Vepesid® 50mg Capsules
INFORMATION FOR THE PATIENT
Vepesid® (etoposide) is a cancer medicine used to treat testicular cancer, lung cancer, ovarian cancer and cancers of the blood (Hodgkin’s and non-Hodgkin’s lymphoma and acute myeloid leukemia).
Vepesid® contains the active substance etoposide and is available as 50mg capsules to be taken by mouth.
Vepesid® is indicated for Small Cell Carcinoma of the Lung, Malignant Lymphoma (histiocytic type), Non-small Cell Carcinoma of the Lung and Testicular Malignancies.
ABOUT THE DISEASE
Small Cell Carcinoma of the Lung
Small-cell carcinoma is a type of highly malignant cancer that most commonly arises within the lung, although it can occasionally arise in other body sites, such as the cervix, prostate, and gastrointestinal tract. Compared to non-small cell carcinoma, small cell carcinoma has a shorter doubling time, higher growth fraction, and earlier development of metastases.
Treatments for SCLC can include:
Chemotherapy, Immunotherapy, Radiation Therapy, Surgery or Palliative Procedures.
Malignant Lymphoma (histiocytic type)
A rare, very aggressive (fast-growing) type of non-Hodgkin lymphoma (cancer that begins in the cells of the immune system). It is marked by large abnormal lymphoid cells that do not look like T cells or B cells.
Non-small Cell Carcinoma of the Lung
Non-small-cell lung carcinoma (NSCLC) is any type of epithelial lung cancer other than small cell lung carcinoma (SCLC). NSCLC accounts for about 85% of all lung cancers. As a class, NSCLCs are relatively insensitive to chemotherapy, compared to small cell carcinoma.
There are different types of treatment for patients with non-small cell lung cancer. These include Surgery, Radiation therapy, Chemotherapy, Targeted therapy, Immunotherapy, Laser therapy, Photodynamic therapy (PDT), Cryosurgery and Electrocautery
Testicular Malignancies (germ cell tumors including seminomas)
A Seminoma is a germ cell tumor of the testicle or, more rarely, the mediastinum or other extra-gonadal locations. It is a malignant neoplasm and is one of the most treatable and curable cancers, with a survival rate above 95% if discovered in early stages.
Testicular seminoma originates in the germinal epithelium of the seminiferous tubules. About half of germ cell tumors of the testicles are seminomas.
The preferred treatment for most forms of stage 1 seminoma is active surveillance. Stage 1 seminoma is characterized by the absence of clinical evidence of metastasis. Active surveillance consists of periodic history and physical examinations, tumor marker analysis, and radiographic imaging. Around 85-95% of these cases will require no further treatment. Modern radiotherapy techniques as well as one or two cycles of single-agent carboplatin have been shown to reduce the risk of relapse but carry the potential of causing delayed side effects. Regardless of treatment strategy, stage 1 seminoma has nearly a 100% cure rate.
Stage 2 seminoma is indicated by the presence of retroperitoneal metastasis. Cases require radiotherapy or, in advanced cases, combination chemotherapy. Large residual masses found after chemotherapy may require surgical resection. Second-line treatment is the same as for nonseminomas.
Stage 3 seminoma is characterized by the presence of metastasis outside the retroperitoneum—the lungs in “good risk” cases or elsewhere in “intermediate risk” cases. This is treated with combination chemotherapy. Second-line treatment follows nonseminoma protocols.
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FREQUENTLY ASKED QUESTIONS
Get emergency medical help if you have signs of an allergic reaction: fever, chills, sweating, fast heartbeats, fainting; hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- sudden chest pain or discomfort, wheezing, dry cough or hack;
- easy bruising, unusual bleeding, purple or red pinpoint spots under your skin;
- vision problems;
- seizure (convulsions);
- liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- low red blood cells (anemia)–pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;
- low white blood cell counts–fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, trouble breathing; or
- severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common side effects may include:
- nausea, vomiting; or
- temporary hair loss.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
- You should not use etoposide if you are allergic to it.
- To make sure you can safely take etoposide, tell your doctor if you have kidney disease.
- Using etoposide may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.
- Do not use etoposide if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.
- It is not known whether etoposide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using etoposide.
- Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
- Take this medicine with a full glass of water.
- Do not break or open the etoposide capsule. Do not use a pill that has been accidentally broken.
- The medicine from a broken capsule can be dangerous if it gets in your eyes, mouth, or nose, or on your skin. If this occurs, wash your skin with soap and water or rinse your eyes with water. Wear disposable rubber gloves when you handle an etoposide capsule. Throw the gloves away after one use.
- Etoposide can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.
- Store etoposide capsules in the refrigerator, do not freeze.
This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient’s body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
Do not receive a “live” vaccine while using etoposide. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Other drugs may interact with etoposide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all the medicines you use now and any medicine you start or stop using.
Your doctor or pharmacist can provide more information about etoposide