Cancer Home > Precautions and Warnings With Etoposide Injection

Bone marrow depression and infusion reactions are just some of the serious complications that may occur with etoposide injection treatment. Other precautions to be aware of include warnings of life-threatening side effects, dangerous drug interactions, or serious infections. There are also potential risks for people with certain allergies or women who are pregnant or nursing.

What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to receiving etoposide injection (Toposar®) 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:
  • Breastfeeding
  • 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 Injection Precautions and Warnings

Some warnings and precautions to be aware of prior to receiving this medication include the following:
  • Etoposide injection can cause significant and potentially life-threatening side effects. Therefore, it should only be given by a healthcare provider experienced in prescribing chemotherapy medicines.
  • Your healthcare provider will weigh the risks and benefits of using this medicine when recommending chemotherapy, and closely monitor you throughout treatment. If you experience potentially serious side effects, your healthcare provider may lower your dosage, recommend you skip a dose, or stop your treatment altogether.
  • Like other chemotherapy medicines, etoposide injection can cause significant bone marrow depression, which means it can affect the ability of the bone marrow to produce red blood cells, white blood cells, and platelets. This can lead to serious side effects, such as anemia, infections, and bleeding.
Your healthcare provider will monitor your blood cell counts closely during treatment using blood tests. 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. Make sure to immediately report any abnormal bleeding or bruising or signs of anemia or infection, such as:
    • A fever
    • Chills
    • Body aches and pains
    • Sore throat or cough
    • Fatigue and weakness
    • Shortness of breath
    • Pale skin.
  • Some people may experience an allergic-type reaction during or shortly after receiving their etoposide injection dose. 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:
    • Fever
    • Chills
    • A fast heart rate (tachycardia)
    • Wheezing, tightness in the chest, or shortness of breath
    • Low blood pressure (hypotension), which could cause dizziness or fainting.
  • Giving this medicine too quickly can cause a significant drop in blood pressure (hypotension). Therefore, you will receive your dose slowly, usually over 30 to 60 minutes. Let your healthcare provider know if you feel dizzy or faint during your infusion, as these can be signs of low blood pressure.
  • People with low levels of albumin (a protein made by the liver) may have a higher risk for certain etoposide injection side effects. Your healthcare provider will check your albumin levels before and during treatment.
  • If you have kidney or liver disease, your healthcare provider may give you a lower etoposide injection dose.
  • This medicine may potentially cause cancer. In rare cases, leukemia (a type of cancer of the blood cell) has been reported to occur in people receiving etoposide injection.
  • This medicine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Toposar and Breastfeeding).
  • Etoposide injection is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see Toposar and Pregnancy).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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