cancer to salvage intrathecal etoposide subsequent to failure of first-line methotrexate: a case report and literature review7 be a simpler and more convenient practice. Cerebrospinal fluid pharmacokinetics after different dosage regimens of intraventricular etoposide3 Unknown Unknown Intraventricular administration via Ommaya reservoir. This study investigated pharmacokinetic parameters of etoposide in CSF following intraventricular administration utilising different dosage schedules in 9 patients aged 3-32 years. Pharmacokinetics of etoposide following intraventricular administration exhibited a linear two-compartment model. Intrathecal administration of etoposide in the treatment of malignant meningitis: feasibility and pharmacokinetic data6 Unknown - “i.v. etoposide formulation” Unknown 1st patient: 0.5mg diluted in 2mL of saline administered intraventricularly via subcutaneous reservoir. 2nd patient: 0.5mg diluted in 2mL of saline administered intrathecally (unclear where this administration took place). This reference describes two case reports of patients’ treated with 0.5mg etoposide on five consecutive days, followed by a second course of 0.5mg etoposide twice daily (2 hours apart for the first patient, 12 hours apart for the second) for 5 days, 21 days after the first course. No systemic toxicities were demonstrated in either patient. Comparison of UK Marketed Products with Products Used in References Note: Products with the same, or similar excipients, may utilise different concentrations. Vepesid, Bristol-Myers Squibb, Germany1,4 Etoposid Ebewe, BASF Pharma, Austria5 ETO-GRY, Teva, Germany4 Absolute ethyl alcohol, Benzyl alcohol, Citric acid, Macrogol 300, Polysorbate 80 Benzyl alcohol, Citric acid, Ethanol, Macrogol 300, Nitrogen, Polysorbate 80 Citric acid, Ethanol, Macrogol 300, Polysorbate 80 Teva UK Limited Most similar to the ETO-GRY product Citric acid, Ethanol, Macrogol 300, Polysorbate 80 Similar content except: UK product does not contain benzyl alcohol – potentially beneficial Similar content except: UK product does not contain benzyl alcohol – potentially beneficial Same content
suggested within the literature to be the “safest”. Austrian product also includes nitrogen as an excipient – impact unclear medac GmbH(Eposin) Currently used in UK practice. Benzyl alcohol, Citric acid, anhydrous, Ethanol, Macrogol 300, Polysorbate 80 Same content Similar content: Austrian product also includes nitrogen as an excipient – impact unclear UK product contains benzyl alcohol Other excipients may be different concentrations Accord Healthcare Limited Benzyl alcohol, Citric acid, anhydrous, Ethanol, anhydrous, Macrogol 300, Polysorbate 80 Same content Similar content except: Austrian product also includes nitrogen – impact unclear UK product contains benzyl alcohol Other excipients may be different concentrations Actavis UK Ltd Citric acid, anhydrous, Ethanol, anhydrous, Macrogol 400, Polysorbate 80 Similar content except: UK product does not contain benzyl alcohol – potentially beneficial UK product utilises macrogol 400 instead of macrogol 300 – impact unclear Similar content except: UK product does not contain benzyl alcohol – potentially beneficial UK product utilises macrogol 400 instead of macrogol 300 – impact unclear Austrian product also includes nitrogen – impact unclear Similar content except: UK product utilises macrogol 400 instead of macrogol 300 – impact unclear Cipla (EU) Limited Benzyl alcohol, Citric acid, anhydrous, Ethanol, Macrogol 300, Polysorbate 80 Same content Similar content: Austrian product also includes nitrogen as an excipient – impact unclear UK product contains benzyl alcohol Other excipients may be different concentrations Fresenius Kabi Oncology Plc. Benzyl alcohol, Citric acid, Ethanol Anhydrous, Macrogol 300, Polysorbate 80 Same content Similar content: Austrian product also includes nitrogen as an excipient – impact unclear UK product contains benzyl alcohol Other excipients may be different concentrations