Pregnancy & Lactation : הריון/הנקה

4.6 Fertility, pregnancy and lactation
Women of childbearing potential/ Contraception in males and females
Women of childbearing potential should use appropriate contraceptive measures to avoid pregnancy during etoposide therapy. Etoposide has been shown to be teratogenic in mice and rats (see section 5.3).

Given the mutagenic potential of etoposide, an effective contraception is required for both male and female patients during treatment and 6 months after ending treatment for females and 3 months after ending treatment for males (see section 4.4). Genetic consultation is recommended if the patient wishes to have children after ending treatment.

Pregnancy
There are no or only limited amount of data from the use of etoposide in pregnant women. Studies in animals have shown reproductive toxicity (see section 5.3). In general, etoposide can cause fetal harm when administered to pregnant women. Etoposide should not be used during pregnancy unless the clinical condition of the woman requires treatment with etoposide. Women of childbearing potential should be advised to avoid becoming pregnant. Women of childbearing potential have to use effective contraception during and up to 6 months after treatment. If this drug is used during pregnancy, or if the patient becomes pregnant while receiving this drug, the patient should be informed of the potential hazard to the fetus.

Breast-feeding
Etoposide is excreted in human milk. There is a potential for serious adverse reactions from etoposide in nursing infants. A decision must be made whether to discontinue breast-feeding or to discontinue etoposide, taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman (see section 4.3).

Fertility
As etoposide may decrease male fertility, preservation of sperm may be considered for the purpose of later fatherhood.