Etoposide Phosphate – Uses, Dosage, Side Effects, Interactions

Etoposide Phosphate is a phosphate salt of a semisynthetic derivative of podophyllotoxin. Etoposide binds to the enzyme topoisomerase II, inducing double-strand DNA breaks, inhibiting DNA repair, and resulting in decreased DNA synthesis and tumor cell proliferation. Cells in the S and G2 phases of the cell cycle are most sensitive to this agent. (NCI04)

A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double-stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle.

Mechanism of action

Etoposide inhibits DNA topoisomerase II, thereby inhibiting DNA re-ligation. This causes critical errors in DNA synthesis at the premitotic stage of cell division and can lead to apoptosis of the cancer cell. Etoposide is cell cycle-dependent and phase-specific, affecting mainly the S and G2 phases of cell division. Inhibition of the topoisomerase II alpha isoform results in the anti-tumor activity of etoposide. The drug is also capable of inhibiting the beta isoform but inhibition of this target is not associated with the anti-tumor activity. It is instead associated with the carcinogenic effect.

Etoposide is an antineoplastic agent and an epipodophyllotoxin (a semisynthetic derivative of the podophyllotoxins). It inhibits DNA topoisomerase II, thereby ultimately inhibiting DNA synthesis. Etoposide is cell cycle-dependent and phase-specific, affecting mainly the S and G2 phases. Two different dose-dependent responses are seen. At high concentrations (10 µg/mL or more), lysis of cells entering mitosis is observed. At low concentrations (0.3 to 10 µg/mL), cells are inhibited from entering prophase. It does not interfere with microtubular assembly. The predominant macromolecular effect of etoposide appears to be the induction of DNA strand breaks by an interaction with DNA-topoisomerase II or the formation of free radicals.

Indications

• For use in combination with other chemotherapeutic agents in the treatment of refractory testicular tumors and as first-line treatment in patients with small cell lung cancer. Also used to treat other malignancies such as lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme.
• Acute Lymphoblastic Leukemia (ALL)
• Acute Myeloid Leukemia (AML)
• Advanced Hodgkin’s Lymphoma
• Ewing’s Sarcoma
• Gestational Trophoblastic Disease
• Merkel cell cancer
• Multiple Myeloma (MM)
• Neuroblastoma (NB)
• Neuroendocrine Tumors
• Non-Hodgkin’s Lymphoma (NHL)
• Non-Small Cell Lung Carcinoma (NSCLC)
• Ovarian Cancer
• Prostate Cancer
• Retinoblastoma
• Sarcoma, Osteogenic
• Small Cell Lung Cancer (SCLC)
• Wilms’ tumor
• Locally advanced Thymoma
• Metastatic Thymic Cancer
• Refractory Sarcoma
• Refractory Testicular cancer

Use in Cancer

Etoposide phosphate is approved to be used with other drugs to treat:

• Small cell lung cancer. It is used with cisplatin as first-line therapy.
• Testicular cancer. It is used in patients who have already been treated with surgery, radiation therapy, or other chemotherapy and have not gotten better.

Etoposide phosphate is also available in a different form called etoposide.

Contraindications

The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:

• a bad infection
• low amount of albumin proteins in the blood
• excess body acid
• decreased function of bone marrow
• anemia
• decreased blood platelets
• a significant decrease in certain blood clotting cells called platelets
• low levels of white blood cells
• low levels of a type of white blood cell called neutrophils
• bleeding
• a type of inflammation of the lung called interstitial pneumonitis
• a condition where there is formation of fibrous tissue in the lung called pulmonary fibrosis
• damage to the liver and inflammation
• pregnancy
• a patient who is producing milk and breastfeeding
• moderate to severe kidney impairment
• a significant drop in a certain type of white blood cell called a neutrophil

Dosage

Strengths: 20 mg/mL; 50 mg

Testicular Cancer

In combination with other approved chemotherapeutic agents:

• 50 to 100 mg/m2 IV over 30 to 60 minutes once a day on days 1 through 5 every 3 to 4 weeks to 100 mg/m2 IV over 30 to 60 minutes once a day on days 1, 3, and 5 every 3 to 4 weeks
  

Small Cell Lung Cancer

IV:
In combination with other approved chemotherapeutic agents:

• 35 mg/m2 IV over 30 to 60 minutes once a day for 4 days to 50 mg/m2 IV over 30 to 60 minutes once a day for 5 days every 3 to 4 weeks
  

In combination with other approved chemotherapeutic agents:

• The recommended dose is 2 times the IV dose rounded to the nearest 50 mg (i.e., 2 times 35 mg/m2 IV once a day for 4 days to 50 mg/m2 IV once a day for 5 days equaling 70 mg/m2 orally once a day for 4 days to 100 mg/m2 orally once a day for 5 days)

Side Effects

The Most Common

• swelling, pain, redness, or burning at the injection site
• pain, burning, irritation, or skin changes where the injection was given;
• severe nausea and vomiting;
• easy bruising, unusual bleeding, purple or red spots under your skin; or
• low white blood cell counts–fever, mouth sores, skin sores, sore throat, cough, trouble breathing.
• nausea
• vomiting
• sores in the mouth and throat
• stomach pain
• diarrhea
• constipation
• loss of appetite or weight
• unusual tiredness or weakness
• pale skin
• fainting
• dizziness
• hair loss
• pain, burning, or tingling in the hands or feet
• eye pain
• rash
• hives
• itching
• difficulty breathing or swallowing
• fast, irregular, or pounding heartbeat
• seizures
• yellowing of the skin or eyes

More Common

• Nausea (interferes with the ability to eat and is unrelieved with prescribed medication)
• Vomiting (vomiting more than 4-5 times in a 24-hour period)
• Diarrhea (4-6 episodes in a 24-hour period)
• Unusual bleeding or bruising
• Black or tarry stools, or blood in your stools or urine
• Extreme fatigue (unable to carry on self-care activities)
• Mouth sores (painful redness, swelling or ulcers)
• Swelling, redness, and/or pain in one leg or arm and not the other
• Numbness or tingling in your fingers or toes
• Yellowing of the skin or eyes
• Pain, redness or swelling at the IV site

Rare

• pain, burning, irritation, or skin changes where the injection was given;
• severe nausea and vomiting;
• easy bruising, unusual bleeding, purple or red spots under your skin; or
• low white blood cell counts–fever, mouth sores, skin sores, sore throat, cough, trouble breathing.
• nausea, vomiting;
• constipation;
• fever;
• trouble swallowing; or
• unusual or unpleasant taste in the mouth.

