Podophyllin Alkaloids

Etoposide (Toposar, VePesid) is a podophyllin alkaloid often used to treat lung cancer.

• Who should not use these medications: Persons with an allergy to etoposide should not take it.



• Use: Scheduling of etoposide doses is important. Current recommendations are to give etoposide by an injection over a 1- to 3-day period in the chemotherapy cycle. The drug may not be given by intrathecal injection (that is, into a cavity within the brain).



• Drug or food interactions: Etoposide may delay the effects of blood thinners, such as warfarin (Coumadin), or platelet (cells in blood that help clotting) inhibitors, such as aspirin. The risk of etoposide further reducing blood cell counts and causing anemia or bleeding may increase when it is used with other chemotherapy drugs. Cyclosporine (Sandimmune, Neoral) and zidovudine (Combivir, Retrovir) increase toxicity of etoposide.



• Side effects: Etoposide may cause a person to bleed or to develop infections more easily. A doctor will check blood and urine for abnormalities that may be caused by these drugs.
  
  
  • A doctor should be contacted immediately if any of the following side effects occur:
    
    
    • Unexplained fever, chills, or sore throat
    
    
    
    • Wheezing or trouble breathing
    
    
    
    • Unusual bleeding or bruising
    
    
    
    • Bloody urine, bowel movement, or vomit
    
    
    
    • Yellowing of skin or eyes
    
    
    
    • Redness, pain, or swelling where the IV is given
    
    
    
    • Dizziness or faintness while the medicine is being given
  
  
  • Other side effects include the following:
    
    
    • Hair loss
    
    
    
    • Appetite loss
    
    
    
    • Weight loss
    
    
    
    • Muscle cramps
    
    
    
    • Bone marrow suppression often causes extremely low white blood cell count, low red blood cell count (anemia), and low platelet count. In rare occasions, the bone marrow suppression results in leukemia.