Etoposide Teva Special Precautions

Etoposide should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents.
Preparation for Intravenous Administration: Etoposide for Injection Concentrate may be diluted with either 5% Dextrose Injection, or 0.9% Sodium Chloride Injection, to give a final concentration of 0.2 mg/ml. The dilutions of Etoposide For Injection Concentrate in 5% Dextrose Injection, or 0.9% Sodium Chloride Injection are stable for 120 hours.
Notes: Etoposide should not be given by rapid intravenous injection.
Etoposide should not be physically mixed with any other drug.
Any solution showing signs of precipitation should be discarded.
Myelosuppression: Patients being treated with Etoposide must be frequently observed for myelosuppression, both during and after therapy. Dose-limiting bone-marrow suppression is the most significant toxicity associated with Etoposide therapy. Therefore, the following studies should be obtained at the start of therapy and prior to each subsequent dose of Etoposide: platelet count, hemoglobin, white blood cell count and differential. The occurrence of a platelet count below 50,000/mm³ or an absolute neutrophil count below 500/mm³ is an indication to withhold further therapy until blood counts have sufficiently recovered.
Anaphylaxis: Anaphylaxis manifested by chills, fever, tachycardia, bronchospasm, dyspnea and hypotension may occur (0.7-2%). The reactions usually respond to cessation of infusion and institution of appropriate therapy. Refer to Management of Acute Hypersensitivity Reactions.
Effects on Mental Alertness: Etoposide injection has no effect on the ability to drive or use machines.