Drug Interactions

DRUG	INTERACTION
Abametapir	The serum concentration of Etoposide can be increased when it is combined with Abametapir.
Abatacept	The metabolism of Etoposide can be increased when combined with Abatacept.
Abciximab	The risk or severity of bleeding can be increased when Abciximab is combined with Etoposide.
Abemaciclib	Abemaciclib may decrease the excretion rate of Etoposide which could result in a higher serum level.
Abiraterone	The serum concentration of Etoposide can be increased when it is combined with Abiraterone.
Abrocitinib	The serum concentration of Etoposide can be increased when it is combined with Abrocitinib.
Acalabrutinib	The metabolism of Etoposide can be decreased when combined with Acalabrutinib.
Acenocoumarol	The therapeutic efficacy of Acenocoumarol can be increased when used in combination with Etoposide.
Acetaminophen	The metabolism of Etoposide can be increased when combined with Acetaminophen.
Acetazolamide	The metabolism of Etoposide can be decreased when combined with Acetazolamide.
Acetyldigitoxin	Acetyldigitoxin may decrease the cardiotoxic activities of Etoposide.
Acetylsalicylic acid	The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Etoposide.
Acyclovir	The metabolism of Acyclovir can be decreased when combined with Etoposide.
Adalimumab	The metabolism of Etoposide can be increased when combined with Adalimumab.
Adenine	The metabolism of Etoposide can be decreased when combined with Adenine.
Adenovirus type 7 vaccine live	The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Etoposide.
Afatinib	The serum concentration of Etoposide can be increased when it is combined with Afatinib.
Agomelatine	The metabolism of Agomelatine can be decreased when combined with Etoposide.
Albendazole	The metabolism of Etoposide can be increased when combined with Albendazole.
Aldesleukin	The metabolism of Etoposide can be decreased when combined with Aldesleukin.
Alectinib	Alectinib may decrease the excretion rate of Etoposide which could result in a higher serum level.
Alefacept	The risk or severity of adverse effects can be increased when Alefacept is combined with Etoposide.
Alemtuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Etoposide.
Alfentanil	The metabolism of Etoposide can be decreased when combined with Alfentanil.
Alfuzosin	The metabolism of Alfuzosin can be decreased when combined with Etoposide.
Allogeneic processed thymus tissue	The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Etoposide.
Allopurinol	The risk or severity of adverse effects can be increased when Allopurinol is combined with Etoposide.
Alosetron	The metabolism of Etoposide can be decreased when combined with Alosetron.
Alpelisib	The metabolism of Etoposide can be increased when combined with Alpelisib.
Alprazolam	The metabolism of Alprazolam can be decreased when combined with Etoposide.
Alteplase	The risk or severity of bleeding can be increased when Alteplase is combined with Etoposide.
Altretamine	The risk or severity of adverse effects can be increased when Altretamine is combined with Etoposide.
Ambrisentan	The metabolism of Etoposide can be decreased when combined with Ambrisentan.
Aminoglutethimide	The metabolism of Etoposide can be increased when combined with Aminoglutethimide.
Aminophenazone	The metabolism of Aminophenazone can be decreased when combined with Etoposide.
Aminophylline	The metabolism of Aminophylline can be decreased when combined with Etoposide.
Amiodarone	The metabolism of Etoposide can be decreased when combined with Amiodarone.
Amitriptyline	The metabolism of Etoposide can be decreased when combined with Amitriptyline.
Amobarbital	The metabolism of Etoposide can be increased when combined with Amobarbital.
Amprenavir	The metabolism of Etoposide can be decreased when combined with Amprenavir.
Amsacrine	The risk or severity of adverse effects can be increased when Amsacrine is combined with Etoposide.
Anagrelide	The metabolism of Etoposide can be decreased when combined with Anagrelide.
Anakinra	The metabolism of Etoposide can be increased when combined with Anakinra.
Anastrozole	The risk or severity of cardiotoxicity can be increased when Etoposide is combined with Anastrozole.
Ancrod	The risk or severity of bleeding can be increased when Ancrod is combined with Etoposide.
Anifrolumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Anifrolumab.
Anistreplase	The risk or severity of bleeding can be increased when Anistreplase is combined with Etoposide.
Anthrax immune globulin human	The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Etoposide.
Anthrax vaccine	The risk or severity of infection can be increased when Anthrax vaccine is combined with Etoposide.
Antilymphocyte immunoglobulin (horse)	The risk or severity of adverse effects can be increased when Etoposide is combined with Antilymphocyte immunoglobulin (horse).
Antipyrine	The metabolism of Antipyrine can be decreased when combined with Etoposide.
Antithrombin Alfa	The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Etoposide.
Antithrombin III human	The risk or severity of bleeding can be increased when Antithrombin III human is combined with Etoposide.
Antithymocyte immunoglobulin (rabbit)	The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Etoposide.
Apalutamide	The serum concentration of Etoposide can be decreased when it is combined with Apalutamide.
Apixaban	The metabolism of Etoposide can be decreased when combined with Apixaban.
Apomorphine	The metabolism of Etoposide can be decreased when combined with Apomorphine.
Apremilast	The metabolism of Etoposide can be increased when combined with Apremilast.
Aprepitant	The metabolism of Etoposide can be decreased when combined with Aprepitant.
Ardeparin	The risk or severity of bleeding can be increased when Ardeparin is combined with Etoposide.
Argatroban	The risk or severity of bleeding can be increased when Argatroban is combined with Etoposide.
Aripiprazole	The metabolism of Aripiprazole can be increased when combined with Etoposide.
Aripiprazole lauroxil	The metabolism of Aripiprazole lauroxil can be increased when combined with Etoposide.
Armodafinil	The metabolism of Etoposide can be increased when combined with Armodafinil.
Arsenic trioxide	The serum concentration of Etoposide can be increased when it is combined with Arsenic trioxide.
Artemether	The metabolism of Etoposide can be decreased when combined with Artemether.
Articaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Articaine.
Asciminib	The serum concentration of Etoposide can be increased when it is combined with Asciminib.
Asenapine	The metabolism of Asenapine can be decreased when combined with Etoposide.
Astemizole	The metabolism of Etoposide can be decreased when combined with Astemizole.
AstraZeneca COVID-19 Vaccine	The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Etoposide.
Asunaprevir	The serum concentration of Etoposide can be increased when it is combined with Asunaprevir.
Atazanavir	The metabolism of Etoposide can be decreased when combined with Atazanavir.
Atorvastatin	The metabolism of Atorvastatin can be decreased when combined with Etoposide.
Atovaquone	The serum concentration of Etoposide can be increased when it is combined with Atovaquone.
Avacopan	The metabolism of Etoposide can be decreased when combined with Avacopan.
Avanafil	Avanafil may decrease the excretion rate of Etoposide which could result in a higher serum level.
Avatrombopag	Avatrombopag may decrease the excretion rate of Etoposide which could result in a higher serum level.
Axitinib	The metabolism of Axitinib can be decreased when combined with Etoposide.
Azacitidine	The risk or severity of adverse effects can be increased when Etoposide is combined with Azacitidine.
Azathioprine	The risk or severity of adverse effects can be increased when Etoposide is combined with Azathioprine.
Azelastine	The metabolism of Etoposide can be decreased when combined with Azelastine.
Azithromycin	The metabolism of Etoposide can be decreased when combined with Azithromycin.
Bacillus calmette-guerin substrain connaught live antigen	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Etoposide.
Bacillus calmette-guerin substrain russian BCG-I live antigen	The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Etoposide.
Bacillus calmette-guerin substrain tice live antigen	The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Etoposide.
Baricitinib	The risk or severity of adverse effects can be increased when Etoposide is combined with Baricitinib.
Basiliximab	The risk or severity of adverse effects can be increased when Basiliximab is combined with Etoposide.
BCG vaccine	The risk or severity of infection can be increased when BCG vaccine is combined with Etoposide.
Beclomethasone dipropionate	The metabolism of Etoposide can be increased when combined with Beclomethasone dipropionate.
Belantamab mafodotin	The serum concentration of Etoposide can be increased when it is combined with Belantamab mafodotin.
Belatacept	The risk or severity of adverse effects can be increased when Etoposide is combined with Belatacept.
Belimumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Belimumab.
Belinostat	The risk or severity of adverse effects can be increased when Etoposide is combined with Belinostat.
Belumosudil	The serum concentration of Etoposide can be increased when it is combined with Belumosudil.
Belzutifan	The serum concentration of Etoposide can be decreased when it is combined with Belzutifan.
Bemiparin	The risk or severity of bleeding can be increased when Bemiparin is combined with Etoposide.
Bendamustine	The risk or severity of adverse effects can be increased when Etoposide is combined with Bendamustine.
Bendroflumethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Etoposide.
Benzocaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Benzocaine.

