VP-16

VP-16 (Vepesid, etoposide)

VP-16 is a chemotherapy drug used in patients with recurrent brain tumors. It is also used to treat a variety of other types of cancer.

How is VP-16 supplied?

VP-16 is supplied in 50 mg capsules (or in intravenous form).

How should I take VP-16?

1. Take nausea medication (e.g., Kytril, Zofran or Anzemet) one hour before taking VP-16 =.
2. You can take VP-16 at any time of the day.
3. This medication is taken daily for 21 consecutive days.

What are common side effects of VP-16 and how should I manage them?

1. Nausea
   Take Kytril or Zofran at least once a day prior to VP-16 dose, but more often if needed. There are also other drugs available to help with nausea if needed.
2. Mouth soreness
   VP-16  may affect your taste buds, causing food to taste different. Some people develop ulcers in their mouths too. If you experience mouth soreness or ulcers that affect normal consumption of food or liquids, contact your neuro-oncology team.
3. Diarrhea and/or constipation
   You may wonder how this medication could cause both diarrhea and constipation. Symptoms vary among people. Some may have loose stools while undergoing chemotherapy and others may fluctuate between loose stools and constipation. If you are having trouble managing your bowels, contact the neuro-oncology office and they can help find a regimen that may work better for you. 
4. Hair loss/thinning
   VP-16 may cause thinning, or even loss, of your hair. If this is concerning to you, talk to your healthcare provider. Your insurance may cover the costs of a wig. There may be resources in the community for assistance as well.
5. Bone marrow suppression (a decrease in WBC, RBC, PLT)
   • White Blood Cells (WBC) – infection fighters
     Your WBC may decrease during when undergoing VP-16 treatment, and your healthcare provider may interrupt your drug therapy if your blood counts are low. This is a normal side effect of the medication. If you experience a fever while taking VP-16, you should call your neuro-oncology team.
   • Red Blood Cells (RBC) – oxygen carriers
     Anemia may worsen over a period of months. In rare cases, a patient may need a blood transfusion.
   • Platelets (PLT) – blood-clotting cells
     Platelets may be affected by VP-16 use, although rarely do patients need a platelet transfusion. If you experience blood in your urine and/or stool, a nosebleed that does not stop or any unusual bleeding, you should immediately contact your neuro-oncologist.
6. Fatigue
   Fatigue associated with VP-16 is usually manageable for most patients. Fatigue may worsen   during the weeks of chemotherapy treatment, but for some patients the fatigue may linger after chemo is completed. Talk to your healthcare provider if fatigue is interfering  with your daily life.

Pharmacy/Insurance Note:

VP-16 is not usually in stock at your local grocery store or pharmacy. Most university hospital pharmacies will keep this drug in stock. If possible, try to get your VP-16 prescription filled at UCLA Health to avoid a delay that will occur when your local pharmacy has to order the medication for delivery.