Medical Editor: John P. Cunha, DO, FACOEP
What Is Vepesid?
VePesid (etoposide) also commonly known as VP-16 is a cancer (antineoplastic) medication used alone or in combination with other chemotherapies to treat cancer of the testicles or lung or other types of cancer. Generic forms of VePesid may be available.
What Are Side Effects of Vepesid?
Common side effects of VePesid include:
- nausea
- vomiting
- loss of appetite
- stomach pain
- diarrhea
- fatigue
- temporary hair loss
- constipation
- trouble swallowing
- unusual or unpleasant taste in your mouth
- numbness or tingly feeling
- mild itching, or
- skin rash.
Dosage for Vepesid
The recommended dosage of VePesid is one capsule usually taken once a day for 4 or 5 days in a row. This cycle may be repeated once every 3 to 4 weeks. Do not break or open an etoposide capsule. The medicine from a broken capsule can be dangerous if it gets in your eyes mouth or nose or on your skin.
What Drugs, Substances, or Supplements Interact with Vepesid?
VePesid may interact with cyclosporine (Neoral Sandimmune Gengraf). Tell your doctor all medications you use.
Vepesid During Pregnancy or Breastfeeding
Tell your doctor if you become pregnant during treatment. Males and females using this drug should use birth control (e.g. birth control pills condoms) during treatment; consult your doctor. It is unknown if this medication passes into breast milk. It may have undesirable effects on a nursing infant. Breastfeeding while using VePesid is not recommended.
Additional Information
Our VePesid (etoposide) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
SLIDESHOW
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Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Call your doctor at once if you have:
- sudden chest pain or discomfort, wheezing, dry cough or hack;
- easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
- vision problems;
- seizure (convulsions);
- liver problems--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or
- low white blood cell counts--fever, mouth sores, skin sores, sore throat, cough, trouble breathing.
Common side effects may include:
- sores or white patches in or around your mouth, trouble swallowing or talking, dry mouth, bad breath, altered sense of taste;
- nausea, vomiting; or
- temporary hair loss.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
SIDE EFFECTS
The following data on adverse reactions are based on both oral and intravenous administration of VePesid (etoposide) as a single agent, using several different dose schedules for treatment of a wide variety of malignancies.
Hematologic Toxicity
Myelosuppression is dose related and dose limiting, with granulocyte nadirs occurring 7 to 14 days after drug administration and platelet nadirs occurring 9 to 16 days after drug administration. Bone marrow recovery is usually complete by day 20, and no cumulative toxicity has been reported. Fever and infection have also been reported in patients with neutropenia. Death associated with myelosuppression has been reported.
The occurrence of acute leukemia with or without a preleukemic phase has been reported rarely in patients treated with VePesid (etoposide) in association with other antineoplastic agents. (See WARNINGS.)
Gastrointestinal Toxicity
Nausea and vomiting are the major gastrointestinal toxicities. The severity of such nausea and vomiting is generally mild to moderate with treatment discontinuation required in 1% of patients. Nausea and vomiting can usually be controlled with standard antiemetic therapy. Mild to severe mucositis/esophagitis may occur. Gastrointestinal toxicities are slightly more frequent after oral administration than after intravenous infusion.
Allergic Reactions
Anaphylactic-like reactions characterized by chills, fever, tachycardia, bronchospasm, dyspnea, and/or hypotension have been reported to occur in 0.7% to 2% of patients receiving intravenous VePesid (etoposide) and in less than 1% of the patients treated with the oral capsules. These reactions have usually responded promptly to the cessation of the infusion and administration of pressor agents, corticosteroids, antihistamines, or volume expanders as appropriate; however, the reactions can be fatal. Hypertension and/or flushing have also been reported. Blood pressure usually normalizes within a few hours after cessation of the infusion. Anaphylactic-like reactions have occurred during the initial infusion of VePesid (etoposide) .
Facial/tongue swelling, coughing, diaphoresis, cyanosis, tightness in throat, laryngospasm, back pain, and/or loss of consciousness have sometimes occurred in association with the above reactions. In addition, an apparent hypersensitivity-associated apnea has been reported rarely.
Rash, urticaria, and/or pruritus have infrequently been reported at recommended doses. At investigational doses, a generalized pruritic erythematous maculopapular rash, consistent with perivasculitis, has been reported.
Alopecia
Reversible alopecia, sometimes progressing to total baldness, was observed in up to 66% of patients.
Other Toxicities
The following adverse reactions have been infrequently reported: abdominal pain, aftertaste, constipation, dysphagia, asthenia, fatigue, malaise, somnolence, transient cortical blindness, optic neuritis, interstitial pneumonitis/pulmonary fibrosis, fever, seizure (occasionally associated with allergic reactions), Stevens-Johnson syndrome, and toxic epidermal necrolysis, pigmentation, and a single report of radiation recall dermatitis.
Hepatic toxicity, generally in patients receiving higher doses of the drug than those recommended, has been reported with VePesid (etoposide) . Metabolic acidosis has also been reported in patients receiving higher doses.
The incidences of adverse reactions in the table that follows are derived from multiple data bases from studies in 2,081 patients when VePesid (etoposide) was used either orally or by injection as a single agent.
| ADVERSE DRUG EFFECT | PERCENT RANGE OF REPORTED INCIDENCE |
| Hematologic toxicity | |
| Leukopenia (less than 1,000 WBC/mm3) | 3-17 |
| Leukopenia (less than 4,000 WBC/mm3) | 60-91 |
| Thrombocytopenia (less than 50,000 platelets/mm3) | 1-20 |
| Thrombocytopenia (less than 100,000 platelets/mm3) | 22-41 |
| Anemia | 0-33 |
| Gastrointestinal toxicity | |
| Nausea and vomiting | 31-43 |
| Abdominal pain | 0-2 |
| Anorexia | 10-13 |
| Diarrhea | 1-13 |
| Stomatitis | 1-6 |
| Hepatic | 0-3 |
| Alopecia | 8-66 |
| Peripheral neurotoxicity | 1-2 |
| Hypotension | 1-2 |
| Allergic reaction | 1-2 |
Read the entire FDA prescribing information for Vepesid (Etoposide)
© Vepesid Patient Information is supplied by Cerner Multum, Inc. and Vepesid Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.
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