Brigatinib	Brigatinib may decrease the excretion rate of Etoposide which could result in a higher serum level.
Brodalumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Brodalumab.
Bromazepam	The metabolism of Bromazepam can be decreased when combined with Etoposide.
Bromotheophylline	The metabolism of Bromotheophylline can be decreased when combined with Etoposide.
Budesonide	The metabolism of Etoposide can be increased when combined with Budesonide.
Bupivacaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Bupivacaine.
Buprenorphine	The metabolism of Etoposide can be decreased when combined with Buprenorphine.
Buspirone	The metabolism of Etoposide can be decreased when combined with Buspirone.
Busulfan	The risk or severity of adverse effects can be increased when Etoposide is combined with Busulfan.
Butacaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Butacaine.
Butalbital	The metabolism of Etoposide can be increased when combined with Butalbital.
Butamben	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Butamben.
Cabazitaxel	The metabolism of Cabazitaxel can be decreased when combined with Etoposide.
Cabergoline	The serum concentration of Cabergoline can be increased when it is combined with Etoposide.
Caffeine	The metabolism of Etoposide can be decreased when combined with Caffeine.
Calcitriol	The metabolism of Etoposide can be increased when combined with Calcitriol.
Canagliflozin	The serum concentration of Etoposide can be increased when it is combined with Canagliflozin.
Canakinumab	The metabolism of Etoposide can be increased when combined with Canakinumab.
Candicidin	The metabolism of Etoposide can be decreased when combined with Candicidin.
Cangrelor	The risk or severity of bleeding can be increased when Cangrelor is combined with Etoposide.
Cannabidiol	The metabolism of Etoposide can be decreased when combined with Cannabidiol.
Capecitabine	The risk or severity of adverse effects can be increased when Etoposide is combined with Capecitabine.
Caplacizumab	The risk or severity of bleeding can be increased when Caplacizumab is combined with Etoposide.
Capmatinib	The serum concentration of Capmatinib can be decreased when it is combined with Etoposide.
Capsaicin	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Capsaicin.
Carbamazepine	The metabolism of Etoposide can be increased when combined with Carbamazepine.
Carboplatin	The risk or severity of adverse effects can be increased when Etoposide is combined with Carboplatin.
Carfilzomib	The serum concentration of Etoposide can be increased when it is combined with Carfilzomib.
Carmustine	The risk or severity of adverse effects can be increased when Carmustine is combined with Etoposide.
Carvedilol	The serum concentration of Etoposide can be increased when it is combined with Carvedilol.
Cefradine	The metabolism of Etoposide can be increased when combined with Cefradine.
Cenobamate	The serum concentration of Etoposide can be decreased when it is combined with Cenobamate.
Cephalexin	The metabolism of Etoposide can be decreased when combined with Cephalexin.
Ceritinib	The metabolism of Etoposide can be decreased when combined with Ceritinib.
Cerivastatin	The metabolism of Etoposide can be increased when combined with Cerivastatin.
Certolizumab pegol	The metabolism of Etoposide can be increased when combined with Certolizumab pegol.
Chlorambucil	The risk or severity of adverse effects can be increased when Chlorambucil is combined with Etoposide.
Chloramphenicol	The metabolism of Etoposide can be decreased when combined with Chloramphenicol.
Chloroprocaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Chloroprocaine.
Chloroquine	The metabolism of Etoposide can be decreased when combined with Chloroquine.
Chlorothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Etoposide.
Chlorpheniramine	The metabolism of Etoposide can be decreased when combined with Chlorpheniramine.
Chlorpromazine	The metabolism of Etoposide can be increased when combined with Chlorpromazine.
Chlorzoxazone	The metabolism of Etoposide can be decreased when combined with Chlorzoxazone.
Cholesterol	Cholesterol may increase the excretion rate of Etoposide which could result in a lower serum level and potentially a reduction in efficacy.
Ciclesonide	The risk or severity of adverse effects can be increased when Etoposide is combined with Ciclesonide.
Cilostazol	The metabolism of Cilostazol can be decreased when combined with Etoposide.
Cimetidine	The metabolism of Etoposide can be decreased when combined with Cimetidine.
Cinacalcet	The metabolism of Cinacalcet can be decreased when combined with Etoposide.
Cinchocaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Cinchocaine.
Cinnarizine	The metabolism of Etoposide can be decreased when combined with Cinnarizine.
Cinoxacin	The metabolism of Etoposide can be decreased when combined with Cinoxacin.
Ciprofloxacin	The metabolism of Etoposide can be decreased when combined with Ciprofloxacin.
Cisapride	The metabolism of Etoposide can be decreased when combined with Cisapride.
Cisplatin	The risk or severity of adverse effects can be increased when Cisplatin is combined with Etoposide.
Citalopram	The metabolism of Etoposide can be decreased when combined with Citalopram.
Cladribine	The risk or severity of adverse effects can be increased when Cladribine is combined with Etoposide.
Clarithromycin	The metabolism of Etoposide can be decreased when combined with Clarithromycin.
Clevidipine	The metabolism of Etoposide can be increased when combined with Clevidipine.
Clindamycin	The metabolism of Clindamycin can be increased when combined with Etoposide.
Clobazam	The metabolism of Etoposide can be increased when combined with Clobazam.
Clobetasol propionate	The metabolism of Etoposide can be increased when combined with Clobetasol propionate.
Clofarabine	The risk or severity of adverse effects can be increased when Clofarabine is combined with Etoposide.
Clofazimine	The serum concentration of Etoposide can be increased when it is combined with Clofazimine.
Clofibrate	The metabolism of Etoposide can be increased when combined with Clofibrate.
Clomifene	The serum concentration of Etoposide can be increased when it is combined with Clomifene.
Clomipramine	The metabolism of Clomipramine can be decreased when combined with Etoposide.
Clonazepam	The metabolism of Clonazepam can be increased when combined with Etoposide.
Clonidine	The metabolism of Etoposide can be decreased when combined with Clonidine.
Clopidogrel	The metabolism of Etoposide can be decreased when combined with Clopidogrel.
Clostridium tetani toxoid antigen (formaldehyde inactivated)	The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Etoposide.
Clozapine	The risk or severity of neutropenia can be increased when Etoposide is combined with Clozapine.
Cobicistat	The metabolism of Etoposide can be decreased when combined with Cobicistat.
Cobimetinib	The metabolism of Etoposide can be decreased when combined with Cobimetinib.
Cocaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Cocaine.
Colchicine	The metabolism of Colchicine can be decreased when combined with Etoposide.
Conivaptan	The metabolism of Etoposide can be decreased when combined with Conivaptan.

