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Etoposide: How to Give by Mouth

Etoposide is a medicine used to kill cancer cells. It stops cancer cells from dividing and making new cells. Etoposide comes in capsule and injection forms.

You may also hear etoposide called VP-16​, or by its brand name VePesid®.

Some children are unable to swallow etoposide 50 mg capsules or need a dose smaller than 50 mg. The etoposide 20 mg/mL injectable solution is given by mouth. Please carefully review the following instructions.

Before giving any chemotherapy, please see Chemotherapy at Home: Safely Handling and Giving Medicines.

When giving your child chemotherapy:

  • wear gloves, a mask, and a gown
  • make sure the disposal supplies are ready
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Avoid contact with the chemotherapy by wearing gloves and a face mask. Cover your clothes with a disposable gown, apron, or old oversized shirt.

You also need:

  • intravenous syringes
  • vial access devices (spikes)
  • an absorbent plastic-backed pad
  • vial containing etoposide medicine

To remove the etoposide from the vial, you need to use the vial access device (spike) and the intravenous syringe.

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Withdrawing etoposide from the vial

  • Remove the plastic cap from the etoposide vial and place the vial upright on a hard surface.
  • Remove the vial spike from its package and insert it into the drug vial.
  • Place the etoposide vial on the counter and align the spike with the centre of the vial closure. Keep the spike straight and push down firmly into the vial until the spike passes through the rubber stopper and the plastic “skirt” snaps onto the vial.
  • Remove the syringe from its packaging. Attach the syringe to the vial spike by pushing and twisting until secure.
  • Turn the vial upside down and pull back the syringe plunger slowly to draw out the required dose.
  • A small balloon will inflate inside the vial to equalize the pressure. This is normal.
  • Remove the syringe from the vial spike.

You are now ready to give the etoposide dose.

Giving your child etoposide by mouth

  • Dilute the etoposide liquid with at least an equal amount of juice to improve the taste. You may use apple juice, orange juice, cola, or lemonade. Grapefruit juice should not be used.
  • Discard the empty syringe into the sharps container when you are finished.
  • When additional doses are needed, a new syringe should be used.
  • The vial spike remains on the etoposide vial and can be used for subsequent doses for up to 10 days. Store the vial upright, in a cool, dry place, protected from light.
  • Use a new vial spike for each new etoposide vial that you use.

For safe storage and disposal information, please see Chemotherapy at Home: Safely Handling and Giving Medicines.

Key points

  • The etoposide 20 mg/mL injectable solution is given by mouth.
  • Wear gloves, mask, and a gown when giving your child etoposide.
  • To remove the etoposide from the vial, you need to use the vial access device (spike) and the intravenous syringe.
  • Dilute etoposide in a liquid. Do not use grapefruit juice.
  • Use a new vial spike for each new etoposide vial that you use.

Elyse Zelunka BScPhm, RPh, ACPR
Lisa Honeyford, RN, MN, CPON 
Tracey Taylor BScPhm, RPh, ACPR
Ann Chang RN, MN, CPON
Drugs & Therapeutics Committee
Haematology/Oncology Quality Utilization & Patient Care Committee

12/23/2010




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