Fatal myelosuppression has been reported following etoposide administration. ****Postmarketing complications reported for extravasation included local soft tissue toxicity, swelling, pain, cellulitis, and necrosis including skin necrosis.In the paragraphs below the incidences of adverse events, given as the mean percent, are derived from studies that utilized single agent etoposide therapy.Myelosuppression (see section 4.4) with fatal outcome has been reported following administration of etoposide. High dose ciclosporin, resulting in plasma concentrations above 2000 ng/mL, administered with oral etoposide has led to an 80% increase in etoposide exposure (AUC) with a 38% decrease in total body clearance of etoposide compared to etoposide alone. Etoposide injection is indicated in combination with other approved chemotherapeutic agents for the treatment of first line, recurrent or refractory testicular cancer in adults. The mean renal clearance of etoposide is 7 to 10 mL/min/m2 or about 35% of the total body clearance over a dose range of 80 to 600 mg/m2. In general etoposide can cause fetal harm when administered to pregnant women. If the drug is used during pregnancy, or if the patient becomes pregnant while receiving the drug, the patient should be informedof the potential hazard to the fetus.Etoposide is excreted in human milk. This drug combination deserves further assessment in therapeutic protocols for patients with acute nonlymphocytic leukemia. Anaphylactic reactions can occur with the initial dose of etoposide.Anaphylactic reactions (see section 4.4), manifested by chills, tachycardia, bronchospasm, dyspnoea, diaphoresis, pyrexia, pruritus, hypertension or hypotension, syncope, nausea, and vomiting have been reported to occur in 3% (7 of 245 patients treated with etoposide in 7 clinical studies) of patients treated with etoposide. Cyclophosphamide Tablets are for oral use. It is made more miscible with water by means of organic solvents. Small cell lung cancer. Unable to load your delegates due to an error Etoposide injection is indicated in combination with other approved chemotherapeutic agents for the treatment of small-cell lung cancer in adults. The effect of renal disease on plasma etoposide clearance is not known in children. Reinduction attempts were unsuccessful in patients who had failed to achieve an initial remission and in those whose relapses occurred while receiving therapy. RESULTS: Progression-free survival at 4 months was 42%. If severe reactions occur, the drug should be reduced in dosage or discontinued and appropriate corrective measures should be taken according to the clinical judgment of the physician. The use of gloves is recommended. Therefore patients with low serum albumin may be at increased risk for etoposide-associated toxicities.In patients with moderate (CrCl =15 to 50 mL/min), or severe (CrCl <15ml/min) renal impairment undergoing haemodialysis, etoposide should be administered at a reduced dose (see section 4.2).Haematological parameters should be measured and dose adjustments in subsequent cycles considered based on haematological toxicity and clinical effect in moderate and severe renal impaired patients.Patients with impaired hepatic function should regularly have their hepatic function monitored due to the risk of accumulation of etoposide.Tumour lysis syndrome (sometimes fatal) has been reported following the use of etoposide in association with other chemotherapeutic drugs. The concentration of diluted solution should not exceed 0.4 mg/mL because of risk of precipitation. Sackmann-Muriel F, Fernández-Barbieri MA, Santarelli MT, Matus-Ridley M, Rosso A, Negri-Aranguren P, Cerutti I, Gomel M, Kvicala R.Look AT, Dahl GV, Kalwinsky D, Senzer N, Mason C, Rivera G.Cancer Chemother Pharmacol. These reactions have usually responded promptly to the cessation of the infusion and administration of pressor agents, corticosteroids, antihistamines, or volume expanders as appropriate.Acute fatal reactions associated with bronchospasm have been reported with etoposide. Glucuronide and/or sulphate conjugates of etoposide are also excreted in human urine. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user.