Dabrafenib	The serum concentration of Etoposide can be decreased when it is combined with Dabrafenib.
Dacarbazine	The risk or severity of adverse effects can be increased when Etoposide is combined with Dacarbazine.
Daclatasvir	The serum concentration of Etoposide can be increased when it is combined with Daclatasvir.
Dacomitinib	The serum concentration of Etoposide can be increased when it is combined with Dacomitinib.
Dactinomycin	The risk or severity of adverse effects can be increased when Etoposide is combined with Dactinomycin.
Dalfopristin	The metabolism of Etoposide can be decreased when combined with Dalfopristin.
Dalteparin	The risk or severity of bleeding can be increased when Dalteparin is combined with Etoposide.
Danaparoid	The risk or severity of bleeding can be increased when Danaparoid is combined with Etoposide.
Danazol	The metabolism of Etoposide can be decreased when combined with Danazol.
Dapagliflozin	The metabolism of Etoposide can be decreased when combined with Dapagliflozin.
Dapsone	The metabolism of Etoposide can be decreased when combined with Dapsone.
Daptomycin	The serum concentration of Etoposide can be increased when it is combined with Daptomycin.
Darbepoetin alfa	The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Etoposide.
Darolutamide	The serum concentration of Etoposide can be increased when it is combined with Darolutamide.
Darunavir	The serum concentration of Etoposide can be increased when it is combined with Darunavir.
Dasabuvir	The metabolism of Etoposide can be decreased when combined with Dasabuvir.
Dasatinib	The metabolism of Etoposide can be decreased when combined with Dasatinib.
Daunorubicin	The metabolism of Etoposide can be decreased when combined with Daunorubicin.
Decitabine	The risk or severity of adverse effects can be increased when Etoposide is combined with Decitabine.
Deferasirox	The serum concentration of Etoposide can be increased when it is combined with Deferasirox.
Defibrotide	The risk or severity of bleeding can be increased when Defibrotide is combined with Etoposide.
Deflazacort	The metabolism of Etoposide can be increased when combined with Deflazacort.
Delavirdine	The metabolism of Etoposide can be decreased when combined with Delavirdine.
Denosumab	The risk or severity of adverse effects can be increased when Denosumab is combined with Etoposide.
Desipramine	The metabolism of Etoposide can be decreased when combined with Desipramine.
Desirudin	The risk or severity of bleeding can be increased when Desirudin is combined with Etoposide.
Deslanoside	Deslanoside may decrease the cardiotoxic activities of Etoposide.
Desogestrel	The metabolism of Etoposide can be increased when combined with Desogestrel.
Desoximetasone	The risk or severity of adverse effects can be increased when Desoximetasone is combined with Etoposide.
Desvenlafaxine	The metabolism of Etoposide can be decreased when combined with Desvenlafaxine.
Deucravacitinib	The risk or severity of adverse effects can be increased when Etoposide is combined with Deucravacitinib.
Deutetrabenazine	The metabolism of Etoposide can be decreased when combined with Deutetrabenazine.
Dexamethasone	The metabolism of Etoposide can be increased when combined with Dexamethasone.
Dexamethasone acetate	The serum concentration of Etoposide can be decreased when it is combined with Dexamethasone acetate.
Dexfenfluramine	The metabolism of Dexfenfluramine can be decreased when combined with Etoposide.
Dexmedetomidine	The metabolism of Etoposide can be decreased when combined with Dexmedetomidine.
Dexrazoxane	The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Etoposide.
Dextran	The risk or severity of bleeding can be increased when Dextran is combined with Etoposide.
Dextromethorphan	The metabolism of Etoposide can be decreased when combined with Dextromethorphan.
Dextropropoxyphene	The metabolism of Etoposide can be decreased when combined with Dextropropoxyphene.
Diacerein	The metabolism of Etoposide can be decreased when combined with Diacerein.
Diazepam	The metabolism of Etoposide can be decreased when combined with Diazepam.
Diclofenac	The metabolism of Etoposide can be decreased when combined with Diclofenac.
Dicloxacillin	The metabolism of Etoposide can be increased when combined with Dicloxacillin.
Dicoumarol	The therapeutic efficacy of Dicoumarol can be increased when used in combination with Etoposide.
Diethylstilbestrol	The metabolism of Etoposide can be decreased when combined with Diethylstilbestrol.
Difluocortolone	The metabolism of Etoposide can be increased when combined with Difluocortolone.
Digitoxin	The serum concentration of Digitoxin can be increased when it is combined with Etoposide.
Digoxin	The serum concentration of Etoposide can be increased when it is combined with Digoxin.
Dihydralazine	The metabolism of Etoposide can be decreased when combined with Dihydralazine.
Dihydroergocornine	The metabolism of Etoposide can be decreased when combined with Dihydroergocornine.
Dihydroergocristine	The metabolism of Etoposide can be decreased when combined with Dihydroergocristine.
Dihydroergotamine	The metabolism of Etoposide can be decreased when combined with Dihydroergotamine.
Diltiazem	The metabolism of Etoposide can be decreased when combined with Diltiazem.
Dimethyl fumarate	The risk or severity of adverse effects can be increased when Etoposide is combined with Dimethyl fumarate.
Dimethyl sulfoxide	The metabolism of Etoposide can be decreased when combined with Dimethyl sulfoxide.
Dinutuximab	The risk or severity of adverse effects can be increased when Etoposide is combined with Dinutuximab.
Diosmin	The serum concentration of Etoposide can be increased when it is combined with Diosmin.
Diphenhydramine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Diphenhydramine.
Dipyridamole	The risk or severity of bleeding can be increased when Dipyridamole is combined with Etoposide.
Diroximel fumarate	The risk or severity of adverse effects can be increased when Etoposide is combined with Diroximel fumarate.
Disopyramide	The metabolism of Etoposide can be decreased when combined with Disopyramide.
Disulfiram	The metabolism of Etoposide can be decreased when combined with Disulfiram.
Docetaxel	The metabolism of Etoposide can be decreased when combined with Docetaxel.
Dolutegravir	The serum concentration of Etoposide can be increased when it is combined with Dolutegravir.
Domperidone	The metabolism of Etoposide can be decreased when combined with Domperidone.
Doravirine	The metabolism of Etoposide can be decreased when combined with Doravirine.
Dosulepin	The metabolism of Etoposide can be decreased when combined with Dosulepin.
Doxazosin	The metabolism of Etoposide can be decreased when combined with Doxazosin.
Doxepin	The metabolism of Doxepin can be decreased when combined with Etoposide.
Doxorubicin	The metabolism of Etoposide can be decreased when combined with Doxorubicin.
Dronabinol	The serum concentration of Dronabinol can be increased when it is combined with Etoposide.
Dronedarone	The serum concentration of Etoposide can be increased when it is combined with Dronedarone.
Drospirenone	The metabolism of Etoposide can be decreased when combined with Drospirenone.
Drotrecogin alfa	The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Etoposide.
Dutasteride	The metabolism of Etoposide can be decreased when combined with Dutasteride.
Duvelisib	The metabolism of Etoposide can be decreased when combined with Duvelisib.
Dyclonine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Dyclonine.
Ebastine	The metabolism of Etoposide can be decreased when combined with Ebastine.
Ebola Zaire vaccine (live, attenuated)	The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Etoposide.
Echinacea	The metabolism of Etoposide can be increased when combined with Echinacea.
Eculizumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Eculizumab.
Edetic acid	The risk or severity of bleeding can be increased when Edetic acid is combined with Etoposide.

Etanercept	The metabolism of Etoposide can be increased when combined with Etanercept.
Ethambutol	The metabolism of Etoposide can be decreased when combined with Ethambutol.
Ethanol	The metabolism of Etoposide can be increased when combined with Ethanol.
Ethinylestradiol	The metabolism of Etoposide can be decreased when combined with Ethinylestradiol.
Ethyl chloride	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Ethyl chloride.
Etidocaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Etidocaine.
Etoricoxib	The metabolism of Etoposide can be decreased when combined with Etoricoxib.
Etravirine	The metabolism of Etoposide can be increased when combined with Etravirine.
Everolimus	The serum concentration of Etoposide can be increased when it is combined with Everolimus.
Famotidine	The metabolism of Etoposide can be decreased when combined with Famotidine.
Favipiravir	The serum concentration of Etoposide can be increased when it is combined with Favipiravir.
Febuxostat	The excretion of Etoposide can be decreased when combined with Febuxostat.
Fedratinib	The serum concentration of Etoposide can be increased when it is combined with Fedratinib.
Felbamate	The metabolism of Etoposide can be increased when combined with Felbamate.
Felodipine	The metabolism of Etoposide can be decreased when combined with Felodipine.
Fenfluramine	The metabolism of Etoposide can be decreased when combined with Fenfluramine.
Fenofibrate	The metabolism of Etoposide can be decreased when combined with Fenofibrate.
Fentanyl	The metabolism of Fentanyl can be decreased when combined with Etoposide.
Fexinidazole	The metabolism of Etoposide can be decreased when combined with Fexinidazole.
Fexofenadine	The serum concentration of Etoposide can be increased when it is combined with Fexofenadine.
Filgotinib	The serum concentration of Etoposide can be increased when it is combined with Filgotinib.
Finasteride	The metabolism of Etoposide can be decreased when combined with Finasteride.
Finerenone	The serum concentration of Finerenone can be increased when it is combined with Etoposide.
Fingolimod	Etoposide may increase the immunosuppressive activities of Fingolimod.
Flecainide	The metabolism of Flecainide can be decreased when combined with Etoposide.
Flibanserin	The serum concentration of Etoposide can be increased when it is combined with Flibanserin.
Floxuridine	The risk or severity of adverse effects can be increased when Floxuridine is combined with Etoposide.
Flucloxacillin	The metabolism of Etoposide can be increased when combined with Flucloxacillin.
Fluconazole	The serum concentration of Etoposide can be increased when it is combined with Fluconazole.
Flucytosine	The risk or severity of adverse effects can be increased when Etoposide is combined with Flucytosine.
Fludarabine	The risk or severity of adverse effects can be increased when Etoposide is combined with Fludarabine.
Fludrocortisone	The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Etoposide.
Fluindione	The therapeutic efficacy of Fluindione can be increased when used in combination with Etoposide.
Flunarizine	The metabolism of Flunarizine can be decreased when combined with Etoposide.
Flunisolide	The metabolism of Etoposide can be increased when combined with Flunisolide.
Flunitrazepam	The metabolism of Etoposide can be decreased when combined with Flunitrazepam.
Fluocinolone acetonide	The metabolism of Etoposide can be increased when combined with Fluocinolone acetonide.
Fluocinonide	The metabolism of Etoposide can be increased when combined with Fluocinonide.
Fluocortolone	The metabolism of Etoposide can be increased when combined with Fluocortolone.
Fluorometholone	The risk or severity of adverse effects can be increased when Fluorometholone is combined with Etoposide.
Fluorouracil	The risk or severity of adverse effects can be increased when Fluorouracil is combined with Etoposide.
Fluoxetine	The metabolism of Etoposide can be decreased when combined with Fluoxetine.
Flupentixol	The risk or severity of myelosuppression can be increased when Flupentixol is combined with Etoposide.
Fluprednisolone	The risk or severity of adverse effects can be increased when Etoposide is combined with Fluprednisolone.
Flurbiprofen	The metabolism of Etoposide can be decreased when combined with Flurbiprofen.
Flutamide	The metabolism of Etoposide can be decreased when combined with Flutamide.
Fluticasone	The metabolism of Etoposide can be increased when combined with Fluticasone.
Fluticasone furoate	The metabolism of Etoposide can be increased when combined with Fluticasone furoate.
Fluticasone propionate	The metabolism of Etoposide can be decreased when combined with Fluticasone propionate.
Fluvastatin	The metabolism of Etoposide can be decreased when combined with Fluvastatin.
Fluvoxamine	The metabolism of Etoposide can be decreased when combined with Fluvoxamine.

