Etoposide
Pronunciation: (ee-TOE-poe-side).
- Generic name
- etoposide
- Drug class
- Cancer & Oncology
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What etoposide is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how etoposide works
Etoposide is a semisynthetic derivative of podophyllotoxin that inhibits the enzyme topoisomerase II. By stabilizing the DNA-topoisomerase II complex, it prevents religation of DNA strands, resulting in DNA breaks and inhibition of cell division. This leads to apoptosis in rapidly dividing cancer cells. (1)
What etoposide is used for
Refractory testicular tumors (FDA-approved, combination therapy)
FDA-labeled indication: combination therapy with other chemotherapeutic agents in patients who have already received appropriate surgical, chemotherapeutic, and radiotherapeutic treatment. (2)
Small cell lung cancer (FDA-approved, combination therapy, first-line)
FDA-labeled indication: combination therapy with other approved chemotherapeutic agents as first-line treatment. (2)
Non-Hodgkin lymphoma (off-label, guideline-based combination use)
Not an FDA-labeled indication for this product; used off-label within combination chemotherapy regimens based on oncology treatment guidelines. (2)
Acute myeloid leukemia (off-label, guideline-based combination use)
Not an FDA-labeled indication for this product; used off-label within combination chemotherapy regimens based on oncology treatment guidelines. (2)
Choriocarcinoma (off-label, guideline-based combination use)
Not an FDA-labeled indication for this product; used off-label within combination chemotherapy regimens based on oncology treatment guidelines. (2)
Before taking etoposide
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to etoposide, severe hepatic impairment, or severe bone marrow suppression. (Contraindication) (2)
- Pregnancy and breastfeeding are contraindications. (Contraindication) (2)
Tell your clinician about
(2)How to take etoposide
- General Instructions: Etoposide dosing and schedule depend on the type of cancer, your body size, and other medications you may be taking. Always follow your oncologist's instructions.. Adult Dosing: Typical adult doses range from 50–100 mg/m²/day for 5 days, repeated every 3–4 weeks. Dosing may be adjusted based on blood counts and organ function.. Pediatric Dosing: Pediatric dosing is individualized based on body surface area and specific cancer protocols. Close monitoring is required.. Administration: Etoposide may be given as an intravenous infusion over 30–60 minutes or taken orally as capsules. Take oral doses on an empty stomach, unless directed otherwise.. When To Stop: Do not stop or skip doses unless instructed by your healthcare provider. Treatment may be paused or stopped if you develop severe side effects or blood count abnormalities.. Storage: Store capsules at room temperature away from moisture and heat. Keep out of reach of children. Follow hospital guidelines for IV preparation and storage.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, contact your healthcare provider immediately for instructions. Do not take an extra dose without medical advice.
Overdose
In case of overdose, seek emergency medical attention or call your local poison control center. Symptoms may include severe bone marrow suppression, infection, or organ toxicity. Supportive care and monitoring are essential. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Myelosuppression
Incidence: Reported in the clinician-authored database; frequency not established
Nausea and vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Alopecia
Incidence: Reported in the clinician-authored database; frequency not established
Anorexia
Incidence: Reported in the clinician-authored database; frequency not established
Peripheral neuropathy
Incidence: Reported in the clinician-authored database; frequency not established
Hypotension
Incidence: Reported in the clinician-authored database; frequency not established
Anaphylaxis
Incidence: Reported in the clinician-authored database; frequency not established
Secondary leukemia
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
BOXED WARNING — serious
Symptoms: BOXED WARNING: Etoposide must be given under the supervision of a physician experienced in the use of cancer chemotherapeutic agents. Severe bone marrow suppression (myelosuppression) with resulting infection or bleeding may occur, and myelosuppression resulting in death has been reported. Complete blood counts must be monitored before each treatment cycle and at appropriate intervals during and after therapy.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Etoposide can cause severe bone marrow suppression, increasing the risk of infection and bleeding — serious
