similar way

See Details

How it works

Etoposide belongs to a class of drugs called antineoplastics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Etoposide works by stopping cells from multiplying (making copies of themselves). This stops the number of cancer cells from increasing.

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etoposide Side Effects

Oral capsule

More common side effects

The more common side effects of etoposide can include:

  • nausea

  • vomiting

  • hair loss that can lead to total baldness (this is reversible after you stop taking this drug)

  • loss of appetite

  • diarrhea

  • mouth sores

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Bone marrow suppression. This is when your bone marrow can’t produce as many blood cells as usual. This condition can cause very low levels of red blood cells, white blood cells, or platelets. It can be fatal (cause death). Symptoms can include:

    • extreme tiredness
    • infection
    • unusual bleeding
    • fever
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Etoposide may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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etoposide May Interact with Other Medications

Oral capsule

Etoposide can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Food interactions

You shouldn’t eat grapefruit or drink grapefruit juice on the days you’re taking this drug and for 2–3 days after. Grapefruit may raise the levels of etoposide in your body. This raises your risk of side effects.

Medications that might interact with this drug

Interactions that increase your risk of side effects
  • Side effects from etoposide: Taking etoposide with certain medications raises your risk of side effects from etoposide. This is because the amount of etoposide in your body may be increased. Examples of these drugs include: 
    • Cyclosporine A.
      • This drug can cause a large increase in the amount of etoposide in your body. This could make the side effects of etoposide worse. 

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Etoposide warnings
low albumin warning
People with low albumin levels in their blood

Albumin is a type of protein in your blood. After you take etoposide, some of the drug combines with albumin in your blood. This part of the drug isn’t active. But some of the drug stays free in your blood. The drug that’s free can cause side effects. If you have low levels of albumin in your blood, more of the drug stays free. This can lead to more side effects from etoposide.

kidney problem warning
People with kidney problems

If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body very well. This may increase the levels of etoposide in your body and cause more side effects. Your doctor may adjust your dosage of this drug if you have kidney disease.

liver problem warning
People with liver problems

If you have liver problems or a history of liver disease, you may not be able to break down this drug in your body. This may increase the levels of etoposide in your body and cause more side effects. Your doctor will monitor your liver function and may adjust your dosage of this drug if needed.

pregnancy warning
Pregnant women

Etoposide is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breast feeding warning
Women who are breast-feeding

It isn’t known if etoposide passes into breast milk. If it does, it may cause side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

senior warning
For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

If you’re 65 years or older, you may have more side effects from this drug.

childrens warning
For children

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 18 years old.

call the doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

allergy warning
Allergies

Etoposide can cause a severe allergic reaction. Symptoms can include:

  • fever
  • chills
  • fast heart rate
  • shortness of breath
  • low blood pressure, which may cause dizziness
  • swelling of your tongue or face
  • coughing
  • sweating
  • a bluish color to your skin
  • tightening of your throat
  • back pain
  • fainting

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take etoposide (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Small cell lung cancer

Generic: Etoposide

Form: Oral capsule
Strength: 50 mg
Adult dosage (ages 18 years and older)
  • Typical starting dosage: You’ll only take this form of the drug after you receive etoposide as an intravenous (IV) injection. Your dose of the oral medication depends on the IV dose you received. Your doctor will calculate your dose based on your body surface area. You’ll take it on days 2–5 of the cycle after you receive an IV dose.
  • Dosage changes: Your doctor will change your dose if your red or white blood cells or platelets are too low. They’ll also change your dose if you’re taking other chemotherapy or x-ray therapy treatments.
Child dosage (ages 0–17 years)

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Kidney disease: Depending on your kidney function, you may receive the typical dose or 75% of the typical dose of this drug.

Warnings

Your doctor will check your blood counts before each cycle of this drug. If your white or red blood cells or platelets are too low, you might not be able to take the drug. Your doctor will explain your blood count numbers to you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Etoposide comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your cancer may get worse or metastasize (spread to other parts of your body).

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • bone marrow suppression, which could lead to dangerous bleeding or an infection
  • seizures
  • drowsiness
  • rash
  • a bluish color to your skin

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Call your doctor if you miss a dose. You may have to repeat a cycle if you don’t take this drug as directed.

How to tell if the drug is working

You won’t be able to tell if the drug is working. Your doctor will do bloodwork and x-rays to see if the drug is working for you.

Etoposide is used for short-term treatment

Store this drug carefully

  • Store etoposide in the refrigerator. Keep it between 36°F and 46°F (2°C and 8°C).
  • Don’t store this medication for more than 36 months (3 years).
  • Don’t freeze this drug.
  • Protect this medication from light.

A prescription for this medication is not refillable

You or your pharmacy will have to contact your doctor for a new prescription if you need this medication refilled.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Kidney function. Your doctor will do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, your doctor may lower your dosage of this drug.
  • Blood counts. Your doctor will do blood tests to check your counts of red and white blood cells and platelets. These tests will make sure you have enough of these blood cells to receive this drug.
  • Liver function. This drug is processed by your liver. It can cause your liver enzymes to increase, especially if you’re receiving high doses. An increase in liver enzymes can be a sign of liver damage. Your doctor will check your liver function and liver enzymes with blood tests. Depending on the results of these tests, your doctor may adjust your dosage.

Your diet

You shouldn’t eat grapefruit or drink grapefruit juice on the days you’re taking this drug and for 2–3 days after. Grapefruit may raise the levels of etoposide in your body. This raises your risk of side effects.

Not every pharmacy stocks this drug

When filling your prescription, be sure to call ahead. Your health insurance company may require you to get this drug at a special pharmacy.

Are there any alteratives

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does etoposide Cost?

Oral capsule

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These prices represent the lowest priced national pharmacies for etoposide on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Mary Moody on February 3, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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