Adults:IV Dosage ranges from 35 mg/m2 /day for 4 days to 50 mg/m2 /day for 5 days. Repeat chemotherapy courses at 3- to 4-week intervals after adequate recovery from any toxicity. PO Two times the IV dose rounded to the nearest 50 mg.
Adults:IV Dosage ranges from 50 to 100 mg/m2 /day on days 1 through 5 to 100 mg/m2 /day on days 1, 3, and 5. Repeat chemotherapy courses at 3- to 4-week intervals after adequate recovery from any toxicity.
Adjustment in Renal Insufficiency
Adults: For patients with CrCl of 15 to 50 mL/min, give 75% of the usual dose. Consider further dose reduction for those with CrCl less than 15 mL/min.
Modify dose to take into account the myelosuppressive effects of other drugs in the combination or the effects of prior x-ray therapy or chemotherapy that may have compromised bone marrow reserve.
Extemporaneous oral solution
Etoposide solution for injection can be mixed to a final concentration 0.4 mg/mL or less with orange juice, apple juice, or lemonade for oral administration.
Stable for 3 h at room temperature.
Dilute prior to use with dextrose 5% or sodium chloride 0.9% to final concentration of 0.2 or 0.4 mg/mL. Concentrations less than 0.4 mg/mL may precipitate.
Infuse over 30 to 60 min. Do not give by rapid IV injection because of the risk of hypotension.
Etoposide’s main effect appears to be at the G2 portion of the cell cycle. At high concentrations (10 mcg/mL or more), lysis of cells entering mitosis is seen; at low concentrations (0.3 to 10 mcg/mL), cells are inhibited from entering prophase. Predominant macromolecular effect appears to be DNA synthesis inhibition.