Irbesartan	The metabolism of Etoposide can be decreased when combined with Irbesartan.
Irinotecan	The metabolism of Etoposide can be decreased when combined with Irinotecan.
Isavuconazole	The serum concentration of Etoposide can be increased when it is combined with Isavuconazole.
Isavuconazonium	The serum concentration of Etoposide can be increased when it is combined with Isavuconazonium.
Isoniazid	The metabolism of Etoposide can be decreased when combined with Isoniazid.
Isradipine	The metabolism of Etoposide can be decreased when combined with Isradipine.
Istradefylline	The serum concentration of Etoposide can be increased when it is combined with Istradefylline.
Itraconazole	The metabolism of Etoposide can be decreased when combined with Itraconazole.

Ketoconazole	The metabolism of Etoposide can be decreased when combined with Ketoconazole.
Lacosamide	The metabolism of Etoposide can be decreased when combined with Lacosamide.
Lamotrigine	The metabolism of Etoposide can be increased when combined with Lamotrigine.
Lanreotide	The metabolism of Etoposide can be decreased when combined with Lanreotide.
Lansoprazole	Lansoprazole may decrease the excretion rate of Etoposide which could result in a higher serum level.
Lapatinib	The serum concentration of Etoposide can be increased when it is combined with Lapatinib.
Larotrectinib	The serum concentration of Etoposide can be increased when it is combined with Larotrectinib.
Lasmiditan	The serum concentration of Etoposide can be increased when it is combined with Lasmiditan.
Ledipasvir	The serum concentration of Etoposide can be increased when it is combined with Ledipasvir.
Lefamulin	The serum concentration of Etoposide can be increased when it is combined with Lefamulin.
Leflunomide	The risk or severity of adverse effects can be increased when Etoposide is combined with Leflunomide.
Lemborexant	The serum concentration of Lemborexant can be decreased when it is combined with Etoposide.
Lenalidomide	The risk or severity of adverse effects can be increased when Lenalidomide is combined with Etoposide.
Lenvatinib	The serum concentration of Etoposide can be increased when it is combined with Lenvatinib.
Lepirudin	The risk or severity of bleeding can be increased when Lepirudin is combined with Etoposide.
Lercanidipine	The metabolism of Etoposide can be decreased when combined with Lercanidipine.
Lesinurad	The metabolism of Etoposide can be increased when combined with Lesinurad.
Letermovir	The metabolism of Etoposide can be decreased when combined with Letermovir.
Levamlodipine	The serum concentration of Levamlodipine can be increased when it is combined with Etoposide.
Levobupivacaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Levobupivacaine.
Levoketoconazole	The metabolism of Etoposide can be decreased when combined with Levoketoconazole.
Levomilnacipran	The metabolism of Levomilnacipran can be increased when combined with Etoposide.
Levonorgestrel	The metabolism of Etoposide can be decreased when combined with Levonorgestrel.
Levothyroxine	The serum concentration of Etoposide can be decreased when it is combined with Levothyroxine.
Lidocaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Lidocaine.
Linagliptin	The serum concentration of Etoposide can be increased when it is combined with Linagliptin.
Linezolid	The risk or severity of adverse effects can be increased when Linezolid is combined with Etoposide.
Lipegfilgrastim	Etoposide may increase the myelosuppressive activities of Lipegfilgrastim.
Lofexidine	The metabolism of Lofexidine can be decreased when combined with Etoposide.
Lomefloxacin	The metabolism of Lomefloxacin can be decreased when combined with Etoposide.
Lomitapide	The serum concentration of Etoposide can be increased when it is combined with Lomitapide.
Lomustine	The risk or severity of adverse effects can be increased when Etoposide is combined with Lomustine.
Lonafarnib	The metabolism of Etoposide can be decreased when combined with Lonafarnib.
Lonapegsomatropin	The metabolism of Etoposide can be increased when combined with Lonapegsomatropin.
Loncastuximab tesirine	The serum concentration of Etoposide can be increased when it is combined with Loncastuximab tesirine.
Loperamide	The serum concentration of Etoposide can be increased when it is combined with Loperamide.
Lopinavir	The serum concentration of Etoposide can be increased when it is combined with Lopinavir.
Lorcaserin	The metabolism of Lorcaserin can be decreased when combined with Etoposide.
Lorlatinib	The serum concentration of Etoposide can be decreased when it is combined with Lorlatinib.
Losartan	The metabolism of Etoposide can be decreased when combined with Losartan.
Lovastatin	The metabolism of Lovastatin can be decreased when combined with Etoposide.
Loxapine	The serum concentration of Etoposide can be increased when it is combined with Loxapine.
Lumacaftor	The serum concentration of Etoposide can be decreased when it is combined with Lumacaftor.
Lumateperone	The serum concentration of Lumateperone can be decreased when it is combined with Etoposide.
Lusutrombopag	The serum concentration of Etoposide can be increased when it is combined with Lusutrombopag.
Magnesium	The serum concentration of Magnesium can be decreased when it is combined with Etoposide.
Manidipine	The metabolism of Etoposide can be decreased when combined with Manidipine.
Mannitol	The serum concentration of Etoposide can be increased when it is combined with Mannitol.
Maprotiline	The metabolism of Maprotiline can be decreased when combined with Etoposide.
Maribavir	The serum concentration of Etoposide can be increased when it is combined with Maribavir.
Mavacamten	The serum concentration of Etoposide can be decreased when it is combined with Mavacamten.
Measles virus vaccine live attenuated	The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Etoposide.
Mechlorethamine	The risk or severity of adverse effects can be increased when Etoposide is combined with Mechlorethamine.
Medroxyprogesterone acetate	The metabolism of Etoposide can be increased when combined with Medroxyprogesterone acetate.
Mefenamic acid	The metabolism of Mefenamic acid can be decreased when combined with Etoposide.
Mefloquine	The serum concentration of Etoposide can be increased when it is combined with Mefloquine.
Melatonin	The metabolism of Melatonin can be decreased when combined with Etoposide.
Meloxicam	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Meloxicam.
Melphalan	The risk or severity of adverse effects can be increased when Etoposide is combined with Melphalan.
Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine	The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Etoposide.
Meperidine	The metabolism of Etoposide can be decreased when combined with Meperidine.
Mephenytoin	The metabolism of Etoposide can be decreased when combined with Mephenytoin.
Mepivacaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Mepivacaine.
Mepolizumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Mepolizumab.
Meprednisone	The metabolism of Etoposide can be increased when combined with Meprednisone.
Mercaptopurine	The risk or severity of adverse effects can be increased when Etoposide is combined with Mercaptopurine.
Metamizole	The risk or severity of myelosuppression can be increased when Metamizole is combined with Etoposide.
Methadone	The metabolism of Etoposide can be decreased when combined with Methadone.
Methimazole	The metabolism of Etoposide can be decreased when combined with Methimazole.
Methotrexate	The risk or severity of adverse effects can be increased when Methotrexate is combined with Etoposide.
Methoxsalen	The metabolism of Etoposide can be decreased when combined with Methoxsalen.
Methoxy polyethylene glycol-epoetin beta	The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Etoposide.
Methylene blue	The serum concentration of Etoposide can be increased when it is combined with Methylene blue.
Methylergometrine	The metabolism of Etoposide can be decreased when combined with Methylergometrine.
Methylphenobarbital	The metabolism of Etoposide can be increased when combined with Methylphenobarbital.
Methylprednisolone	The metabolism of Etoposide can be increased when combined with Methylprednisolone.
Methylprednisone	The metabolism of Etoposide can be decreased when combined with Methylprednisone.
Methysergide	The metabolism of Etoposide can be decreased when combined with Methysergide.
Metoclopramide	The metabolism of Metoclopramide can be decreased when combined with Etoposide.
Metreleptin	The metabolism of Etoposide can be increased when combined with Metreleptin.
Metronidazole	The metabolism of Etoposide can be decreased when combined with Metronidazole.
Metyrapone	The metabolism of Etoposide can be increased when combined with Metyrapone.
Mexiletine	The metabolism of Etoposide can be decreased when combined with Mexiletine.
Mianserin	The metabolism of Mianserin can be decreased when combined with Etoposide.
Miconazole	The metabolism of Etoposide can be decreased when combined with Miconazole.
Midazolam	The serum concentration of Midazolam can be increased when it is combined with Etoposide.
Midostaurin	The metabolism of Etoposide can be decreased when combined with Midostaurin.
Mifepristone	The serum concentration of Etoposide can be decreased when it is combined with Mifepristone.
Milnacipran	The metabolism of Milnacipran can be increased when combined with Etoposide.
Miocamycin	The metabolism of Etoposide can be decreased when combined with Miocamycin.
Mirabegron	The serum concentration of Etoposide can be increased when it is combined with Mirabegron.
Mirtazapine	The metabolism of Etoposide can be decreased when combined with Mirtazapine.
Mitapivat	The metabolism of Etoposide can be increased when combined with Mitapivat.
Mitomycin	The risk or severity of adverse effects can be increased when Mitomycin is combined with Etoposide.
Mitotane	The metabolism of Etoposide can be increased when combined with Mitotane.
Mitoxantrone	The risk or severity of adverse effects can be increased when Etoposide is combined with Mitoxantrone.
Mobocertinib	The serum concentration of Etoposide can be decreased when it is combined with Mobocertinib.
Modafinil	The metabolism of Etoposide can be increased when combined with Modafinil.
Moderna COVID-19 Vaccine	The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Etoposide.

