Etoposide is a chemotherapy drug and is also known by its brand name Etopophos or Vepesid. You might have it as a treatment for a number of different types of cancer.
How etoposide works
This chemotherapy drug destroys quickly dividing cells, such as cancer cells.
How you have etoposide
You usually have etoposide into your bloodstream (intravenously). Or you might have it has a capsule you take by mouth.
Into your bloodstream
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
- central line
- PICC line
If you don't have a central line
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you can have etoposide as capsules (Vepesid). You take these with a glass of water on an empty stomach.
Taking your capsules
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your specialist or advice line before you stop taking a cancer drug.
When you have etoposide
If you have etoposide into your bloodstream you usually have it as a course of several cycles of treatment.
When and how you have etoposide will depend on your cancer type. For example, you might take the capsules each day for 5 consecutive days. This happens every 3 to 4 weeks.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
Common side effects
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Bruising, bleeding gums or nosebleeds
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
Tiredness and weakness (fatigue)
Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
Feeling and being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Loss of apetitie
You might not feel like eating and may lose weight. It is important to eat as much as you can. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life-threatening alert your nurse or doctor if notice any of these symptoms
- an irregular heart beat (arrhythmia)
- a heart attack – you’ll be closely monitored when having this drug
- changes to your blood pressure – it may go up (hypertension) or drop (hypotension)
- mouth sores and ulcers
- dry and itchy skin
- inflammation around the drip site which can cause pain and swelling
- a second cancer called acute leukaemia
Rare side effects
This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
- a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening
- high temperature (fever)
- eyesight changes – such as temporary loss of site sight
- reddening of the skin in areas treated with radiotherapy
- numbness and tingling in your hands or feet
- taste changes
- difficulty swallowing
- breathing problems that can cause difficulty breathing and cough
- feeling sleepy
- seizures (fits)
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Loss of fertility
You may not be able to father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you want to have a baby in the future. You may be able to store sperm before starting treatment.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.