Etopul Special Precautions

Etoposide should be administered with caution in the following patients: Patients with bone marrow depression.
Patients with hepatic impairment, cardiac impairment, patients who have a complication of infection, chickenpox (fatal systemic symptom may appear).
Severe adverse reaction including bone marrow depression may occur. Therefore, monitor patient’s condition and perform clinical tests (hematologic, hepatic, renal test) frequently. If any symptoms occur, the dose of the drug should be reduced or the drug should be discontinued and appropriate corrective measures should be taken.
Since long-term therapy may cause serious adverse reaction or become chronic, the administration should be cautioned.
Manifestation or ingravescence of bleeding tendency should be cautioned.
Use in pediatric should be especially considered about manifestation of adverse reaction and the administration cautioned.
In use in children or patients of child bearing age, the influence on gonad should be considered.
Etoposide should not be administered subcutaneously or intramuscularly.
IV administration may cause vascular pain, phlebitis, hypotension, arrhythmia, therefore, injection site and administration method should be considered. And rate of injection should be as slow as possible.
When etoposide is administered intravenously, care should be taken to avoid extravasation.
Etoposide should be diluted to the concentration of not more than 0.25 mg/mL to avoid precipitation. The reconstituted solution should be used immediately after reconstitution.
Others: In the treatment of acute leukemia, peripheral vessel and bone marrow should be regularly monitored and also period of the administration should be reduced or prolonged.
In animal studies, the drug has been excreted in milk. Use in nursing mothers should be avoided.
Use in the Elderly: No dosage adjustment is necessary among the elderly.
Use in Children: Use in children should be especially considered because of the possibility of occurrence of adverse reactions. Safety and effectiveness in children have not been established.
Use in Pregnancy and Lactation: In animal studies, teratogenesis has been reported. Therefore, the drug should not be administered to pregnant women or women suspected of being pregnant.