Zuvitop

Etoposide (also commonly known as VP-16) is a semisynthetic derivative of podophyllotoxin used in the treatment of certain neoplastic diseases.

It is 4′-demethylepipodophyllotoxin 9-[4,6-O-(R)-ethylidene-β-D-glucopyranoside].

It is very soluble in methanol and chloroform, slightly soluble in ethanol, and sparingly soluble in water and ether.

It is made more miscible with water by means of organic solvents.

It has a molecular weight of 588.56 and a molecular formula of C29H32O13.

Etoposide is administered orally.

Etoposide is available as 50 mg pink capsules.

Each liquid-filled, soft gelatin capsule contains 50 mg of etoposide in a vehicle consisting of citric acid, glycerin, purified water, and polyethylene glycol 400.

The soft gelatin capsules contain gelatin, glycerin, sorbitol, purified water, and parabens (ethyl and propyl) with the following dye system:

• Iron oxide (red)
• Titanium dioxide

The capsules are printed with edible ink.

Zuvitop-50 capsules are indicated in the management of the following neoplasms:

• Small Cell Lung Cancer

• Malignant Lymphomas

Usage

Etoposide is used to treat certain forms of lung cancer (such as small cell lung cancer).

Etoposide works by slowing the growth of cancer cells.

Etoposide is a specific antitumor drug that clinical and basic research has demonstrated to be effective in treating SCLC, malignant lymphoma, and ovarian cancer.

Zuvitop has been shown to cause metaphase arrest in chick fibroblasts.

Its main effect, however, appears to be at the G2 portion of the cell cycle in mammalian cells.

Two different dose-dependent responses are seen.

At high concentrations (10 µg/mL or more), lysis of cells entering mitosis is observed.

At low concentrations (0.3-10 µg/mL), cells are inhibited from entering prophase.

It does not interfere with microtubular assembly.

The predominant macromolecular effect of etoposide appears to be the induction of DNA strand breaks by an interaction with DNA topoisomerase II or the formation of free radicals.

• Read the label carefully before use.

• Keep out the reach of children.

Etoposide Capsules

In small cell lung cancer, the recommended dose of Zuvitop-50 capsules is two times the IV dose rounded to the nearest 50 mg (i.e., two times 35 mg/m²/day for 4 days to 50 mg/m²/day for 5 days).

For one courses of therapy, the normal adult dose in 175-200mg of Zuvitop-50 daily for 5 consecutive days orally, followed by a recession (withdrawal) interval of 3 weeks.

Therapy can be repeated if necessary.

The dose can be increased or reduced.

The dosage by either route should be modified to take into account the myelosuppressive effects of other drugs in the combination or the effects of prior radiation therapy or chemotherapy.

Chemotherapy courses are repeated at 3- to 4-week intervals after adequate recovery from any toxicity.

The dosage should be modified to take into account the myelosuppressive effects of other drugs in the combination or the effects of prior X-ray therapy or chemotherapy which may have compromised bone marrow reserve.

Administration Precautions

To minimize the risk of dermal exposure, always wear impervious gloves when handling blister packs of individually labelled blisters containing etoposide capsules.

This includes all handling activities in clinical settings, pharmacies, storerooms, and home healthcare settings, including during unpacking and inspection, transport within a facility, and dose preparation and administration.

Stability

Etoposide capsules must be stored under refrigeration 2° – 8° C (36° – 46° F).

The capsules are stable for 24 months under such refrigeration conditions.