Mycophenolate mofetil	The metabolism of Etoposide can be decreased when combined with Mycophenolate mofetil.
Mycophenolic acid	The risk or severity of adverse effects can be increased when Etoposide is combined with Mycophenolic acid.
Nabumetone	The metabolism of Etoposide can be decreased when combined with Nabumetone.
Nadroparin	The risk or severity of bleeding can be increased when Nadroparin is combined with Etoposide.
Nafcillin	The metabolism of Etoposide can be increased when combined with Nafcillin.
Nalidixic acid	The metabolism of Etoposide can be decreased when combined with Nalidixic acid.
Naloxone	The metabolism of Etoposide can be decreased when combined with Naloxone.
Naproxen	The metabolism of Naproxen can be decreased when combined with Etoposide.
Natalizumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Natalizumab.
Nateglinide	The metabolism of Etoposide can be decreased when combined with Nateglinide.
Nefazodone	The metabolism of Etoposide can be decreased when combined with Nefazodone.
Nelarabine	The risk or severity of adverse effects can be increased when Etoposide is combined with Nelarabine.
Nelfinavir	The metabolism of Etoposide can be decreased when combined with Nelfinavir.
Neratinib	The serum concentration of Etoposide can be increased when it is combined with Neratinib.
Netupitant	The serum concentration of Etoposide can be increased when it is combined with Netupitant.
Nevirapine	The metabolism of Etoposide can be decreased when combined with Nevirapine.
Niacin	The metabolism of Etoposide can be decreased when combined with Niacin.
Nicardipine	The metabolism of Etoposide can be decreased when combined with Nicardipine.
Niclosamide	The metabolism of Etoposide can be decreased when combined with Niclosamide.
Nifedipine	The metabolism of Etoposide can be decreased when combined with Nifedipine.
Nilotinib	The metabolism of Etoposide can be decreased when combined with Nilotinib.
Nilvadipine	The metabolism of Etoposide can be decreased when combined with Nilvadipine.
Nimesulide	The risk or severity of bleeding can be increased when Nimesulide is combined with Etoposide.
Nintedanib	The metabolism of Etoposide can be decreased when combined with Nintedanib.
Nisoldipine	The metabolism of Etoposide can be decreased when combined with Nisoldipine.
Nitrendipine	The metabolism of Etoposide can be decreased when combined with Nitrendipine.
Norethisterone	The metabolism of Etoposide can be decreased when combined with Norethisterone.
Norfloxacin	The metabolism of Etoposide can be decreased when combined with Norfloxacin.
Norgestimate	The serum concentration of Etoposide can be increased when it is combined with Norgestimate.
Nortriptyline	The serum concentration of Nortriptyline can be increased when it is combined with Etoposide.
Noscapine	The metabolism of Etoposide can be decreased when combined with Noscapine.
Novobiocin	Novobiocin may decrease the excretion rate of Etoposide which could result in a higher serum level.
Nuvaxovid	The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Etoposide.
Obeticholic acid	The risk or severity of adverse effects can be increased when Obeticholic acid is combined with Etoposide.
Obinutuzumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Obinutuzumab.
Ocrelizumab	Ocrelizumab may increase the immunosuppressive activities of Etoposide.
Octreotide	The serum concentration of Etoposide can be increased when it is combined with Octreotide.
Ofatumumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Ofatumumab.
Olanzapine	The metabolism of Etoposide can be decreased when combined with Olanzapine.
Olaparib	The metabolism of Etoposide can be decreased when combined with Olaparib.
Oliceridine	The serum concentration of Oliceridine can be decreased when it is combined with Etoposide.
Omadacycline	The serum concentration of Etoposide can be increased when it is combined with Omadacycline.
Ombitasvir	The metabolism of Etoposide can be decreased when combined with Ombitasvir.
Omeprazole	The metabolism of Etoposide can be increased when combined with Omeprazole.
Ondansetron	The metabolism of Etoposide can be decreased when combined with Ondansetron.
Oritavancin	The metabolism of Etoposide can be increased when combined with Oritavancin.
Orphenadrine	The metabolism of Etoposide can be decreased when combined with Orphenadrine.
Osilodrostat	The serum concentration of Etoposide can be increased when it is combined with Osilodrostat.
Osimertinib	The serum concentration of Etoposide can be decreased when it is combined with Osimertinib.
Oteseconazole	The serum concentration of Etoposide can be increased when it is combined with Oteseconazole.
Ouabain	Ouabain may decrease the cardiotoxic activities of Etoposide.
Oxaliplatin	The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Etoposide.
Oxcarbazepine	The metabolism of Etoposide can be increased when combined with Oxcarbazepine.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Oxetacaine.
Oxtriphylline	The metabolism of Oxtriphylline can be decreased when combined with Etoposide.
Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Oxybuprocaine.
Oxybutynin	The metabolism of Etoposide can be decreased when combined with Oxybutynin.
Oxycodone	The metabolism of Etoposide can be decreased when combined with Oxycodone.
Ozanimod	The risk or severity of adverse effects can be increased when Etoposide is combined with Ozanimod.
Paclitaxel	The metabolism of Etoposide can be increased when combined with Paclitaxel.
Pacritinib	The serum concentration of Etoposide can be increased when it is combined with Pacritinib.
Palbociclib	The serum concentration of Etoposide can be increased when it is combined with Palbociclib.
Palifermin	The therapeutic efficacy of Palifermin can be decreased when used in combination with Etoposide.
Paliperidone	The serum concentration of Etoposide can be increased when it is combined with Paliperidone.
Panobinostat	The risk or severity of adverse effects can be increased when Etoposide is combined with Panobinostat.
Pantoprazole	Pantoprazole may decrease the excretion rate of Etoposide which could result in a higher serum level.
Paritaprevir	The metabolism of Etoposide can be decreased when combined with Paritaprevir.
Parnaparin	The risk or severity of bleeding can be increased when Parnaparin is combined with Etoposide.
Paroxetine	The metabolism of Etoposide can be decreased when combined with Paroxetine.
Pasireotide	The metabolism of Etoposide can be decreased when combined with Pasireotide.
Pazopanib	The metabolism of Etoposide can be decreased when combined with Pazopanib.
Pefloxacin	The metabolism of Etoposide can be decreased when combined with Pefloxacin.
Pegaspargase	The risk or severity of adverse effects can be increased when Pegaspargase is combined with Etoposide.
Pegcetacoplan	The risk or severity of adverse effects can be increased when Etoposide is combined with Pegcetacoplan.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Etoposide.
Peginterferon alfa-2a	The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Etoposide.
Peginterferon alfa-2b	The serum concentration of Etoposide can be increased when it is combined with Peginterferon alfa-2b.
Peginterferon beta-1a	The risk or severity of adverse effects can be increased when Etoposide is combined with Peginterferon beta-1a.
Pemetrexed	The risk or severity of adverse effects can be increased when Pemetrexed is combined with Etoposide.
Penciclovir	The metabolism of Etoposide can be decreased when combined with Penciclovir.
Penicillamine	The risk or severity of adverse effects can be increased when Etoposide is combined with Penicillamine.
Pentamidine	The metabolism of Etoposide can be decreased when combined with Pentamidine.
Pentobarbital	The metabolism of Etoposide can be increased when combined with Pentobarbital.
Pentosan polysulfate	The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Etoposide.
Pentostatin	The risk or severity of adverse effects can be increased when Pentostatin is combined with Etoposide.
Pentoxifylline	The metabolism of Pentoxifylline can be decreased when combined with Etoposide.
Perampanel	The metabolism of Perampanel can be increased when combined with Etoposide.
Perphenazine	The metabolism of Perphenazine can be decreased when combined with Etoposide.
Pertussis vaccine	The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Etoposide.
Pertuzumab	The risk or severity of cardiotoxicity can be increased when Etoposide is combined with Pertuzumab.
Pexidartinib	The metabolism of Etoposide can be decreased when combined with Pexidartinib.
Phenindione	The therapeutic efficacy of Phenindione can be increased when used in combination with Etoposide.

