Etoposide

Topoisomerase inhibitor

MECHANISM OF ACTION

Delay transit of cells through the S phase and arrest cells in late S or early G2 phase

MECHANISM OF KIDNEY INJURY

Unclear mechanism of AKI.

CLINICAL KIDNEY SYNDROME

High dose etoposide has been shown to cause AKI in children receiving HSCT.

CARDIOVASCULAR ADVERSE EFFECTS

LYTE ABNORMALITIES

RISK FACTORS

MITIGATION STRATEGIES

SUGGESTIONS

Reduce dose by 50%; not removed by hemodialysis so may be administered before or after dialysis

NOTES/COMMENTS

eGFR 30-59 ml/min , 75% of the dose
eGFR < 30 ml/min, unclear (75% of the dose per ADDIKD)

PHARMACOKINETICS

Molecular Weight

588

Volume of Distribution

; Adults: 7 to 17 L/m2

Plasma Protein Binding

98%

Metabolism

Bioavailability

Half-life elimination

4-11 hours

Time to peak

Excretion

Urine 56% and Feces 44%

Dialyzable?

REF:

PMID: 29528179
Uptodate
ADDIKD

PATHOLOGY SLIDES:

ENTRY UPDATES:

Raad Chowdhury

United States

Sep 25, 2022

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