Etoposide (Etopophos ®, Vepesid ®)
This information should ideally be read with our general information about chemotherapy and the type of cancer you have.
You will be given etoposide in the chemotherapy day unit or during a stay in hospital. A chemotherapy nurse will give it to you. Etoposide can be given in combination with other chemotherapy drugs. During treatment, you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse. This is who we mean when we mention doctor or nurse in this information.
Before or on the day of treatment, a nurse or a person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that it is okay for you to have chemotherapy.
You will also see a doctor or nurse before you have chemotherapy. They will ask you how you have been feeling. If your blood results are alright on the day of your treatment, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Your nurse will give you anti-sickness drugs before you start. Etoposide is then given in one of the following ways:
- through a short thin tube the nurse puts into a vein in your arm or hand (cannula)
- through a fine tube that goes under the skin of your chest and into a nearby vein (central line)
- through a fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line)
- as capsules.
If you don’t have the drug as capsules, your nurse will give you etoposide as a drip (infusion) into your cannula or line. They usually run the drip through a pump, which gives you the treatment over a period of up to three and a half hours.
When the etoposide is being given
Some people might have side effects while they are having the chemotherapy.
Some people have an allergic reaction to etoposide. This can happen when it is given, or for up to an hour afterwards. You will be given drugs before the infusion to reduce the chance of a reaction happening. A reaction is usually mild but, rarely, it can be more severe. If you have a reaction, the nurses can usually treat this by slowing or stopping the drip. You will have the rest of your treatments given at a slower rate.
You will be monitored closely during treatment. Tell your nurse or doctor if you feel unwell or have any of the following symptoms:
- flu-like symptoms, such as headache, feeling flushed, having a fever, chills or dizziness
- red, warm and itchy bumps on the skin (like nettle rash)
- a feeling of swelling in the lips, tongue or throat
- breathlessness, wheezing, a cough or sudden difficulty breathing
- tight chest or chest pain.
The drug leaks outside the vein
If this happens when you’re having etoposide, it can damage the tissue around the vein. This is called extravasation. If you have any stinging, pain, redness or swelling around the vein, tell the nurse straight away. Extravasation is not common but, if it happens, it’s important that it’s dealt with quickly.
If you get any of these symptoms after you get home, contact the doctor or nurse straight away on the number they gave you.
Taking etoposide capsules
Take your etoposide capsules exactly as explained to you. This is important to make sure they work as well as possible for you.
Swallow the capsules whole on an empty stomach. If you are sick just after taking the capsules, contact the hospital. You may need to take another dose. If you forget to take a capsule, do not take a double dose. Keep to your regular schedule and let your doctor or nurse know.
Other things to remember about your capsules:
- Keep them in the original package at room temperature and away from heat and direct sunlight.
- Keep them safe and out of the reach of children.
- If your treatment is stopped, return any remaining capsules to the pharmacist.
Your course of chemotherapy
You have chemotherapy as a course of several sessions (or cycles) of treatment over a few months. This will depend on the type of cancer you have. Your doctor or nurse will tell you more about this and the number of cycles you are likely to have.
Possible side effects of etoposideBack to top
We explain the most common side effects of etoposide here. We don’t include all the rare ones that are unlikely to affect you.
You may get some of the side effects we mention, but you are very unlikely to get all of them. If you are having other chemotherapy drugs as well, you may have some side effects that we don’t list here. Always tell your doctor or nurse about any side effects you have.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as explained. This means they will be more likely to work better for you. Your nurse will give you advice about managing your side effects. After your treatment is over, the side effects will start to improve.
Serious and life-threatening side effects
Sometimes cancer drugs can result in very serious side effects which, rarely, may be life-threatening. Your cancer doctor and nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your phone or keep them somewhere safe.
More information about etoposide
We are unable to list every side effect for this treatment here, particularly the rarer ones. For more detailed information, you can visit the electronic Medicines Compendium (eMC).
Risk of infection
Etoposide can reduce the number of white blood cells in your blood. This will make you more likely to get an infection. When the number of white blood cells is low, it’s called neutropenia.
Contact the hospital straight away on the number you’ve been given if:
- your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your chemotherapy team
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection – these can include feeling shaky, a sore throat, a cough or needing to pass urine often.
The number of white blood cells usually increases steadily and returns to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cell numbers are still low, your doctor may delay your treatment for a short time.
