III. Mechanism

  1. See Mitotic Inhibitor Chemotherapy
  2. Etoposide is a semisynthetic derivative of Podophyllotoxin with antineoplastic activity
    1. Podophyllotoxin extracted from the mandrake root (Podophyllum peltatum)
  3. Etoposide is a Topoisomerase Inhibitor
    1. Binds to topoisomerase 2, inhibiting DNA ligation
    2. DNA breaks accumulate
    3. Inhibits DNA Replication and transcription
    4. Arrests cell cycle in G2 and S phases
    5. Results in cell apoptosis and death

IV. Medications

  1. IV Solution: 5, 25 and 50 ml vials
  2. Oral Capsules: 50 mg

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Alopecia
  2. Anaphylaxis
  3. Hypotension
  4. Myelosuppression
  5. Nephrotoxicity
  6. Secondary Malignancy (esp. Acute Myelogenous Leukemia)
  7. Somnolence

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Renal Function Tests

VIII. Drug Interactions

  1. Warfarin
    1. Etoposide may increase INR

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