Administer as a slow intravenous infusion, typically over 30 to 60 minutes, after dilution in Dextrose 5% in Water or 0.9% Sodium Chloride Injection. Avoid rapid infusion due to risk of hypotension.

Etoposide inhibits DNA topoisomerase II, an enzyme crucial for DNA replication, repair, and transcription. By stabilizing the topoisomerase II-DNA cleavable complex, etoposide causes irreversible DNA strand breaks, leading to G2/M phase arrest and apoptosis in cancer cells.

• •Severe bone marrow depression (myelosuppression)
• •Hypersensitivity to etoposide or any component of the formulation
• •Severe hepatic or renal impairment (relative contraindication, requires significant dose adjustment)

Store unopened vials at controlled room temperature (20°C to 25°C, excursions permitted to 15°C to 30°C) or refrigerated (2°C to 8°C) depending on specific manufacturer guidelines. Protect from light. Diluted solution is stable for specific periods, check product monograph.

Symptoms of overdose include severe myelosuppression, mucositis, and liver toxicity. Treatment is supportive, including blood product transfusions, anti-infectives, and managing symptoms. No specific antidote.

Pregnancy Category D. Etoposide can cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised to avoid becoming pregnant. Not recommended during breastfeeding due to potential for serious adverse effects on the infant.