– Concentrated solution of etoposide must be diluted before admistration with 0,9% sodium chloride or 5% dextrose injection to obtain a solution containing from 200 to 400 µg/ml (at a concentration above 400 µg/ml, precipitation may be occur).

– Etoposide is administered by slow IV infusion. Etoposide solution should not be admisitered by rapid IV injection because it may be cause hypotension. So, etoposide solution should be infused slowly over a period at least 30-60 minutes.

– Dosage of etoposide must be based on the clinical and hematologic response and tolerance of patient and whether or not other chemotherapy or radiation has been used in order to obtain optimum therapeutic results with minimum adverse effects.

• Small cell lung carcinoma: the usual dosage of etoposide ranges from 35 mg/m²daily for 4 consecutive days to 50 mg/m² daily for 5 consecutive days, every 3-4 weeks.
• Testicular tumors: For treatment of refractory testicular tumors, the usual IV dosage of etoposide in combination chemotherapy regiments is 50-100 mg/m²daily on days 1, 3 and 5 every 3-4 weeks for 3 or 4 courses of therapy.
• Other malignant neoplasms: Similar dosages to be used in the treatment of refract testicular tumors. But it has varied widely. For the treatment of Kaposi’s sarcoma in patients with AIDS, etoposide has been given in an IV dosage of 150 mg/m²daily for 3 consecutive days, every 4 weeks, with the cycles of therapy repeated depending on the myelosuppressive effect of the drug.
• Dosage in renal impairment: initial dose of etoposide may be adjusted depending on creatinine clearance

– Subsequent etoposide dosing should be based on patient tolerance and clinical effect. In patients with creatinine clearance less than 15 ml/minute, further dose reduction should be considered.

• Dosage in hepatic impairment: the effect of hepatic impairment on the eliminaton of etoposide may be reduced in patients with impaired hepatic function.
• Pediatric: the dosage is undefined; the drug can be life threatening to children especially infants, with symptoms such as: renal-hepatic impairment, respiratory failure, thrombocytopenia and ascitic.