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Precautions and Warnings With Etoposide Phosphate

People who receive chemotherapy treatment with etoposide phosphate should be aware of associated safety precautions, including warnings for people who have anemia, any type of infection, or bone marrow problems. People with medical issues such as these may have an increased risk for problems. Also, women who are pregnant or nursing may need to avoid this drug.

What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to receiving etoposide phosphate (Etopophos®) 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 cell count)
  • 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 Phosphate Precautions and Warnings

Some warnings and precautions to be aware of prior to using this medication include the following:
  • This medicine can cause significant and potentially life-threatening side effects. Therefore, it should only be given by a healthcare provider who is experienced in prescribing chemotherapy drugs.
  • Etoposide phosphate 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 start treatment and prior to each treatment cycle. If your blood cell counts become too low, your healthcare provider may delay your treatment to give your body more time to recover.
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 signs of anemia, infection, or bleeding, such as:
    • Fever
    • Chills
    • Body aches and pains
    • Sore throat or cough
    • Fatigue and weakness
    • Shortness of breath
    • Pale skin
    • Abnormal bruising
    • Blood in the stool or urine.
  • Etoposide phosphate may cause an allergic-type reaction, which 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:
    • Chills
    • Fever
    • A fast heart rate (tachycardia)
    • Wheezing, tightness in the chest, or shortness of breath
    • Low blood pressure (hypotension), which could cause dizziness or fainting.
  • 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.
  • Some people may develop a skin reaction at the site of their injection, especially if the medicine leaks from the vein into the surrounding tissue. Let your healthcare provider know immediately if you notice redness, pain, irritation, or swelling at your infusion site.
  • There is a small chance that you could develop certain types of cancer years after receiving etoposide phosphate. There have been rare reports of people developing leukemia (a type of cancer of the blood cells) after treatment.
  • People with low levels of albumin (a protein made by the liver) may have a higher risk for etoposide phosphate side effects. Your healthcare provider will check your albumin levels before and during treatment.
  • People with kidney or liver disease are generally given lower doses of this medicine, especially at the beginning of treatment.
  • Etoposide phosphate is likely to pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Etopophos and Breastfeeding).
  • Etoposide phosphate is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see Etopophos and Pregnancy).
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Etoposide Phosphate Drug Information

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