Etoposide (Eposin, Etopophos, Vepesid) | Cancer Research UK
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What etoposide is

Etoposide is a chemotherapy drug mainly used to treat lung cancer and testicular cancer. Doctors can also use it to treat other types of cancer including stomach cancer and non Hodgkin lymphoma. Etoposide is made from the mandrake plant.

 

How etoposide works

Etoposide works by blocking an enzyme (called topoisomerase 2) which is necessary for cancer cells to divide and so grow into 2 new cells. If this enzyme is blocked, the cell's DNA gets tangled up and the cell can't divide. DNA is the genetic code that is in the nucleus of all animal and plant cells. It controls everything the cell does. 

 

How you have etoposide

Etoposide is available as capsules or as a fluid that you have into a vein. It is usually given as a course of several cycles of treatment. The exact treatment plan depends on which cancer you have.

Etoposide capsules

You may have etoposide as capsules that you swallow. You take them each day, usually for 5 consecutive days every 3 weeks. Their brand name is Vepesid. 

It is very important that you take the capsules according to the instructions your doctor or pharmacist gives you. For example, 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. And never stop taking a cancer drug without talking to your specialist first.

Etoposide into a vein

Some people have etoposide into their bloodstream (intravenously). Its brand name is Eposin or Etopophos.

You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.

You can read our information about having chemotherapy into a vein.

 

Tests during treatment

You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells. They also check how well your liver and kidneys are working.

 

About side effects

We've listed the side effects associated with etoposide below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.

You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)

The side effects may be different if you are having etoposide with other drugs.

Tell your doctor or nurse straight away if any of the side effects get severe.

 

Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
  • Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
  • Feeling or being sick happens to about 4 out of every 10 (40%) people – it is more common when etoposide is given as tablets. It is usually mild to moderate and well controlled with anti sickness medicines. If you are sick within an hour of taking etoposide capsules, don't take an extra dose but tell your doctor or nurse as soon as possible
  • Hair loss happens to about 7 out of 10 (70%) people 
  • A metallic taste when having the drug through a drip
  • Your blood pressure can drop if etoposide is given too quickly – if you feel dizzy or faint, call your nurse straight away to slow your drip down
  • Loss of appetite happens to about 1 in 8 (12%) people
  • A sore mouth and tongue swelling
 

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Women may stop having periods (amenorrhoea) but this may only be temporary
  • Loss of fertility – you may not be able to become pregnant or father a child after this treatment. 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
  • Reddening of the skin in areas where you have had radiotherapy in the past,. The skin may get dry and flaky and feel sore and hot – this goes away on its own but keep affected areas out of the sun
  • A skin rash
  • Diarrhoea or constipation
  • An allergic reaction during the treatment – let your nurse or doctor know straight away if you have a sudden skin rash, itching, breathlessness or swelling of the lips, face or throat
  • Abdominal (tummy) pain
  • Taste changes
  • Dizziness – don't drive or operate machinery if you have this
 

Rare side effects

Fewer than 1 in 100 people have these.

  • Inflammation around the drip sitetell your nurse or doctor if you have any stinging or burning, leakage of fluid, or redness or swelling around your drip site during or after treatment
  • There is a small risk that you may get a second cancer some years after etoposide treatment. If this is going to happen, it most often occurs 5 to 8 years after treatment
  • Raised blood pressure
  • Liver changes – you are unlikely to notice any symptoms and your liver function will almost certainly go back to normal when treatment is finished
  • Changes in lung tissue may lead to a cough or breathlessness
  • Kidney changes that are unlikely to cause symptoms – the kidneys will almost certainly go back to normal when treatment is finished
  • Difficulty swallowing – let your nurse know if you have this
  • Temporary changes in eyesight
 

Important points to remember

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception

This drug may 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.

Breastfeeding

Do not breastfeed during this treatment because the drug may come through in the breast milk.

 

Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.

 

More information about etoposide

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 27 April 2015