Symptoms: Etoposide can cause severe bone marrow suppression, increasing the risk of infection and bleeding. May cause fetal harm if used during pregnancy (Pregnancy Category D). Use with caution in patients with liver or kidney impairment. Monitor for signs of allergic reactions during infusion. Secondary malignancies (such as leukemia) have been reported with long-term use.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
The formally labeled contraindication is prior hypersensitivity to etoposide or any component of the formulation — serious
Symptoms: The formally labeled contraindication is prior hypersensitivity to etoposide or any component of the formulation. Severe hepatic impairment, severe bone marrow suppression, active infection, and prior radiation/chemotherapy are major precautions requiring extreme caution and individualized dose modification by the treating oncologist, rather than absolute contraindications on the same footing as hypersensitivity. Pregnancy and breastfeeding should be avoided given the fetal-harm and unknown breast-milk-excretion risk.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Cyclosporine A (high-dose) | At cyclosporine concentrations above 2,000 ng/mL, etoposide exposure has been reported to increase by roughly 80% with clearance reduced by roughly 38%, increasing the risk of etoposide toxicity. Close monitoring is needed when these are combined. | (2) |
| CYP3A4 inhibitors or inducers | Etoposide is metabolized in part via CYP3A4 (O-demethylation); CYP3A4 inhibitors or inducers can raise or lower etoposide levels. Always inform your healthcare provider of all medications and supplements you are taking. | (1) |
| Protein-binding displacers (phenylbutazone, sodium salicylate, aspirin) | These agents can displace protein-bound etoposide, potentially increasing free-drug exposure and toxicity risk. | (2) |
| Other chemotherapy agents, immunosuppressants, anticoagulants (such as warfarin), and phenytoin | Etoposide may interact with other chemotherapy agents, immunosuppressants, anticoagulants (such as warfarin), and phenytoin. Always inform your healthcare provider of all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Pregnancy Category D. Etoposide is teratogenic in animal studies, causing skeletal abnormalities and CNS defects, and pregnancy is a contraindication per the clinician record. Women of childbearing potential should use effective contraception during treatment and for a period afterward; discuss family planning with the treating oncologist before starting treatment. (2)
Breastfeeding
It is not known whether etoposide is excreted into breast milk. Because of the potential for serious adverse reactions in a nursing infant, a decision should be made with the treating oncologist to discontinue either nursing or the drug. (2)
Children
Frequency: Not recommended for pediatric use.. Weight Based: Not established for pediatric use.. Max Daily Dose: Not recommended for pediatric use.. Max Single Dose: Not recommended for pediatric use.. Age Restrictions: Safety not established in children. (2)
Renal_impairment
Renal impairment: creatinine clearance above 50 mL/min uses 100% of the standard dose; 15-50 mL/min uses about 75% of the standard dose; below 15 mL/min a further dose reduction is recommended by the treating oncologist. Hepatic impairment: no specific dose-adjustment table was found in the sources reviewed; severe hepatic impairment requires extreme caution and individualized dosing by the treating oncologist rather than a standard dose. (2)
Hepatic_impairment
Renal impairment: creatinine clearance above 50 mL/min uses 100% of the standard dose; 15-50 mL/min uses about 75% of the standard dose; below 15 mL/min a further dose reduction is recommended by the treating oncologist. Hepatic impairment: no specific dose-adjustment table was found in the sources reviewed; severe hepatic impairment requires extreme caution and individualized dosing by the treating oncologist rather than a standard dose. (2)
Monitoring
(2)Storage
IV formulation: unopened vials are stable for 24 months at room temperature (25°C); once diluted, solutions are stable for 96 hours at 0.2 mg/mL or 24 hours at 0.4 mg/mL at 25°C under fluorescent light — follow hospital/pharmacy protocols for IV preparation and storage. Oral capsules: store at room temperature away from moisture and heat. Keep out of reach of children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Refractory testicular tumors (FDA-labeled, combination therapy)
Dose summary: 50-100 mg/m²/day IV on days 1-5, or 100 mg/m²/day IV on days 1, 3, and 5; repeated every 3-4 weeks after recovery from toxicity, infused over 30-60 minutes.
