(brand names: Eposin
) is an inhibitor of the enzyme topoisomerase II
. It is used as a form of chemotherapy
for malignancies such as Ewing's sarcoma
, lung cancer
, testicular cancer
, 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
Chemically it derives from podophyllotoxin, a toxin found in the American Mayapple.
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.
Patients are generally 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.
Less common are: