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Systematic (IUPAC) name
4'-demethyl-epipodophyllotoxin 9-[4,6-O-(R)-ethylidene-beta-D-glucopyranoside], 4' -(dihydrogen phosphate)
Clinical data
  • AU: D
  • US: D (Evidence of risk)
Routes of
Oral, intravenous
Legal status
Legal status
Pharmacokinetic data
Bioavailability Highly variable, 25 to 75%
Protein binding 97%
Metabolism Hepatic (CYP3A4 involved)
Biological half-life Oral: 6 h., IV: 6-12 h., IV in children: 3 h.
Excretion Renal and fecal
CAS Number 33419-42-0
ATC code L01CB01 (WHO)
PubChem CID 36462
DrugBank APRD00239
ChemSpider 4447613
Chemical data
Formula C29H32O13
Molar mass 588.557 g/mol[[Script error: No such module "String".]]
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Etoposide phosphate (brand names: Eposin, Etopophos, Vepesid, VP-16) is a cancer drug. It inhibits the enzyme topoisomerase II, which unwinds DNA, and by doing so causes DNA strands to break. Cancer cells are less able to repair this damage than healthy cells. It is used as a form of chemotherapy for cancers such as Ewing's sarcoma, lung cancer, testicular cancer, lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme. It is often given in combination with other drugs. It is also sometimes used in a conditioning regimen prior to a bone marrow or blood stem cell transplant.

Its chemical make-up derives from podophyllotoxin, a toxin found in the American Mayapple.

The name VP-16 likely comes from a compounding of the last name of the chemists who performed early work on the drug (von Wartburg and von Kuhn) and podophyllotoxin[1]. Another chemist who was integral in the development of podophyllotoxin-based chemotherapeutics was Hartmann F. Stähelin.

Mechanism of Action

Etoposide forms a ternary complex with DNA and the topoisomerase II enzyme, preventing re-ligation of the DNA strands. This causes errors in DNA synthesis and promotes apoptosis of the cancer cell.


It is given intravenously or orally in capsule form. If the drug is given by IV it must be done slowly over a 30 to 60 minute period because it can lower blood pressure as it is being administered. Blood pressure is checked often during infusing, with the speed of administration adjusted accordingly.

In general, patients are advised to call their doctor in case of fever, symptoms of infection or painful injection sites, as these may progress severely without adequate medical attention.

Patients are advised to drink large amounts of fluids after treatment to prevent damage to the bladder and kidneys, typically 1.5 to 3.5 litres of water on the day of treatment and for several days after.


Common are:

Less common are:

External links



fr:Étoposide it:Etoposide ja:エトポシド pl:Etopozyd pt:Etopósido ru:Этопозид