Etopul Drug Interactions

The co-administration of high doses of cyclosporine (serum concentration >2000 ng/mL) and oral etoposide led to AUC values for etoposide that were elevated by 80% and to clearance that was reduced by 38% in comparison with etoposide monotherapy.
Concomitant treatment with cisplatin is associated with reduced total body clearance of etoposide. Concomitant phenytoin or phenobarbital therapy is associated with increased etoposide clearance and reduced efficacy.
Prior or concurrent use of other drugs with similar myelosuppression action as etoposide may be expected to have additive or synergetic effects.
There is increased risk of fatal systemic vaccinal disease with the use of yellow fever vaccine. Live vaccines are contraindicated in immunosuppressed patients.
In vitro, plasma protein binding is 97%. Phenylbutazone, sodium salicylate, and acetylsalicylic acid may displace etoposide from plasma protein binding. Concomitant warfarin therapy may result in elevated international normalized ratio (INR). Close monitoring of INR is recommended.
Cross resistance between anthracyclines and etoposide has been reported in preclinical experiments.