Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Avoid or Use Alternate Drug. Use Caution/Monitor. Avoid or Use Alternate Drug. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation. Classification: Topoisomerase inhibitor About: Etoposide (Toposar, VePesid, Etopophos,VP-16) Etoposide works by blocking the action of an enzyme in cells called topoisomerase, which is necessary for cell replication and tumor growth. Consider reducing dose when used concomitantly with lomitapide. Results: Escalated etoposide dosing (90 mg/kg) combined with dexrazoxane (125 mg/kg) and cerebral radiotherapy (10 Gy 1) increased the median survival by 60% ( P = 0.001) without increased toxicity, suggesting that escalated etoposide levels may indeed represent a new strategy for improving radiotherapy. Use Caution/Monitor. Indications and dose For etoposide Stage 4 neuroblastoma, Germ-cell tumours, Intracranial germ-cell tumours, Rhabdomyosarcoma, Soft-tissue sarcomas, Neuroectodermal tumours (including medulloblastoma), Relapsed Hodgkin's disease, Non-Hodgkin's lymphoma, Ewing tumour, Acute lymphoblastic leukaemia, Acute myeloid leukaemia for etoposide By mouth, or by intravenous infusion Helps you get and maintain an erection when you need it. Use Caution/Monitor. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. Use Caution/Monitor. levoketoconazole will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Etoposide may harm an unborn baby. Either increases toxicity of the other by immunosuppressive effects; risk of infection. quinidine will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. eslicarbazepine acetate will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ribociclib will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. trastuzumab, etoposide. Monitor Closely (1)etoposide will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)primidone will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. etoposide decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, blood problems (such as low red blood cells/white blood cells/platelets), previous radiation/chemotherapy treatment.Etoposide can make you more likely to get infections or may make current infections worse. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Monitor Closely (1)etoposide will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown. Use Caution/Monitor. Avoid or Use Alternate Drug. A 100 mg oral dose would be comparable to . Use Caution/Monitor. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. Consult your doctor before breast-feeding. New Trials in Lymphoma and MM: Could Your Patient Benefit? Women using this medication should ask about reliable forms of birth control during treatment and for 6 months after the last dose. It is also available as a clear liquid given by vein (IV) Etoposide can pose a health hazard to caregivers. Monitor Closely (1)rifabutin will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Use Caution/Monitor. Grapefruit can affect the removal of etoposide from your body, which may affect how etoposide works. Evaluate for loss of therapeutic effect if medication must be coadministered. Avoid or Use Alternate Drug. idelalisib will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.Serious - Use Alternative (1)tucatinib will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. aprepitant will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 4. Modify Therapy/Monitor Closely. ranolazine will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. You should not become pregnant while using etoposide. etoposide will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erdafitinib will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. Consider dose reduction of sensitive CYP3A4 substrates. Use Caution/Monitor. Otherwise, call a poison control center right away. Monitor Closely (1)posaconazole will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. restrictions. Etoposide is a phase-specific, cytotoxic drug acting in the late S and early G2 phases of the cell cycle. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)etoposide will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. This drug is available at a higher level co-pay. Use Caution/Monitor. Use Caution/Monitor. Etoposide is in a class of medications known as podophyllotoxin derivatives. nefazodone will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. It inhibits DNA topoisomerase II, thereby ultimately inhibiting DNA synthesis. etoposide increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling. Antineoplastics, Podophyllotoxin Derivatives. dichlorphenamide, etoposide. and formulary information changes. Minor/Significance Unknown. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Use Caution/Monitor. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Minor/Significance Unknown. Use Caution/Monitor. Always ask your health care professional for complete information about this product and your specific health needs. Use Caution/Monitor.cyclosporine will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.etoposide will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Compare formulary status to other drugs in the same class. Monitor Closely (1)belzutifan will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. The above information is provided for general trazodone will decrease the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Use Caution/Monitor. nicardipine will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. iloperidone increases levels of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases toxicity of the other by immunosuppressive effects; risk of infection. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvdmVwZXNpZC10b3Bvc2FyLWV0b3Bvc2lkZS0zNDIwOTg=, View explanations for tiers and tecovirimat will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Nausea and vomiting can be severe. Consider dose reduction of sensitive CYP3A4 substrates. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index. Adjust dose according to prescribing information if needed. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Use Caution/Monitor. Use Caution/Monitor. Etoposide (also called VP-16 or Vepesid ) is an anticancer drug. Use Caution/Monitor.Serious - Use Alternative (1)nefazodone will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. amiodarone will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Apalutamide induces UGT and may decrease systemic exposure of drugs that are UGT substrates. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Avoid or Use Alternate Drug. Monitor Closely (1)cimetidine will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. Minor/Significance Unknown. Avoid or Use Alternate Drug. bosentan will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Ask your doctor for more details.A very serious allergic reaction to this drug is rare. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. Use Caution/Monitor. Dosage Warning This medicine may lower the ability of your bone marrow to make blood cells that your body needs. Monitor Closely (1)rifapentine will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor Closely (1)itraconazole will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. MISSED DOSE: It is important to take each dose of etoposide as scheduled. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)mitotane decreases levels of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CLINICAL PARTICULARS 4.1Therapeutic indications Small cell carcinoma of the lung. . Monitor Closely (1)etoposide will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. PRECAUTIONS: Before taking etoposide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis. Monitor Closely (1)ranolazine will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Both drugs can cause metabolic acidosis. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Serious - Use Alternative (1)tepotinib will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. If not feasible, avoid use of abametapir. ivacaftor increases levels of etoposide by P-glycoprotein (MDR1) efflux transporter. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects. Modify Therapy/Monitor Closely. Monitor Closely (1)acalabrutinib, etoposide. Use Caution/Monitor. tepotinib will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. It is very soluble in methanol and chloroform, slightly soluble in ethanol, and sparingly soluble in water and ether. erythromycin stearate will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor Closely (1)vemurafenib increases levels of etoposide by P-glycoprotein (MDR1) efflux transporter. Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy. Use Caution/Monitor.erythromycin ethylsuccinate will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. If not feasible, avoid use of abametapir. The largest diagnostic groups were neuroblastoma (n = 20), rhabdomyosarcoma/soft tissue sarcoma (n = 16) and brain tumours (n = 16). lorlatinib will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. anastrozole will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Pronounced: e-TOE-poe-side Classification: Topoisomerase inhibitor About: Etoposide Oral Formula (VePesid, VP-16) Etoposide works by blocking the action of an enzyme in cells called topoisomerase, which is necessary for cell replication and tumor growth. Minor/Significance Unknown. Avoid or Use Alternate Drug. Use Caution/Monitor. pentobarbital will decrease the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. trastuzumab deruxtecan, etoposide. Immunosuppressive drugs may reduce the immune response to influenza vaccine. bosutinib increases levels of etoposide by P-glycoprotein (MDR1) efflux transporter. USES: Etoposide is used to treat certain forms of lung cancer (such as small cell lung cancer). Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates. Use Caution/Monitor. Avoid or Use Alternate Drug. Use Caution/Monitor. fosamprenavir will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In children, approximately 55% of the dose is excreted in the urine as etoposide in 24 hours. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Minor/Significance Unknown. Use Caution/Monitor.rifampin will decrease the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. 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