CLASS: Podophyllotoxin derivative SYNONYM: VP-16, VP-16-213, EPEG, Toposar, VePesid, Etopophos EXTRAVASATION RISK: Can cause irritation or phlebitis ROUTES OF ADMINISTRATION: IV, PO DRUG REACTIONS: May increase the hypoprothrombinemic effects of warfarin. ADVERSE REACTIONS: SECONDARY MALIGNANCY: AML increased. HYPERSENSITIVITY: Anaphylaxis could occur up to 2% of patients. GASTROINTESTINAL: Moderate to low potential for N/V. Mucositis with high doses or prior XRT. Elevation of LFTs, hepatocellular necrosis. CARDIOVASCULAR: Hypotension with large doses or rapid administration. CNS: Peripheral neuropathy (rare) GU: Amenorrhea HEME: Bone marrow suppression, nadir 7-14 days (PMN) & 9-16 days (PLTs) DERM: Alopecia, radiation recall ADJUSTMENTS IN RENAL INSUFFICIENCY: CrClearance: IF 16-50 ml/min THEN use 75% of usual dosage. IF 0-15 ml/min THEN consider further dose reductions!! ADJUSTMENTS IN HEPATIC INSUFFICIENCY: Specific guidelines not available!
|