Section 1 - CHEMICAL PRODUCT AND COMPANY IDENTIFICATION

PRODUCT NAME

VUMON

NFPA

PRODUCT USE

Semi- synthetic derivative of podophyllotoxin. An antineoplastic agent with anti- mitotic
properties (ie inhibits cell division). Used in the treatment of solid tumors of the lung
and testes (by intravenous infusion in sodium chloride). May also be given by mouth.
Inhibits DNA synthesis and induces double- strand and single- strand breaks in DNA; most
active in late S- phase and G2- phase of the cell cycle. Inhibits topoisomerase II.

SYNONYMS

C32-H32-O13-S, "epipodophyllotoxin, 4'-demethyl-, ", "epipodophyllotoxin, 4'-demethyl-,
", "9-(4, 6-O-2-thenylidene-beta-D-glucopyranoside", "9-(4, 6-O-2-thenylidene-beta-D-
glucopyranoside", 4'-demethylepipodophyllotoxin, 4'-demethylepipodophyllotoxin, 4'-
demethyl-epipodophyllotoxin-beta-D-thenylidene-glucoside, 4'-demethyl-epipodophyllotoxin-
beta-D-thenylidene-glucoside, "4'-demethyl-1-O-[4, 6-O, O-(2-thenylidene)-beta-D-
glucopyranosyl]-", "4'-demethyl-1-O-[4, 6-O, O-(2-thenylidene)-beta-D-glucopyranosyl]-",
epipodophyllotoxin, "epipodophyllotoxin-beta-D-thenylidene-glucoside, 4-demethyl-",
"epipodophyllotoxin-beta-D-thenylidene-glucoside, 4-demethyl-", "(5S', 5aR, 8aS, 9R)-5,
8, 8a, 9-tetrahydro-5-(4-hydroxy-3, 5-dimethoxyphenyl)-", "(5S', 5aR, 8aS, 9R)-5, 8, 8a,
9-tetrahydro-5-(4-hydroxy-3, 5-dimethoxyphenyl)-", "9-(4, 6-O-thenylidene-beta-D-
glucopyranosyloxy)isobenzofuro[5, 6-f][1, 3]-", "9-(4, 6-O-thenylidene-beta-D-
glucopyranosyloxy)isobenzofuro[5, 6-f][1, 3]-", benzodioxo-6(5aH)-one, EPT, PTG, NSC-
122819, Teniposide, Vehem, VM-26, "antineoplastic/ cytotoxic/ anti-cancer agent",
tumoristat, tumouristat, "topoisomerase II inhibitor", "topoisomerase II inhibitor"

Section 2 - HAZARDS IDENTIFICATION

CANADIAN WHMIS SYMBOLS

EMERGENCY OVERVIEW

RISK

Irritating to skin.
May cause heritable genetic damage.
Limited evidence of a carcinogenic effect.
May impair fertility.
May cause harm to the unborn child.
Toxic: danger of serious damage to health by prolonged exposure if swallowed.

POTENTIAL HEALTH EFFECTS

ACUTE HEALTH EFFECTS

SWALLOWED

  Although ingestion is not thought to produce harmful effects, the material may still be damaging to the health of the individual following ingestion, especially where pre-  existing organ (e.g. liver, kidney) damage is evident. Present definitions of harmful or toxic substances are generally based on doses producing mortality (death) rather than those producing morbidity (disease, ill-health). Gastrointestinal tract discomfort may produce nausea and vomiting. In an occupational setting however, ingestion of insignificant quantities is not thought to be cause for concern.  The killing action of antineoplastic drugs used for cancer chemotherapy is not selective for cancerous cells alone but affect all dividing cells. Acute side effects include loss of appetite, nausea and vomiting, allergic reaction (skin rash, itch, redness, low blood pressure, unwellness and anaphylactic shock) and local irritation. Gout and renal failure can occur.  

EYE

  Although the material is not thought to be an irritant, direct contact with the eye may cause transient discomfort characterized by tearing or conjunctival redness (as with windburn). Slight abrasive damage may also result. The material may produce foreign body irritation in certain individuals.  

SKIN

  This material can cause inflammation of the skin oncontact in some persons.  The material may accentuate any pre-existing dermatitis condition.  Skin contact with the material may damage the health of the individual; systemic effects may result following absorption.  Open cuts, abraded or irritated skin should not be exposed to this material.  Entry into the blood-stream, through, for example, cuts, abrasions or lesions, may produce systemic injury with harmful effects. Examine the skin prior to the use of the material and ensure that any external damage is suitably protected.  

INHALED

  Inhalation may produce health damage*.  The material is not thought to produce respiratory irritation (as classified using animal models). Nevertheless inhalation of dusts, or fume, especially for prolonged periods, may produce respiratory discomfort and occasionally, distress.  Inhalation of dusts, generated by the material during the course of normal handling, may be damaging to the health of the individual.  

CHRONIC HEALTH EFFECTS

  Toxic: danger of serious damage to health by prolonged exposure if swallowed.  This material can cause serious damage if one is exposed to it for long periods. It can be assumed that it contains a substance which can produce severe defects. This has been demonstrated via both short- and long-term experimentation.  Ample evidence exists from experimentation that reduced human fertility is directly caused by exposure to the material.  Ample evidence exists, from results in experimentation, that developmental disorders are directly caused by human exposure to the material.  Limited evidence suggests that repeated or long-term occupational exposure may produce cumulative health effects involving organs or biochemical systems.  Exposure to the material may result in a possible risk of irreversible effects. The material may produce mutagenic effects in man. This concern is raised, generally, on the basis ofappropriate studies with similar materials using mammalian somatic cells in vivo. Such findings are often supported by positive results from in vitro mutagenicity studies.  Anti-cancer drugs used for chemotherapy can depress the bone marrow with reduction in the number of white blood cells and platelets and bleeding. Susceptibility to infections and bleeding is increased, which can be life- threatening. Digestive system effects may include inflammation of the mouth cavity, mouth ulcers, esophagus inflammation, abdominal pain and bleeds, diarrhea, bowel ulcers and perforation. Reversible hair loss can result and wound healing may be delayed. Long-term effects on the gonads may cause periods to stop and inhibit sperm production. Most anti-cancer drugs can potentially cause mutations and birth defects, and coupled with the effects of the suppression of the immune system, may also cause cancer.  Exposure to small quantities may induce hypersensitivity reactions characterized by acute bronchospasm, hives (urticaria), deep dermal wheals (angioneurotic edema), running nose (rhinitis) and blurred vision . Anaphylactic shock and skin rash (non-thrombocytopenic purpura) may occur. An individual may be predisposed to such anti-body mediated reaction if other chemical agents have caused prior sensitization (cross-sensitivity).  Hypersensitisation reactions have occurred amongst patients exposed to the congener etoposide. Leucopenia (decrease in leucocytes), thrombocytopenia (decrease in number of blood platelets) and pancytopenia (deficiencies in all blood cell components, viz aplastic anaemia) have been reported in  patients undergoing etoposide treatment. Peripheral neuropathies have been reported following therapeutic use of etoposide.