Composition
Inj: Per ml: Etoposide 20 mg; 5 ml, 2.5 ml, 10 ml vial. Cap 50 mg/100 mg: Etoposide 50 mg/100 mg.
Indications & Dosage
Small cell carcinoma of the bronchus, the lymphomas and testicular cancer: BY IV INF: Adults: 60-120 mg/m2slow IV INF over 1/2-1 hr daily for 3-5 days followed by treatment-free interval of 14 days.
Administration
Administer lower doses IVP Bolus over at least 30 min to minimize the risk of hypotensive reactions. At room temperature in D5W or NS in polyvinyl chloride, the concentration is stable as follows: 0.2 mg/ml: 96 hours; 0.4 mg/ml: 48 hours; 0.6 mg/ml: 8 hours; 1 mg/ml: 2 hours; 2 mg/ml: 1 hour; 20 mg/ml (undiluted): 24 hours. Standard IV Dilution: Lower dose regimens (<1 gm/dose): Doses may be diluted in 100-1000 ml of D5W or NS. If the concentration is >0.6 mg/ml, it is highly unstable and a syringe of undiluted etoposide accompanied with the appropriate volume of diluent will be sent to the nursing unit to be mixed at the bedside just prior to administration. High-dose regimens (>1 gm/dose): Total dose should be drawn into an empty Viaflex container and the appropriate amount of diluent (for a final concentration of 1 mg/ml) will be sent. Use the 2-Channel Pump Method: Instill all of the etoposide dose into one container (concentration equal to 20 mg/ml). Infuse this into one channel. The etoposide should be Y-sited into the port most proximal to the patient. A 0.22 micron filter should be attached to the line after the Y-site and before entry into the patient.
Compatibility
Stable in D5W, LR.
Contraindications
Severe hepatic dysfunction; acute infection.
Precautions
Debilitated patients; prolonged chemotherapy. Monitor blood count; avoid contact with skin & eyes; avoid extravasation. Not to be admin-istered intrapleurally or intraperitoneally.
Pregnancy
Positive evidence of risk: Avoid
Lactation
Contraindicated. Discontinue breast-feeding.
Side Effects
Alopecia, bone-marrow suppression, hyperuricaemia, irritant to tissues, nausea, oral mucositis, thromboembolism, tumourlysis syndrome, vomiting