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EP

Find out about the chemotherapy combination EP, how you have it and other important information.

EP is a chemotherapy drug combination. It includes the drugs:

  • E – etoposide (also known as Vepesid, Eposin or Etopophos)
  • P – cisplatin (sometimes called platinum)

It is a treatment for:

  • small cell lung cancer
  • germ cell cancers, these most often occur in the ovary or testicle
  • small cell of the neck of the womb (cervix)

How EP works

These chemotherapy drugs divide quickly dividing cells, such as cancer cells.

How you have EP

You have etoposide and cisplatin into your bloodstream (intravenously). You can have the drugs through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Etoposide also comes as capsules that you swallow.

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have it

You usually have EP chemotherapy as cycles of treatment. Each cycle lasts 3 weeks. You may have up to 6 cycles. 

Lung cancer

For lung cancer you have each cycle of treatment in the following way:

Day 1
  • Etoposide as a drip for a couple of hours
  • Cisplatin as a drip for a couple of hours
Day 2 and 3
  • Etoposide as a drip or you have it as capsules that you take at home for 4 days
Days 4 or 5 to 21
  • You have no treatment during this time. Then you start the cycle again.

Germ cell cancer

For germ cell cancer of the ovary or testicle, you have each cycle of treatment in the following way:

Day 1
  • Etoposide and cisplatin as a drip for a couple of hours
Day 2 and 3
  • Etoposide as a drip, in some hospitals you may also have a further 2 days of etoposide as a drip

You have no treatment for just over 2 weeks. Then you start the next cycle.

Small cell cervical cancer

For small cell cervical cancer you have each cycle in the following way:

Day 1, 2 and 3
  • Etoposide and cisplatin as a drip for a couple of hours
Day 4 and 5
  • Etoposide on its own as a drip

You have no treatment for 17 days. Then you start the next cycle.

Fluids

You will have fluids (sterile salt water or saline) into your drip before and after the EP drips. This helps to keep your kidneys working properly.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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