Procarbazine	The risk or severity of adverse effects can be increased when Etoposide is combined with Procarbazine.
Progesterone	The metabolism of Etoposide can be decreased when combined with Progesterone.
Promazine	The metabolism of Etoposide can be decreased when combined with Promazine.
Propafenone	The serum concentration of Etoposide can be increased when it is combined with Propafenone.
Proparacaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Proparacaine.
Propofol	The metabolism of Etoposide can be decreased when combined with Propofol.
Propoxycaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Propoxycaine.
Propranolol	The metabolism of Etoposide can be decreased when combined with Propranolol.
Propylthiouracil	The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Etoposide.
Protein C	The risk or severity of bleeding can be increased when Protein C is combined with Etoposide.
Protein S human	The risk or severity of bleeding can be increased when Protein S human is combined with Etoposide.
Prucalopride	The metabolism of Prucalopride can be decreased when combined with Etoposide.
Quetiapine	The metabolism of Etoposide can be decreased when combined with Quetiapine.
Quinidine	The serum concentration of Etoposide can be increased when it is combined with Quinidine.
Quinine	The serum concentration of Etoposide can be increased when it is combined with Quinine.
Quinupristin	The metabolism of Etoposide can be decreased when combined with Quinupristin.
Rabeprazole	Rabeprazole may decrease the excretion rate of Etoposide which could result in a higher serum level.
Rabies immune globulin, human	The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Etoposide.
Rabies virus inactivated antigen, A	The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Etoposide.
Rabies virus inactivated antigen, B	The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Etoposide.
Raloxifene	The metabolism of Etoposide can be decreased when combined with Raloxifene.
Raltitrexed	The risk or severity of adverse effects can be increased when Raltitrexed is combined with Etoposide.
Ramelteon	The metabolism of Ramelteon can be decreased when combined with Etoposide.
Ranitidine	The metabolism of Ranitidine can be decreased when combined with Etoposide.
Ranolazine	The metabolism of Ranolazine can be increased when combined with Etoposide.
Rasagiline	The metabolism of Rasagiline can be decreased when combined with Etoposide.
Ravulizumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Ravulizumab.
Regorafenib	The serum concentration of Etoposide can be increased when it is combined with Regorafenib.
Relugolix	The metabolism of Etoposide can be decreased when combined with Relugolix.
Remdesivir	The metabolism of Etoposide can be decreased when combined with Remdesivir.
Reserpine	The serum concentration of Etoposide can be increased when it is combined with Reserpine.
Retapamulin	The metabolism of Retapamulin can be decreased when combined with Etoposide.
Reteplase	The risk or severity of bleeding can be increased when Reteplase is combined with Etoposide.
Revefenacin	The serum concentration of Etoposide can be increased when it is combined with Revefenacin.
Reviparin	The risk or severity of bleeding can be increased when Reviparin is combined with Etoposide.
Ribociclib	The metabolism of Etoposide can be decreased when combined with Ribociclib.
Rifabutin	The metabolism of Etoposide can be increased when combined with Rifabutin.
Rifampicin	The serum concentration of Etoposide can be decreased when it is combined with Rifampicin.
Rifamycin	The serum concentration of Etoposide can be increased when it is combined with Rifamycin.
Rifapentine	The metabolism of Etoposide can be increased when combined with Rifapentine.
Rilonacept	The metabolism of Etoposide can be increased when combined with Rilonacept.
Rilpivirine	The metabolism of Etoposide can be decreased when combined with Rilpivirine.
Riluzole	The metabolism of Etoposide can be decreased when combined with Riluzole.
Rimegepant	The metabolism of Rimegepant can be increased when combined with Etoposide.
Riociguat	The serum concentration of Etoposide can be increased when it is combined with Riociguat.
Ripretinib	The serum concentration of Etoposide can be increased when it is combined with Ripretinib.
Risankizumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Risankizumab.
Risperidone	The metabolism of Etoposide can be decreased when combined with Risperidone.
Ritonavir	The serum concentration of Etoposide can be increased when it is combined with Ritonavir.
Rituximab	The risk or severity of adverse effects can be increased when Rituximab is combined with Etoposide.
Rivaroxaban	The metabolism of Etoposide can be decreased when combined with Rivaroxaban.
Rofecoxib	The metabolism of Etoposide can be increased when combined with Rofecoxib.
Roflumilast	The serum concentration of Roflumilast can be increased when it is combined with Etoposide.
Rolapitant	The serum concentration of Etoposide can be increased when it is combined with Rolapitant.
Romidepsin	The metabolism of Etoposide can be decreased when combined with Romidepsin.
Ropeginterferon alfa-2b	The risk or severity of adverse effects can be increased when Etoposide is combined with Ropeginterferon alfa-2b.
Ropivacaine	The risk or severity of methemoglobinemia can be increased when Etoposide is combined with Ropivacaine.
Rosoxacin	The metabolism of Etoposide can be decreased when combined with Rosoxacin.
Rosuvastatin	The metabolism of Etoposide can be decreased when combined with Rosuvastatin.
Rotavirus vaccine	The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Etoposide.
Roxadustat	The serum concentration of Etoposide can be increased when it is combined with Roxadustat.
Roxithromycin	The metabolism of Etoposide can be decreased when combined with Roxithromycin.
Rubella virus vaccine	The risk or severity of infection can be increased when Rubella virus vaccine is combined with Etoposide.
Rucaparib	The metabolism of Etoposide can be decreased when combined with Rucaparib.

