When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to etoposide.

How to Use This Medicine:
Capsule, Liquid Filled Capsule

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Etoposide is sometimes given together with certain other medicines. If you are using a combination of medicines, make sure that you take each one at the proper time and do not mix them. If you are taking some of these medicines by mouth, ask your doctor to help you plan a way to remember to take your medicines at the right times.
• Always wear impervious gloves when handling the blisterpacks containing the capsules. This would prevent exposure to the medicine.
• You may also receive medicines to help prevent nausea and vomiting.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using cyclosporine (Gengraf®, Neoral®, Sandimmune®).
• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Make sure your doctor knows if you are breastfeeding, or if you have kidney disease, liver disease, any type of infection, or a history of low albumin (plasma protein).
• This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have chills, fever, lightheadedness, dizziness, fainting, fast heartbeat, swelling of the face, tongue, or throat, or trouble with breathing after taking the medicine.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine may cause leukemia (cancer of the blood or bone marrow) in rare cases. Talk with your doctor about any concerns you have about this.
• This medicine may make your mouth sore and irritated. Brush your teeth with a soft-bristle toothbrush or mouth swab.
• Cancer medicine can cause nausea or vomiting, sometimes even after you receive medicine to prevent these effects. Ask your doctor or nurse about other ways to control any nausea or vomiting that might happen. If the medicine does not help (you can't keep liquids down), call your doctor.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash.
• Blood in the urine or stools.
• Blue fingernails, lips, skin, palms, or nail beds.
• Blurred vision or changes in vision.
• Confusion, restlessness, or loss of consciousness.
• Fast, slow, pounding, or uneven heartbeat.
• Increased sweating, or shivering.
• Lightheadedness, dizziness, or fainting.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Painful mouth sores that keep you from drinking liquids.
• Seizures or tremors.
• Severe diarrhea.
• Shortness of breath, trouble with breathing, chest or throat tightness, or wheezing.
• Swelling in your face, mouth, or tongue.
• Trouble with swallowing.
• Unexplained fever, chills, cough, or sore throat.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Back pain.
• Bad or unusual taste in your mouth.
• Constipation, diarrhea, nausea, vomiting, or stomach pain.
• Hair loss.
• Loss of appetite.
• Mild skin rash, itching, or hives.
• Sleepiness or unusual drowsiness.
• Warmth or redness in your face, neck, arms, or upper chest.
• Weakness.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088