Etoposide

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Etoposide
Systematic (IUPAC) name
4'-demethyl-epipodophyllotoxin 9-[4,6-O-(R)-ethylidene-beta-D-glucopyranoside], 4' -(dihydrogen phosphate)
Identifiers
CAS number	33419-42-0
ATC code	L01CB01
PubChem	36462
DrugBank	APRD00239
Chemical data
Formula	C29H32O13
Mol. mass	588.557 g/mol
Pharmacokinetic data
Bioavailability	Highly variable, 25 to 75%
Protein binding	97%
Metabolism	Hepatic (CYP3A4 involved)
Half life	Oral: 6 h., IV: 6-12 h., IV in children: 3 h.
Excretion	Renal and fecal
Therapeutic considerations
Pregnancy cat.	D(AU) D(US)
Legal status	POM(UK) ℞-only(US)
Routes	Oral, intravenous

WikiDoc Resources for Etoposide
Articles
Most recent articles on Etoposide Most cited articles on Etoposide Review articles on Etoposide Articles on Etoposide in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Etoposide Images of Etoposide Photos of Etoposide Podcasts & MP3s on Etoposide Videos on Etoposide
Evidence Based Medicine
Cochrane Collaboration on Etoposide Bandolier on Etoposide TRIP on Etoposide
Clinical Trials
Ongoing Trials on Etoposide at Clinical Trials.gov Trial results on Etoposide Clinical Trials on Etoposide at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Etoposide NICE Guidance on Etoposide NHS PRODIGY Guidance FDA on Etoposide CDC on Etoposide
Books
Books on Etoposide
News
Etoposide in the news Be alerted to news on Etoposide News trends on Etoposide
Commentary
Blogs on Etoposide
Definitions
Definitions of Etoposide
Patient Resources / Community
Patient resources on Etoposide Discussion groups on Etoposide Patient Handouts on Etoposide Directions to Hospitals Treating Etoposide Risk calculators and risk factors for Etoposide
Healthcare Provider Resources
Symptoms of Etoposide Causes & Risk Factors for Etoposide Diagnostic studies for Etoposide Treatment of Etoposide
Continuing Medical Education (CME)
CME Programs on Etoposide
International
Etoposide en Espanol Etoposide en Francais
Businness
Etoposide in the Marketplace Patents on Etoposide
Experimental / Informatics
List of terms related to Etoposide

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Overview

Etoposide phosphate (brand names: Eposin, Etopophos, Vepesid, VP-16) is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as Ewing's sarcoma, lung cancer, testicular cancer, lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme. It is often given in combination with other drugs.

Chemically it derives from podophyllotoxin, a toxin found in the American Mayapple.

Administration

It is given intravenously or orally in capsule form. If the drug is given by IV it must be done slowly over a 30 to 60 minute period because it can lower blood pressure as it is being administered. Blood pressure is checked often during infusing with the speed of administration adjusted accordingly.

Patients are generally advised to call their doctor in case of fever, symptoms of infection or painful injection sites, as these may progress severely without adequate medical attention.

Patients are advised to drink large amounts of fluids after treatment to prevent damage to the bladder and kidneys, typically 1.5 to 3.5 litres of water on the day of treatment and for several days after.

Side effects

Common are:

• low blood pressure
• hair loss
• pain and or burning at the IV site
• constipation or diarrhea
• metallic food taste
• Bone marrow suppression, leading to:
  • decreased white blood cell counts (leading to increased susceptibility to infections)
  • low red blood cell counts (anemia)
  • low platelet counts (leading to easy bruising and bleeding)

Less common are:

• nausea and vomiting
• allergic type reactions
• rash
• fever, often occurring shortly after IV administration and not due to infection
• mouth sores

v • d • e Chemotherapeutic agents/Antineoplastic agents (L01)
Alkylating and alkylating-like agents	Nitrogen mustards: (Chlorambucil, Chlormethine, Cyclophosphamide, Ifosfamide, Melphalan, Bendamustine, Uramustine) Nitrosoureas:(Carmustine, Fotemustine, Lomustine, Streptozocin) Platinum (alkylating-like): (Carboplatin, Cisplatin, Oxaliplatin, Triplatin tetranitrate, Satraplatin) Alkyl sulfonates:(Busulfan, Treosulfan) Hydrazines:(Procarbazine, Dacarbazine, Temozolomide) Aziridines:(ThioTEPA)
Antimetabolites	Folic acid: (Aminopterin, Methotrexate, Pemetrexed, Raltitrexed). Purine:(Cladribine, Clofarabine, Fludarabine, Mercaptopurine, Pentostatin, Thioguanine) Pyrimidine:(Capecitabine, Cytarabine, Decitabine, Fluorouracil, Floxuridine, Gemcitabine)
Spindle poison/mitotic inhibitor	Taxane: (Docetaxel, Larotaxel, Paclitaxel). Vinca: (Vinblastine, Vincristine, Vindesine, Vinorelbine).
Cytotoxic/antitumor antibiotics	Anthracycline family: (Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitoxantrone, Pixantrone, Valrubicin) streptomyces (Actinomycin, Bleomycin, Mitomycin, Plicamycin) - Hydroxyurea
Topoisomerase inhibitors	Camptotheca: (Camptothecin, Topotecan, Irinotecan, Rubitecan), Podophyllum:(Etoposide, Teniposide)
CI monoclonal antibodies	Receptor tyrosine kinase (Cetuximab, Panitumumab, Trastuzumab) - CD20 (Rituximab, Tositumomab) - other (Alemtuzumab, Bevacizumab, Gemtuzumab)
Photosensitizers	Aminolevulinic acid, Methyl aminolevulinate, Porfimer sodium, Verteporfin
Tyrosine kinase inhibitors	Axitinib, Bosutinib, Cediranib, Dasatinib, Erlotinib, Gefitinib, Imatinib, Lapatinib, Lestaurtinib, Nilotinib, Semaxanib, Sorafenib, Sunitinib, Vandetanib
Cyclin-dependent kinase inhibitor	Seliciclib
Other	retinoids (Alitretinoin, Tretinoin), Fusion protein (Aflibercept) - Altretamine, Amsacrine, Anagrelide, Arsenic trioxide, Asparaginase (Pegaspargase), Bexarotene, Bortezomib, Celecoxib, Denileukin diftitox, Elesclomol, Estramustine, Irofulven, Ixabepilone, Masoprocol, Mitotane, Oblimersen, Testolactone, Tipifarnib, Trabectedin

v • d • e WikiDoc Research Resources for Etoposide (Click show to right to view)
Articles on Etoposide	Most recent articles on Etoposide • Most cited articles on Etoposide • Review articles on Etoposide • Articles on Etoposide in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Etoposide	Powerpoint slides on Etoposide • Images of Etoposide • Photos of Etoposide • Podcasts & MP3s on Etoposide • Videos on Etoposide
Evidence Based Medicine Regarding Etoposide	Cochrane Collaboration on Etoposide • Bandolier on Etoposide • TRIP on Etoposide
Cost Effectiveness of Etoposide	Cost Effectiveness of Etoposide
Clinical Trials Involving Etoposide	Ongoing Trials on Etoposide at Clinical Trials.gov • Trial results on Etoposide • Clinical Trials on Etoposide at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Etoposide	US National Guidelines Clearinghouse on Etoposide • NICE Guidance on Etoposide • NHS PRODIGY Guidance • FDA on Etoposide • CDC on Etoposide
Textbook Information on Etoposide	Books and Textbook Information on Etoposide
Pharmacology Resources on Etoposide	Dosing of Etoposide • Drug interactions with Etoposide • Side effects of Etoposide • Allergic reactions to Etoposide • Overdose information on Etoposide • Carcinogenicity information on Etoposide • Etoposide in pregnancy • Pharmacokinetics of Etoposide •
Genetics, Pharmacogenomics, and Proteinomics of Etoposide	Genetics of Etoposide • Pharmacogenomics of Etoposide • Proteomics of Etoposide
Newstories on Etoposide	Etoposide in the news • Be alerted to news on Etoposide • News trends on Etoposide
Commentary on Etoposide	Blogs on Etoposide
Patient Resources on Etoposide	Patient resources on Etoposide • Discussion groups on Etoposide • Patient Handouts on Etoposide • Directions to Hospitals Treating Etoposide • Risk calculators and risk factors for Etoposide
Healthcare Provider Resources on Etoposide	Symptoms of Etoposide • Causes & Risk Factors for Etoposide • Diagnostic studies for Etoposide • Treatment of Etoposide
Continuing Medical Education (CME) Programs on Etoposide	CME Programs on Etoposide
International Resources on Etoposide	Etoposide en Espanol • Etoposide en Francais
Business Resources on Etoposide	Etoposide in the Marketplace • Patents on Etoposide
Informatics Resources on Etoposide	List of terms related to Etoposide

de:Etoposid

fr:Étoposide ja:エトポシド

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .