Your child needs to take the medicine called etoposide (say: e-toe-POE-side). This information sheet explains what etoposide does, how to give it, and what side effects or problems your child may have when they take this medicine.
What is etoposide?
Etoposide is a medicine used to kill cancer cells. It stops cancer cells from dividing and making new cells.
You may also hear etoposide called VP-16, or by its brand name VePesid. Etoposide comes in a capsule and injection forms. In some cases, the injection form may be given by mouth.
Before giving etoposide to your child
Tell your doctor if your child has reacted badly to etoposide or any other medication in the past.
Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- low blood cell counts
- infection or recent exposure to infections such as chickenpox
- liver or kidney problems
How should you give your child etoposide?
Etoposide is most often given into a vein (IV or intravenously). It is a clear liquid. Usually your child will get this medicine in the hospital clinic or the nursing unit.
Follow these instructions if you are giving your child etoposide by mouth:
- Etoposide is best given on an empty stomach but if your child has an upset stomach, you may give it with some food.
- If your child is getting liquid etoposide, ask your nurse or pharmacist to review how to prepare the dose. Liquid etoposide should be mixed with juice or pop.
- If you are giving etoposide by mouth once a day, give it at bedtime unless your child's doctor tells you otherwise.
- Do not give grapefruit or grapefruit juice while your child is taking etoposide.
What should you do if your child misses a dose of etoposide?
- Give the missed dose as soon as you remember.
- If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
- Do not give your child 2 doses to make up for 1 missed dose.
What are the possible side effects of etoposide?
Your child may have some of these side effects while they take etoposide. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:
- loss of appetite
- sores in the mouth and lips
- upset stomach or throwing up
- watery bowel movements (diarrhea)
- changes in how food tastes
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:
- unusual tiredness or weakness
- fever, chills
- cough or sore throat
- lower back or side pain
- trouble or pain while urinating
- severe upset stomach, throwing up, or diarrhea
- unusual bruising or bleeding
- blood in urine or stools
- black, tarry stools
- skin rash, itching, or pinpoint red spots on the skin
- shortness of breath, difficulty in breathing
- numbness or tingling of fingers or toes
If your child is getting etoposide by injection, watch for these signs of an allergic reaction while the drug is being given into a vein. Let the nurse know right away if any of these appear:
- skin redness or rash
- itching or swelling of the face
- coughing or shortness of breath
- fever or chills
- stuffy nose or sneezing
- chest pain or racing heart
What safety measures should you take when your child is using etoposide?
Etoposide can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:
- Avoid people with infections, such as a cold or the flu.
- Avoid places that are very crowded with large groups of people.
- Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
- You and your child should not touch your child's eyes or inside their nose without washing hands first.
- Your child's nurse will review with you what to do in case of fever.
Etoposide can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:
- Be careful not to cut your child when using a razor, fingernail scissors or toenail clippers.
- Be careful when shaving or waxing.
- Your child should avoid contact sports where bruising or injury could occur.
- Your child should not receive a permanent tattoo or any kind of body piercing.
- Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking etoposide.
Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) and chickenpox vaccine.
Your child may lose their hair. It will grow back when your child stops getting etoposide. The colour and feel of your child's hair may change when it grows back. Use a gentle shampoo and a soft brush on your child's hair.
Etoposide may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your child's nurse or pharmacist can tell you how to make this. Do not use store-bought mouthwash as it may sting and cause a dry mouth.
There is a chance that etoposide may cause secondary leukemia. Your doctor will discuss this in more detail with you and your child.
There is a chance that etoposide may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active it is recommended that they use some kind of birth control while receiving etoposide. Tell the doctor right away if your child may be pregnant.
After receiving etoposide your child may not be able to have children or have more difficulty having children. Your child's doctor will discuss this in more detail with you and your child.
After your child stops receiving etoposide, it may still cause side effects. These delayed effects may include certain types of cancer. Check with your doctor immediately if you notice any of the following effects even after etoposide treatment has stopped:
- yellow eyes or skin
- black tarry bowel movements
- blood in urine or stools
- lower back or side pain
- stomach pain
- cough or a hoarse voice
- unusual bleeding or bruising
- diarrhea
Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).
Your child will receive medicine to prevent upset stomach and throwing up caused by etoposide given by injection.
What other important information should you know about etoposide?
- Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
- Tell your doctor or dentist that your child is receiving etoposide before your child has any operation, even on the teeth, or an emergency treatment.
- Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
- Make sure you always have enough etoposide to last through weekends, holidays, and vacations. Call your pharmacy at least 2 days before your child runs out of medicine to order refills.
- Keep etoposide at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
Keep etoposide (vp-16) out of your child’s sight and reach and locked up in a safe place. If your child takes too much etoposide (vp-16), call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.
