Severe lowering of blood counts (myelosuppression) may occur, which may cause infection or bleeding (sometimes fatal). Seek immediate medical attention if you develop symptoms of infection (fever, chills, persistent sore throat) or unusually easy bruising or bleeding (see also Side Effects section).

Etoposide is used alone or in combination with other chemotherapies to treat certain forms of cancer (e.g., small cell lung cancer). Etoposide works by slowing cancer cell growth. It is also commonly known as VP-16.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This drug may also be used to treat certain types of leukemias, lymphomas, ovarian cancer, testicular cancer, and a certain type of prostate cancer.

How to use etoposide Oral
Take this medication by mouth exactly as prescribed. The dosage is based on your medical condition and response to therapy.
Do not increase your dose or take this medication more often without your doctor\'s approval. Your condition will not improve any faster and the risk of serious side effects may be increased.
Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit juice can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.
Do not stop taking this medication, even if you feel nauseated or experience vomiting. If you vomit shortly after a dose or if you miss a dose, contact your doctor.
Since dust containing this drug may be inhaled, women who are pregnant or who may become pregnant should not handle or break the capsules of this medication.

(see also Warning section)
Nausea, vomiting, loss of appetite, strange aftertaste, diarrhea, mouth sores, muscle aches, drowsiness, fatigue, or skin color changes may occur. Nausea and vomiting can be quite severe. In some cases, drug therapy may be necessary to prevent or relieve nausea and vomiting. Changes in diet such as eating several small meals or limiting activity may help decrease some of these effects. If these effects persist or worsen, notify your doctor or pharmacist promptly.
Temporary hair loss may occur. Hair growth should return after treatment has ended.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Etoposide, along with certain other anti-cancer drugs, has been known to cause acute leukemia. This is very rare. Consult your doctor for more details.
Etoposide can lower the body\'s ability to fight an infection. Notify your doctor promptly if you develop any signs of an infection, such as fever, chills or persistent sore throat.
Tell your doctor immediately if this unlikely side effect occurs: tingling of hands or feet.
Tell your doctor immediately if any of these rare but very serious side effects occur: yellowing of the eyes or skin, tarry or bloody stool, vision changes, abdominal pain, redness or swelling of your veins.
A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, sweating, chest tightness, fast or irregular heartbeat, skin turning blue, cough, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking etoposide, tell your doctor or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, blood problems (e.g., anemia, thrombocytopenia), heart problems.
Do not have immunizations/vaccinations without the consent of your doctor and avoid contact with people who have recently received oral polio vaccine.
To lower the chance of getting cut, bruised or injured, use caution with sharp objects like safety razors or nail cutters, and avoid activities such as contact sports.
Wash your hands well to prevent the spread of infections.
This drug may make you drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.
Limit alcoholic beverages as drinking alcohol may increase your chances of bleeding in your stomach or intestines.
Caution is advised when using this drug in the elderly because they may be more sensitive to its effects.
Caution is advised when using etoposide in children because they may be more sensitive to the allergic effects of this drug.
Etoposide should be used during pregnancy only when clearly needed. It may cause harm to an unborn baby. If you become pregnant or think you may be pregnant, inform your doctor immediately. Women of child-bearing age should use an effective form of birth control while using this medication. Discuss the use of birth control, the risks, the benefits and any other concerns about using this medication with your doctor.
This medication passes into breast milk. Because of the potential risk to the infant, breast-feeding while using etoposide is not recommended. Consult your doctor before breast-feeding.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.
Etoposide should not be used with the following medication because very serious interactions may occur: live vaccines.
Before starting etoposide, tell your doctor if you have received live vaccines or plan to get one.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: cyclosporine, glucosamine, levamisole, St John\'s wort.
Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin) that can increase your risk of bleeding. Low-dose aspirin should be continued if prescribed by your doctor for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day). Consult your doctor or pharmacist for more details.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

NOTES:
Do not share this medication with others.
Laboratory tests (e.g., complete blood cell counts, kidney function, liver function) should be performed periodically to monitor your progress and check for side effects. Consult your doctor for more details. Keep all scheduled medical appointments.

MISSED DOSE:
It is important that you receive etoposide as scheduled by your doctor. If you miss a dose, contact your doctor immediately to obtain a new dosing schedule.

STORAGE:
Different brands of this medication may have different storage requirements. Refer to the package labeling or ask your pharmacist for the storage requirements for the brand you are using.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).
Information last revised May 2012. Copyright(c) 2012 First Databank, Inc.