BIOPOSIDE INJECTION 100MG

Indications

• Testicular cancer
• Small cell lung cancer
• Acute lymphoblastic leukemia
• Non-Hodgkin lymphoma
• Choriocarcinoma

Dosage

Children: Refer to the BNF for Children for specific paediatric dosing recommendations, as this may depend on the child’s age, weight, and specific condition being treated.

Adults: Refer to the BNF for specific dosing guidelines based on the type of cancer and treatment regimen. Dosing may vary widely depending on the individual patient's condition and treatment protocol.

Mechanism of action

Etoposide exerts its anticancer effects by inhibiting the enzyme topoisomerase II, which is crucial for DNA replication and repair. By stabilizing the enzyme-DNA complex, etoposide prevents the re-ligation of DNA strands during replication, resulting in DNA breaks and ultimately triggering apoptosis in cancer cells.

Pharmacodynamics

Etoposide demonstrates dose-dependent cytotoxicity against a variety of cancer cell lines. Its effectiveness is influenced by the rate of cell division; rapidly dividing cells are more susceptible to its effects. The drug's activity is also associated with the induction of p53-dependent apoptosis, which plays a role in the cellular response to DNA damage.

Pharmacokinetics

Etoposide is administered intravenously or orally and has a bioavailability of approximately 50% when taken orally. It is extensively metabolized in the liver, primarily by the cytochrome P450 system. The elimination half-life ranges from 3 to 11 hours, depending on the route of administration and individual patient factors. Etoposide is primarily excreted via urine, with about 50% of the dose appearing as metabolites and less than 10% as unchanged drug.

Contra-indications

• Hypersensitivity to etoposide or any of its components
• Severe bone marrow suppression
• Pregnancy

Adverse effects

• Nausea
• Vomiting
• Alopecia
• Myelosuppression
• Infection
• Secondary malignancies

Interactions

• Ciclosporin: Moderate (increases exposure)
• Antiepileptics (carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone): Unknown (decreases efficacy)
• Live vaccines: Unknown (increases risk of generalised infection, possibly life-threatening)
• Netupitant: Unknown (increases exposure)

Precautions

• Monitor blood counts regularly due to the risk of myelosuppression
• Use caution in patients with preexisting liver dysfunction
• Ensure appropriate hydration to prevent renal toxicity

Pregnancy

Etoposide is contraindicated in pregnancy due to potential harm to the fetus.

Breast-feeding

It is not known whether etoposide is excreted in human milk. Caution should be exercised when administering etoposide to nursing mothers.

Storage

Store in a cool, dry place at room temperature. Protect from light.

Formulations

• Capsules
• Injection solution