Precautions and Warnings With Etoposide
Using etoposide could increase your risk for potentially dangerous complications, such as low blood cell counts, infusion reactions, and potentially life-threatening side effects. Warnings like these should be reviewed with your healthcare provider before starting treatment. Other precautions for etoposide include being aware of possible risks for people taking certain medications, those who have certain allergies, and women who are pregnant or breastfeeding.
What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to using etoposide if you have:
- Kidney disease, such as kidney failure (renal failure)
- Liver disease, such as hepatitis, cirrhosis, or liver failure
- An infection of any kind
- Anemia (low red blood cells)
- Been told you have low albumin levels (hypoalbuminemia)
- Bone marrow problems
- Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Specific Etoposide Precautions and WarningsSome warnings and precautions to be aware of prior to using this drug include the following:
- This medicine can cause significant and potentially life-threatening side effects, and its use requires careful monitoring. It should only be given by a healthcare provider experienced in using chemotherapy medicines to treat cancer.
- Your healthcare provider will weigh the risks and benefits of using etoposide before recommending treatment. If you develop serious side effects, your healthcare provider may recommend a lower dose, give you a break in treatment, or stop treatment altogether.
- Etoposide can cause bone marrow depression, which occurs when the bone marrow is unable to make adequate amounts of red blood cells, white blood cells, and platelets. This can lead to serious problems, such as:
- Anemia due to low red blood cells
- Infections due to low white blood cells
- Bleeding due to low platelets.
- Your healthcare provider will monitor your blood cell counts using blood tests before you begin etoposide treatment and prior to each treatment cycle. If your blood cell counts become too low, you may need to miss doses until your blood cell counts return to normal. Make sure to immediately report any signs of anemia, infection, or bleeding, such as:
- Body aches and pains
- A sore throat
- Fatigue and weakness
- Shortness of breath
- Pale skin
- Abnormal bruising
- Blood in the stool or urine.
- Because you will be more susceptible to infections, you should avoid being in close contact with people who are sick or have an infection (such as a cold or the flu) while you are receiving this medicine.
- People receiving etoposide via an intravenous infusion (as a slow injection through a needle inserted into a vein) may experience an allergic-type reaction. This can occur while you are receiving your infusion or shortly after. If you experience such a reaction, your healthcare provider will stop your infusion and treat your symptoms if necessary. Let your healthcare provider know immediately if you experience signs of an infusion reaction, such as:
- A fast heart rate (tachycardia)
- Wheezing, tightness in the chest, or shortness of breath
- Low blood pressure (hypotension), which could cause dizziness or fainting.
- This medicine may cause certain types of cancer. There have been rare reports of leukemia (cancer of the blood cells) occurring in people treated with etoposide.
- People with low levels of albumin (a protein made by the body) may have an increased risk for etoposide side effects. Therefore, your healthcare will check your albumin levels using a blood test during treatment.
- People with kidney or liver disease are normally given lower doses of etoposide, especially at the beginning of treatment.
- Etoposide may react with a number of other medications (see Drug Interactions With Etoposide).
- Etoposide is a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy (see Etoposide and Pregnancy).
- Etoposide passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to using the drug (see Etoposide and Breastfeeding).