by Wood D

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications may help to either prevent or reduce side effects of treatment or to manage certain side effects once they occur. You can develop side effects from the treatment and/or from the cancer itself. Tell your doctor when you notice a new symptom, and ask her if any of these medications are appropriate for you.

Prescription Medications

Antiemetics

  • Prochlorperazine
  • Odansetron
  • Granisetron
  • Metoclopramide

Corticosteroids

  • Dexamethasone
  • Prednisone

Opioids

  • Hydrocodone
  • Morphine
  • Oxycodone
  • Methadone
  • Fentanyl
  • Oxymorphone
  • Oxycodone and acetaminophen
  • Hydrocodone and acetaminophen
  • Tapentadol

Blood stem cell support drugs

  • Filgrastim
  • Epoetin

Over-the-Counter Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Ibuprofen
  • Naproxen

Prescription Medications

Antiemetics

Common names include:

  • Prochlorperazine
  • Odansetron
  • Granisetron
  • Metoclopramide

Antiemetics are given to help treat nausea or vomiting that may be caused by chemotherapy , radiation therapy, or surgery to treat lung cancer. Medications can be given by mouth, injection, or as a suppository.

Side effects may include:

For prochlorperazine:

  • Blurred vision, change in color vision, or difficulty seeing at night
  • Fainting
  • Loss of balance control
  • Feeling sleepy or groggy
  • Restlessness or need to keep moving
  • Shuffling walk
  • Stiffness of arms or legs
  • Trembling and shaking of hands and fingers

For odansetron:

For granisetron:

  • Abdominal pain
  • Constipation
  • Diarrhea
  • Headache
  • Unusual tiredness or weakness

For metoclopramide:

  • Diarrhea—with high doses
  • Drowsiness
  • Restlessness
  • Increased risk of tardive dyskinesia (a serious neurological condition) in those who take metoclopramide for longer than 3 months
Corticosteroids

Common names include:

  • Dexamethasone
  • Prednisone

Corticosteroids help to minimize inflammation and relieve pain due to inflammation. You may experience pain and inflammation for a variety of reasons, such as:

  • Bone pain from cancer that has spread to your bones
  • Edema (fluid buildup in cells) caused by tumors or treatment

Common side effects include:

  • Increased appetite
  • Indigestion
  • Nervousness or restlessness
Opioids

Common names include:

  • Hydrocodone
  • Morphine
  • Oxycodone
  • Methadone
  • Fentanyl
  • Oxymorphone
  • Oxycodone and acetaminophen
  • Hydrocodone and acetaminophen
  • Tapentadol

Opioids act on the central nervous system to relieve pain. These drugs can be very effective however, they must be used with great caution. If you are going to take one of these drugs for a long period of time, your doctor will closely monitor you.

An opioid pain reliever and acetaminophen used together may provide better pain relief than either medication used alone. There is a limit to how much acetaminophen one can take per day. Remember to discuss taking an over-the-counter acetaminophen (Tylenol) with your healthcare team while you are taking one of the combination products.

The most common side effects of narcotics include:

  • Lightheadedness or feeling faint
  • Drowsiness
  • Nausea or vomiting
  • Constipation
Blood Stem Cell Support Drugs

Common names include:

  • Filgrastim
  • Epoetin

During cancer treatment, blood cells can be destroyed along with cancer cells. Filgrastim helps your bone marrow make new white blood cells. White blood cells help your body fight infection. Therefore, filgrastim helps to reduce your risk of infection.

Epoetin helps your bone marrow to make new red blood cells. Low red blood cell levels can lead to anemia . Therefore, Epoetin helps reduce your risk of anemia. Epoetin is quite effective, but it has a two-week delay between the injection and when your red blood cell count really starts to come back. It is not used as a “quick fix” for a low red blood cell count. A blood transfusion is usually performed if you need to recover your red blood cell count more quickly.

Both medications are given by injection.

Common side effects include:

For filgrastim:

  • Headache
  • Pain in arms or legs
  • Pain in joints or muscles
  • Pain in lower back or pelvis
  • Skin rash or itching

For epoetin:

  • Cough, sneezing, or sore throat
  • Fever
  • Swelling of face, fingers, ankles, feet, or lower legs
  • Weight gain

Over-the-Counter Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names include:

  • Ibuprofen
  • Naproxen

NSAIDs are used to relieve pain and inflammation. You may experience pain and inflammation for a variety of reasons, such as:

  • Bone pain from cancer that has spread to your bones
  • Edema (fluid buildup in cells) caused by tumors or treatment

Common side effects include:

  • Stomach cramps, pain, or discomfort
  • Lightheadedness
  • Drowsiness
  • Headache
  • Heartburn, indigestion, nausea, or vomiting

NSAIDs may cause an increased risk of serious cardiovascular thrombotic events like a heart attack or stroke . This risk is especially important for those with cardiovascular disease or risk factors for cardiovascular disease.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.

References

Cancer pain. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T113832/Cancer-pain  . Updated September 7, 2017. Accessed September 13, 2017.

How do I manage side effects? American Lung Association website. Available at: http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/patients/treatment/manage-side-effects. Accessed Sepember 13, 2017.

Managing cancer-related side effects. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects.html. Accessed September 13, 2017.

Supportive (palliative care). American Lung Association website. Available at: http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/patients/treatment/types-of-treatment/supportive-palliative-care.html. Accessed September 13, 2017.

Toxicities of chemotherapeutic agents. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115935/Toxicities-of-chemotherapeutic-agents  . Updated March 15, 2017. Accessed September 13, 2017.

Understanding and managing chemotherapy side effects. Cancer Care website. Available at: https://www.cancercare.org/publications/24-understanding%5Fand%5Fmanaging%5Fchemotherapy%5Fside%5Feffects. Accessed September 13, 2017.

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