Renal context: Creatinine clearance >50 mL/min: 100% of dose. CrCl 15-50 mL/min: 75% of dose. CrCl <15 mL/min: further dose reduction, individualized by the treating oncologist. (1) (2)
General
Indication: Small cell lung cancer (FDA-labeled, first-line combination therapy)
Dose summary: 35 mg/m²/day IV for 4 days, or 50 mg/m²/day IV for 5 days; repeated every 3-4 weeks after recovery from toxicity.
Renal context: Creatinine clearance >50 mL/min: 100% of dose. CrCl 15-50 mL/min: 75% of dose. CrCl <15 mL/min: further dose reduction, individualized by the treating oncologist. (2)
Frequently asked questions
What types of cancer is etoposide used to treat?
Etoposide is commonly used to treat small cell lung cancer, testicular cancer, lymphomas, acute myeloid leukemia, and other solid tumors. It is often part of combination chemotherapy regimens.
How is etoposide administered?
Etoposide can be given as an intravenous infusion in a hospital or clinic, or taken orally as capsules. The route and schedule depend on your specific cancer and treatment plan.
What should I do if I experience severe side effects?
Contact your healthcare provider immediately if you experience severe side effects such as fever, chills, unusual bleeding, severe nausea, or signs of an allergic reaction.
Can I take etoposide during pregnancy or breastfeeding?
Etoposide should not be used during pregnancy or breastfeeding due to the risk of harm to the baby. Discuss contraception and family planning with your doctor before starting treatment.
Are there foods or medications I should avoid while taking etoposide?
Avoid grapefruit and grapefruit juice, and inform your doctor about all other medications and supplements you take, as drug interactions are possible.
How will my doctor monitor me during etoposide treatment?
Your doctor will regularly check your blood counts, liver and kidney function, and monitor for side effects. Dose adjustments may be made based on these results.
Is hair loss from etoposide permanent?
Hair loss caused by etoposide is usually temporary. Hair typically regrows after treatment ends.
What happens if I take too much Etoposide?
Taking too much Etoposide can lead to severe side effects, including profound myelosuppression (low blood cell counts), increased risk of infection, bleeding, and other systemic toxicities. If an overdose is suspected, it is crucial to seek immediate emergency medical attention. Healthcare providers will manage symptoms and provide supportive care.
Can I drink alcohol while taking Etoposide?
It is generally recommended to avoid alcohol while taking Etoposide. Alcohol can exacerbate certain side effects of chemotherapy, such as nausea, vomiting, and liver toxicity. Additionally, alcohol can weaken the immune system, which is already compromised by Etoposide, increasing the risk of infections. Always consult your healthcare provider for personalized advice.
Is Etoposide safe during pregnancy?
Etoposide is generally not recommended during pregnancy due to its potential to cause harm to the developing fetus. It falls into a pregnancy category that indicates a risk of fetal abnormalities. Women of childbearing potential should use effective contraception during treatment and for a period afterward. Always consult your doctor to discuss the risks and benefits if you are pregnant or planning to become pregnant.
What is the mechanism of action of etoposide?
Etoposide is a semisynthetic derivative of podophyllotoxin that inhibits the enzyme topoisomerase II. By stabilizing the DNA-topoisomerase II complex, it prevents religation of DNA strands, resulting in DNA breaks and inhibition of cell division. This leads to apoptosis in rapidly dividing cancer cells. (1)
What is the generic name of Etoposide?
The generic name is etoposide.
What class of drug is etoposide?
Etoposide is classed as: Cancer & Oncology.
References
- Etoposide — MedGuideGlobal clinician-authored medicine recordMedGuideGlobal (internal clinician database) · Not applicable (global professional resource) · accessed 2026-08-06 · source 1
- Etoposide Injection, USP — prescribing informationU.S. Food and Drug Administration · United States · accessed 2026-08-06 · source 2
- Etoposide — FDA approval record (Drugs@FDA ANDA074529)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 3
- etoposide — RxNorm normalized drug concept (RXCUI 24614)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 4
Brand names by country
Single-ingredient etoposide names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Avopef500 mg/25mL, 100 mg/5mL · avyxa pharma, llc
- ETOPOPHOS100 mg · h2-pharma, llc
- VePesid50 mg · amneal pharmaceuticals ny llc
Canada
- VEPESID