Etoposide Interactions

Brand names: Etoposide

Topoisomerase Inhibitor · Topoisomerase Inhibitors

Route: Intravenous

FDA Black Box Warning

WARNINGS Etoposide injection should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Severe myelosuppression with resulting infection or bleeding may occur.

Contraindications

CONTRAINDICATIONS Etoposide injection is contraindicated in patients who have demonstrated a previous hypersensitivity to etoposide or any component of the formulation.

Pregnancy & Breastfeeding

Pregnancy Etoposide Injection can cause fetal harm when administered to a pregnant woman. Etoposide has been shown to be teratogenic in mice and rats. In rats, an intravenous etoposide dose of 0.4 mg/kg/day (about 1/20 th of the human dose on a mg/m 2 basis) during organogenesis caused maternal toxicity, embryotoxicity, and teratogenicity (skeletal abnormalities, exencephaly, encephalocele, and anophthalmia); higher doses of 1.2 and 3.6 mg/kg/day (about 1/7 th and 1/2 of human dose on a mg/m 2 basis) resulted in 90 and 100% embryonic resorptions. In mice, a single 1 mg/kg (1/16 th of human dose on a mg/m 2 basis) dose of etoposide administered intraperitoneally on days 6, 7, or 8 of gestation caused embryotoxicity, cranial abnormalities, and major skeletal malformations. An I.P. dose of 1.5 mg/kg (about 1/10 th of human dose on a mg/m 2 basis) on day 7 of gestation caused an increase in the incidence of intrauterine death and fetal malformations and a significant decrease in the average fetal body weight. Women of childbearing potential should be advised to avoid becoming pregnant. If this drug is used during pregnancy, or if the patient becomes pregnant while receiving this drug, the patient should be warned of the potential hazard to the fetus. Etoposide injection should be considered a potential carcinogen in humans. The occurrence of acute leukemia with or without a preleukemic phase has been reported in rare instances in patients treated with etoposide alone or in association with other neoplastic agents. The risk of development of a preleukemic or leukemic syndrome is unclear. Carcinogenicity tests with etoposide injection have not been conducted in laboratory animals. Pregnancy Teratogenic Effects Pregnancy "Category D." (See WARNINGS section.)

9 interactions on record

High-dose cyclosporin A (concentrations >2000 ng/mL) increases etoposide exposure by 80% and decreases total body clearance by 38%, potentially increasing etoposide toxicity.

Source: NLP:etoposide

Acute pulmonary edema and hypotension leading to death reported when used with pentostatin in combination chemotherapy regimen for bone marrow transplant.

Source: NLP:pentostatin

Increased etoposide exposure possible; no dosage adjustment needed but monitor for adverse reactions.

Source: NLP:aprepitant

Increased exposure of chemotherapeutic agent; no dosage adjustment needed but monitor for adverse effects.

Source: NLP:fosaprepitant

Increased exposure possible via CYP3A4 inhibition, but no dosage adjustment needed. Monitor for adverse reactions.

Source: NLP:fosaprepitant dimeglumine

Chemotherapy agent metabolized by CYP3A4; systemic exposure can increase with AKYNZEO; caution and monitoring advised.

Source: NLP:netupitant and palonosetron

Co-administration of etoposide with warfarin can result in elevated international normalized ratio (INR). Monitor INR more frequently and modify warfarin dosage as appropriate.

Source: NLP:etoposide