Bruising and bleeding
This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. If you have any bruising or bleeding you can’t explain, tell your doctor. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets.
Anaemia (low number of red blood cells)
Etoposide can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. If you feel like this, tell your doctor or nurse. If you are very anaemic, you may need a drip to give you extra red blood cells (blood transfusion).
This may happen in the first few days after chemotherapy. Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It is easier to prevent sickness than to treat it after it has started.
If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti-sickness drug to one that works better for you.
Loss of appetite
You may lose your appetite during your treatment. Try to eat small meals regularly. Don’t worry if you don’t eat much for a day or two. If your appetite doesn’t improve after a few days, let your nurse or dietitian know. They can give you advice on getting more calories and protein in your diet. They may give you food supplements or meal replacement drinks to try. Your doctor can prescribe them. You can also buy them from chemists.
Your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. If you have diarrhoea, make sure you drink at least two litres (three and a half pints) of fluids every day.
Etoposide may make you constipated and cause tummy pain. Drinking at least two litres of fluids (three and a half pints) every day will help. Try to eat more foods that contain fibre such as fruit, vegetables and wholemeal bread. Also try to take some regular gentle exercise.
Feeling very tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it’s finished. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery. You might find our information about coping with extreme tiredness (fatigue) helpful.
Your mouth may become sore and you may get ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth and/or dentures in the morning, at night and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might ask you to rinse your mouth regularly or use mouthwashes. It is important to follow any advice you are given and to drink plenty of fluids.
If you have any problems with your mouth, tell your nurse or doctor. They can prescribe medicines to prevent or treat mouth infections and to reduce any soreness.
You usually lose all the hair on your head. Your eyelashes, eyebrows and other body hair may also thin or fall out. It is almost always temporary and your hair will grow back after chemotherapy ends. It is important to cover your head to protect your scalp when you are out in the sun until your hair grows back. Your nurse can give you advice about coping with hair loss. You might also find our information on coping with hair loss helpful.
Chemotherapy may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. Etoposide can cause a rash, which may be itchy. Your skin may darken. It will return to its normal colour after you finish treatment. If you’ve had radiotherapy (either recently or in the past), the area that was treated may become red or sore.
Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when your treatment finishes.
Numb or tingling hands or feet
These symptoms are caused by the effect of etoposide on the nerves. It is called peripheral neuropathy. You may find it hard to fasten buttons or do other fiddly tasks.
If you have these symptoms, always tell your doctor. They may be able to control them by lowering the dose of etoposide. The symptoms usually improve slowly after treatment finishes but, in some people, they may never go away. If you are worried about this, talk to your doctor.
Changes in the way the kidneys and liver work
Treatment can affect how your kidneys and liver work. This is usually mild and goes back to normal after treatment. You will have blood tests before chemotherapy to check how well your kidneys and liver are working.
Less common side effects of etoposideBack to top
Effects on the lungs
Etoposide can cause changes to the lungs. If you develop wheezing, a cough, fever or feel breathless, always tell your doctor. You should also let them know if any existing breathing problems get worse. If necessary, they can arrange for you to have tests to check your lungs.
Effects on the nervous system
Etoposide can affect the nervous system. You may feel anxious or restless, have problems sleeping or experience mood changes. Some people may feel drowsy or confused. If you notice any of these symptoms, tell your doctor or nurse straight away. It is important not to drive or operate machinery if you notice these effects.
Rarely, etoposide may affect your vision. If you have eye pain or notice any change in your vision, always tell your doctor or nurse.
Rarely, etoposide can increase the risk of developing a second cancer, usually leukaemia, years later. But the benefits of treatment usually far outweigh this risk. Your doctor can talk to you about this.
It is important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Other information about etoposideBack to top
Blood clot risk
Cancer increases the chances of a blood clot (thrombosis) and chemotherapy can add to this risk. A clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. If you have any of these symptoms, contact your doctor straight away. A blood clot is serious, but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can interact with chemotherapy or be harmful when you are having chemotherapy. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Etoposide can affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor before treatment starts.
Your doctor will advise you not to become pregnant or father a child during treatment. This is because the drugs may harm a developing baby. It is important to use contraception during chemotherapy and for six months after. You can talk to your doctor or nurse about this.
If you have sex within the first couple of days of having chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluid.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is chemotherapy in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Give them contact details for your cancer doctor.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having chemotherapy.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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