teniposide teniposide teniposide (trade name vumon) is a chemotherapeutic medication used in the treatment of childhood acute lymphocytic leukemia (all), hodgkin's lymphoma, certain brain tumours, and other types of cancer. it is in a class of drugs known as podophyllotoxin derivatives and slows the growth of cancer cells in the body. teniposideclinical datatrade namesvumonother namesvm-26ahfs/drugs.commonographmedlineplusa692045pregnancycategory au: d routes ofadministrationintravenousatc codel01cb02 (who) legal statuslegal status us: ℞-only pharmacokinetic databioavailabilityn/aprotein binding>99%metabolismhepatic (cyp2c19-mediated)elimination half-life5 hoursexcretionrenal and fecalidentifiers iupac name (5r,5ar,8ar,9s)-5,8,8a,9-tetrahydro-5-(4-hydroxy-3,5-dimethoxyphenyl)-9-(oxy)furonaphtho-1,3-dioxol-6(5ah)-one cas number29767-20-2 ypubchem cid34698iuphar/bps6843drugbankdb00444 nchemspider31930 nunii957e6438qakeggd02698 ychebichebi:75988 nchemblchembl1200536 ncomptox dashboard (epa)dtxsid8023638 echa infocard100.045.286 chemical and physical dataformulac32h32o13smolar mass656.66 g·mol−13d model (jsmol)interactive image smiles coc1cc(cc(c1o)oc)2c3cc4c(cc3(52c(=o)oc5)o6((7(o6)coc(o7)c8cccs8)o)o)oco4 inchi inchi=1s/c32h32o13s/c1-37-19-6-13(7-20(38-2)25(19)33)23-14-8-17-18(42-12-41-17)9-15(14)28(16-10-39-30(36)24(16)23)44-32-27(35)26(34)29-21(43-32)11-40-31(45-29)22-4-3-5-46-22/h3-9,16,21,23-24,26-29,31-35h,10-12h2,1-2h3/t16-,21+,23+,24-,26+,27+,28+,29+,31?,32-/m0/s1 nkey:nrukocrgynpupr-pszsyxfxsa-n n ny (what is this?) (verify) medical uses teniposide is used for the treatment of a number of cancer types in children. in the us, it is approved for the second-line therapy of acute lymphocytic leukemia (all) in combination with other antineoplastic drugs. in europe, it is also approved for the treatment of hodgkin's lymphoma, generalized malignant lymphoma, reticulocyte sarcoma, acute leukaemia, primary brain tumours (glioblastoma, ependymoma, astrocytoma), bladder cancer, neuroblastoma and other solid tumours in children. administration the medication is injected though a vein and burns if it leaks under the skin. it can be used in combination with other anticancer drugs. contraindications the drug is contraindicated during pregnancy and lactation, in patients with severe liver or kidney impairment or severely impaired haematopoiesis. side effects teniposide, when used with other chemotherapeutic agents for the treatment of all, results in severe bone marrow suppression. other common side effects include gastrointestinal toxicity, hypersensitivity reactions, and reversible alopecia. interactions no systematic interaction studies are available. the enzyme inducers phenobarbital and phenytoin have been found to lower its blood plasma concentrations. theoretically possible interactions include increased plasma concentrations when combined with sodium salicylate, sulfamethizole or tolbutamide, which displace teniposide from plasma protein binding, at least in vitro. pharmacology mechanism of action teniposide causes dose-dependent single- and double-stranded breaks in dna and dna-protein cross-links. the substance has been found to act as an inhibitor of topoisomerase ii (an enzyme that aids in dna unwinding), since it does not intercalate into dna or bind strongly to dna. the cytotoxic effects of teniposide are related to the relative number of double-stranded dna breaks produced in cells, which are a reflection of the stabilization of a topoisomerase ii-dna intermediate. chemistry an illustration of the wild mandrake, showing part of the rhizome (at bottom) teniposide is a semisynthetic derivative of podophyllotoxin from the rhizome of the wild mandrake (podophyllum peltatum). more specifically, it is a glycoside of podophyllotoxin with a d-glucose derivative. it is chemically similar to the anti-cancer drug etoposide, being distinguished only by a thienyl rest where etoposide has a methyl. both these compounds have been developed with the aim of creating less toxic derivatives of podophyllotoxin.