Etoposide (Vepesid, VP-16)

Etoposide is a chemotherapy drug that is used in the treatment of some types of cancer including testicular, ovarian, lung cancer, lymphomas and leukaemias. It may be helpful to read the general chemotherapy information section together with this section, as it will give more advice on chemotherapy side effects.

What Etoposide looks like?

It is a colourless fluid when dissolved from a powder.
It also comes in pink 50mg and 100mg tablets.

How is it given?

Etoposide can be given as an infusion (intravenous) into a peripheral cannula or via a central line.
Etoposide can be taken in tablet form. Tablets are swallowed whole.

Side effects

The side effects mentioned below may not affect everyone, as each patient’s reaction to chemotherapy is different. It will also depend on how many chemotherapy drugs you are receiving. If you experience any effects that you think are related to your chemotherapy, please discuss them with your oncology doctor or chemotherapy nurse.


You will be more prone to infection as Etoposide affects your white cell production from the bone marrow. This effect usually occurs about 7 days after your chemotherapy. Your white cells however do gradually recover and are usually within normal ranges for your next chemotherapy course.
You should contact your doctor or the Oncology Unit straight away if you if you have a sore throat,cough, pain passing urine, redness and swelling at e.g. at a catheter site. Or have a temperature of 38 degrees° C or greater.


You may feel lethargic and breathless due to a reduction in your red cells caused by Etoposide. Inform your doctor if you are feeling these effects.


Etoposide can also affect the production of platelets, which can cause bleeding or bruising. Inform your doctor if you notice any unexplained bleeding or bruising.

Nausea and vomiting

Etoposide can make make you feel sick nausea   or to to be sick vomit  . When this occurs can vary. It is more common when you are taking the oral form of Etoposide. Your doctor will prescribe some medications to prevent this anti-emetics  . If you continue to feel sick it is important to inform your doctor.

Hair loss (alopecia)

You may lose all your hair or it may just thin out. This usually happens after your first course of chemotherapy. This is temporary and your hair will grow back.

Sore mouth

You may develop a sore mouth or ulcers due to your chemotherapy. You will be prescribed some mouthwashes. Inform your doctor or nurse if your mouth becomes sore or you develop ulcers. You may also experience some taste changes, which will resolve when you finish your treatment.


You may experience some diarrhoea. It is important to inform your doctor or nurse if you are having a lot of bowel motions in a day.


You may feel very tired. This can last for a few months after your treatment. Inform your doctor or nurse of how you are feeling.

Loss of appetite

You may find that your appetite decreases while you are receiving chemotherapy. You should maintain a healthy diet and ask to speak to your dietician if you have any worries.

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Less common side effects

Skin changes

Etoposide can sometimes cause a rash, which may be itchy. Inform your doctor if you notice a rash anywhere on your body.
Your skin may look darker due to increased pigmentation, this usually returns to normal after treatment has finished.

Hypersensitivity reaction

This reaction can occur while the chemotherapy drug is infusing. You may develop facial flushing, shortness of breath or a rash. This reaction is rare. Your blood pressure may also drop but this usually only occurs if the drug is given too quickly.

Neurological effects

Etoposide can cause headaches or confusion but this is very rare. Inform your doctor if you are experiencing these effects.

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Other information


It is important to discuss this with your doctor as etoposide may affect your fertility.


It is important to use a reliable form of contraception while you are on treatment and for at least two years after your treatment has completed. It is not advised to get pregnant while on treatment as the drugs may affect the foetus.

Other medications

It is important to inform your doctor of any medications that you are taking, including over the counter medications or herbal drugs as they can interfere with some chemotherapy drugs.

Care of chemotherapy tablets

  • Do not handle the tablets, take them directly from the package or use gloves.
  • Take the tablets as prescribed by your doctor.
  • If you miss a dose, inform your doctor.
  • If you vomit immediately after taking a tablet, inform your nurse or doctor. You may need to repeat the dose.
  • Keep them in a cool dry place away from sunlight and out of reach of children.
  • Return any unused tablets to the pharmacy.


  • The Chemotherapy Source Book (2nd edition). M. Perry, Lippincott, Williams and Wilkins, 1997
  • British National Formulary (53rd edition). British Medical Association and Royal Pharmaceutical Society of Great Britain, March 2007
  • The Cytotoxics Handbook (3rd edition). M. Allwood, A. Stanley and P. Wright, Radcliffe Medical Press, Oxford and New York, 1997
  • Cancer Chemotherapy Handbook. T. Dorr and W.L. Fritz, Kimpton Medical Publications, London, 1980
  • Handbook of Chemotherapy in Clinical Oncology (2nd edition). E. Cvitkovic, J.P. Droz, J.P. Armand and S. Khoury, Scientific Communication International Ltd, 1993

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