Etoposide-Associated Muscle Cramps and Management with Diazepam

Aim: Etoposide is an anti-neoplastic drug used in the management of testicular malignancies. In this report, we describe an unexpected adverse reaction experienced by a 27-year-old male patient undergoing first line treatment for metastatic testicular cancer with bleomycin, etoposide, and cisplatin (BEP) protocol. Case Report: The patient, on separate days, experienced two episodes of severe muscle cramps associated with excruciating pain shortly after the administration of etoposide therapy. With no other drugs administered at the time of the etoposide infusions, and a Naranjo probability score of seven, the association between etoposide and the muscle cramps experienced by the patient is probable. To maintain the patient on first-line therapy, diazepam was administered prior to each infusion of etoposide with a favorable response. The patient continued to receive therapy with etoposide without the occurrence of muscle cramps. Conclusion: To the extent of our knowledge, this is the first case report describing such an adverse reaction, also highlighting a possible means of management.