Tizanidine	The metabolism of Etoposide can be decreased when combined with Tizanidine.
Tocainide	The metabolism of Etoposide can be decreased when combined with Tocainide.
Tocilizumab	The metabolism of Etoposide can be increased when combined with Tocilizumab.
Tofacitinib	The metabolism of Tofacitinib can be decreased when combined with Etoposide.
Tolvaptan	The serum concentration of Tolvaptan can be increased when it is combined with Etoposide.
Topiramate	The metabolism of Etoposide can be increased when combined with Topiramate.
Topotecan	The risk or severity of adverse effects can be increased when Etoposide is combined with Topotecan.
Toremifene	The serum concentration of Etoposide can be increased when it is combined with Toremifene.
Tositumomab	The risk or severity of adverse effects can be increased when Tositumomab is combined with Etoposide.
Trabectedin	The risk or severity of adverse effects can be increased when Etoposide is combined with Trabectedin.
Tramadol	The metabolism of Tramadol can be decreased when combined with Etoposide.
Trastuzumab	Trastuzumab may increase the neutropenic activities of Etoposide.
Trastuzumab emtansine	The metabolism of Trastuzumab emtansine can be decreased when combined with Etoposide.
Trazodone	The serum concentration of Etoposide can be decreased when it is combined with Trazodone.
Tretinoin	The metabolism of Etoposide can be decreased when combined with Tretinoin.
Triamcinolone	The metabolism of Etoposide can be increased when combined with Triamcinolone.
Triamterene	The metabolism of Etoposide can be decreased when combined with Triamterene.
Triazolam	The metabolism of Etoposide can be decreased when combined with Triazolam.
Trichlormethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Etoposide.
Triclabendazole	The metabolism of Etoposide can be decreased when combined with Triclabendazole.
Trifluoperazine	The metabolism of Trifluoperazine can be decreased when combined with Etoposide.
Trifluridine	The risk or severity of adverse effects can be increased when Trifluridine is combined with Etoposide.
Triflusal	The risk or severity of bleeding can be increased when Triflusal is combined with Etoposide.
Trilaciclib	The metabolism of Etoposide can be increased when combined with Trilaciclib.
Trilostane	The risk or severity of adverse effects can be increased when Etoposide is combined with Trilostane.
Trimipramine	The serum concentration of Trimipramine can be increased when it is combined with Etoposide.
Troglitazone	The metabolism of Etoposide can be increased when combined with Troglitazone.
Troleandomycin	The metabolism of Etoposide can be decreased when combined with Troleandomycin.
Trovafloxacin	The metabolism of Etoposide can be decreased when combined with Trovafloxacin.
Tucatinib	Tucatinib may decrease the excretion rate of Etoposide which could result in a higher serum level.
Typhoid vaccine	The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Etoposide.
Typhoid Vaccine Live	The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Etoposide.
Typhoid Vi polysaccharide vaccine	The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Etoposide.
Ubrogepant	The serum concentration of Etoposide can be increased when it is combined with Ubrogepant.
Udenafil	The metabolism of Etoposide can be decreased when combined with Udenafil.
Umbralisib	The serum concentration of Etoposide can be increased when it is combined with Umbralisib.
Umeclidinium	The serum concentration of Etoposide can be increased when it is combined with Umeclidinium.
Upadacitinib	The risk or severity of adverse effects can be increased when Etoposide is combined with Upadacitinib.
Urokinase	The risk or severity of bleeding can be increased when Urokinase is combined with Etoposide.
Valbenazine	The metabolism of Etoposide can be decreased when combined with Valbenazine.
Valproic acid	The metabolism of Etoposide can be decreased when combined with Valproic acid.
Vandetanib	The serum concentration of Etoposide can be increased when it is combined with Vandetanib.
Vardenafil	The metabolism of Vardenafil can be decreased when combined with Etoposide.
Varicella zoster vaccine (live/attenuated)	The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Etoposide.
Varicella zoster vaccine (recombinant)	The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Etoposide.
Vedolizumab	The risk or severity of adverse effects can be increased when Etoposide is combined with Vedolizumab.
Velpatasvir	The serum concentration of Etoposide can be increased when it is combined with Velpatasvir.
Vemurafenib	The serum concentration of Etoposide can be increased when it is combined with Vemurafenib.
Venetoclax	The serum concentration of Etoposide can be increased when it is combined with Venetoclax.
Venlafaxine	Venlafaxine may increase the excretion rate of Etoposide which could result in a lower serum level and potentially a reduction in efficacy.
Verapamil	The serum concentration of Etoposide can be increased when it is combined with Verapamil.
Vibrio cholerae CVD 103-HgR strain live antigen	The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Etoposide.
Vilanterol	The risk or severity of adverse effects can be increased when Etoposide is combined with Vilanterol.
Viloxazine	The metabolism of Etoposide can be decreased when combined with Viloxazine.
Vinblastine	The metabolism of Etoposide can be increased when combined with Vinblastine.
Vincristine	The metabolism of Etoposide can be decreased when combined with Vincristine.
Vindesine	The risk or severity of adverse effects can be increased when Vindesine is combined with Etoposide.
Vinflunine	The serum concentration of Vinflunine can be increased when it is combined with Etoposide.
Vinorelbine	The risk or severity of adverse effects can be increased when Vinorelbine is combined with Etoposide.
Vismodegib	Vismodegib may decrease the excretion rate of Etoposide which could result in a higher serum level.
Vitamin E	The metabolism of Etoposide can be increased when combined with Vitamin E.
Voclosporin	The serum concentration of Etoposide can be increased when it is combined with Voclosporin.
Vorapaxar	The serum concentration of Etoposide can be increased when it is combined with Vorapaxar.
Voriconazole	The metabolism of Etoposide can be decreased when combined with Voriconazole.
Vorinostat	The risk or severity of adverse effects can be increased when Etoposide is combined with Vorinostat.
Vortioxetine	The metabolism of Etoposide can be decreased when combined with Vortioxetine.
Voxelotor	The serum concentration of Etoposide can be increased when it is combined with Voxelotor.
Voxilaprevir	The serum concentration of Etoposide can be increased when it is combined with Voxilaprevir.
Warfarin	The therapeutic efficacy of Warfarin can be increased when used in combination with Etoposide.
Ximelagatran	The risk or severity of bleeding can be increased when Ximelagatran is combined with Etoposide.
Yellow fever vaccine	The risk or severity of infection can be increased when Yellow fever vaccine is combined with Etoposide.
Zafirlukast	The metabolism of Etoposide can be decreased when combined with Zafirlukast.
Zaleplon	The metabolism of Etoposide can be decreased when combined with Zaleplon.
Zidovudine	The metabolism of Etoposide can be increased when combined with Zidovudine.
Zileuton	The metabolism of Etoposide can be decreased when combined with Zileuton.
Zimelidine	The metabolism of Etoposide can be decreased when combined with Zimelidine.
Ziprasidone	The metabolism of Etoposide can be decreased when combined with Ziprasidone.
Zolmitriptan	The metabolism of Etoposide can be decreased when combined with Zolmitriptan.
Zolpidem	The metabolism of Etoposide can be decreased when combined with Zolpidem.
Zonisamide	The serum concentration of Etoposide can be increased when it is combined with Zonisamide.
Zopiclone	The metabolism of Zopiclone can be decreased when combined with Etoposide.
Zotepine	The metabolism of Zotepine can be decreased when combined with Etoposide.
Zuclopenthixol	The metabolism of Etoposide can be decreased when combined with Zuclopenthixol.

Pregnancy and Lactation

AU TGA pregnancy category: D
US FDA pregnancy category: D

Pregnancy

Using etoposide phosphate may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk. Etoposide can harm an unborn baby if the mother or the father is using this medicine. If you are a woman, do not use etoposide if you are pregnant. Etoposide, the active moiety of etoposide phosphate is, teratogenic in mice and rats. Advise pregnant women of the potential hazard to a fetus. Advise women of childbearing potential to avoid becoming pregnant., In the U.S. general population, the estimated background risk of major birth defects and, miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively

Breastfeeding

Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy. It may be possible to breastfeed safely during intermittent therapy with this drug after an appropriate period of breastfeeding abstinence; however, experts differ on the appropriate length of abstinence. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breast milk. Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant. It might be possible to breastfeed safely during intermittent therapy with etoposide after an appropriate period of breastfeeding abstinence. A period of at least 24 hours is required after a dose of 80 mg/sq m or less. Others have suggested an abstinence period of 72 hours after etoposide use.[1] Chemotherapy may adversely affect the normal microbiome and chemical makeup of breast milk.[2] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.

Precautions:

• Before starting etoposide treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
• Do not receive any kind of immunization or vaccination without your doctor’s approval while taking etoposide.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (etoposide may be hazardous to the fetus.  Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
• For both men and women: Do not conceive a child (get pregnant) while taking etoposide. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking this medication.

Self-care tips:

• Apply warm compresses if you have any pain, redness or swelling at the IV site, and notify your doctor.
• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your healthcare provider.
• Wash your hands often.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Avoid sun exposure.  Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your healthcare team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

References

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