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Etoposide

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MDR

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!