Etoposide
Antineoplastic Agent | Mitotic Inhibitor
Etoposide is a chemotherapy medication used primarily for the treatment of various cancers, including small cell lung cancer, testicular cancer, and certain types of lymphoma.
- Administration Forms: Etoposide is available in both oral and intravenous (IV) formulations. The bioavailability of the oral form can be variable, so it's crucial to maintain consistent administration conditions to ensure predictable absorption.
- Infusion-Related Reactions: When administered IV, etoposide can cause hypotension, especially if infused too rapidly. Typically, the infusion should be administered over at least 30 to 60 minutes to minimize this risk.
- Myelosuppression Monitoring: Etoposide can cause bone marrow suppression, leading to neutropenia, anemia, and thrombocytopenia. Regular monitoring of complete blood counts is essential, and dose adjustments may be necessary based on the patient's blood cell counts.
- Drug Interactions: Etoposide is metabolized by CYP3A4 enzymes, so concomitant use with strong CYP3A4 inhibitors or inducers can alter etoposide levels and effects, potentially leading to increased toxicity or decreased efficacy.
- Handling and Disposal: As with many chemotherapy agents, proper handling and disposal procedures are important to avoid exposure to health care workers and others.
- Mucositis Prevention: Etoposide can cause mucositis. Good oral hygiene and possibly the use of mucosal coating agents or other supportive care measures can be helpful in managing or preventing this side effect.
- Alopecia: Hair loss is a common side effect of etoposide, and patients should be counseled about this potential and offered options for coping with hair loss if it occurs.
- Nausea and Vomiting: Antiemetic prophylaxis and treatment are essential since etoposide can significantly induce nausea and vomiting. The use of a serotonin receptor antagonist in combination with other antiemetics (such as NK1 receptor antagonists) depending on the emetogenic risk is advisable.
- Storage and Stability: Etoposide solutions should be stored properly, and attention should be given to the stability of the drug once it is reconstituted or diluted for administration.
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