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.
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)
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!