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Medications to Treat Side Effects of Melanoma Treatment

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The more you know about your health, the better prepared you are to make informed healthcare decisions. Our health library gives you the information you need to take charge of your health.

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 healthcare provider.

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 him or her if any of these medications are appropriate for you.

Prescription Medications

Anti-nauseants

  • Prochlorperazine (Compazine)
  • Ondansetron (Zofran)
  • Granisetron (Granisol)
  • Metoclopramide (Reglan)

Painkillers—Narcotics

  • Hydromorphone (Dilaudid, Hydrostat)
  • Morphine (Kadian, MS Contin, Avinza, Oramorph SR, Roxanol)
  • Fentanyl (Duragesic)
  • Methadone
  • Oxycodone (Oxecta, Oxycontin)
  • Oxymorphone (Opana)
  • Hydrocodone and acetaminophen (Vicodin)
  • Oxycodone and acetaminophen (Percocet)
  • Tapentadol (Nucynta)

Blood Stem Cell Support Drugs

  • Filgrastim (Neupogen)
  • Epoetin (Epogen, Procrit)

Over-the-Counter Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

  • Ibuprofen
  • Naproxen

Prescription Medications

Anti-nauseants

Common names include:

  • Prochlorperazine (Compazine)
  • Ondansetron (Zofran)
  • Granisetron (Granisol)
  • Metoclopramide (Reglan)

Anti-nauseants, also called anti-emetics, are given to help treat nausea and vomiting that may be caused by chemotherapy, radiation, or surgery to treat cancer.

Possible side effects include:

For prochlorperazine:

  • Drowsiness
  • Lightheadedness
  • Blurred vision or impaired night vision
  • Skin reactions
  • Low blood pressure
  • Ceased menstrual cycle

For ondansetron:

  • Headache
  • Diarrhea
  • Lightheadedness
  • Constipation
  • Fever
  • Drowsiness
  • Fatigue
  • Urinary retention
  • Itchiness

For granisetron:

  • Headache
  • Constipation
  • Abdominal pain
  • Diarrhea
  • Fatigue
  • Fever

For metoclopramide:

  • Restlessness
  • Drowsiness
  • Diarrhea (with high doses)
  • Increased risk of tardive dyskinesia, a serious neurological condition, in patients who take metoclopramide for longer than three months
Painkillers—Narcotics

Common names include:

  • Hydromorphone (Dilaudid, Hydrostat)
  • Morphine (Kadian, MS Contin, Avinza, Oramorph SR, Roxanol)
  • Fentanyl (Duragesic)
  • Methadone
  • Oxycodone (Oxecta, Oxycontin)
  • Oxymorphone (Opana)
  • Hydrocodone and acetaminophen (Vicodin)
  • Oxycodone and acetaminophen (Percocet)
  • Tapentadol (Nucynta)

Narcotics 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.

Percocet and Vicodin are examples of combination medication. A narcotic analgesic and acetaminophen used together may provide better pain relief than either medicine used alone. In some cases, lower doses of each medicine are necessary to achieve pain relief. 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 physician while you taking one of the combination products.

The most common side effects of narcotics include:

  • Lightheadedness or feeling faint
  • Drowsiness
  • Nausea or vomiting
  • Severe constipation

Blood Stem Cell Support Drugs

Common names include:

Common names include:

  • Filgrastim (Neupogen)
  • Epoetin (Epogen, Procrit)

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. This may be important when you have anemia, or low red blood cell levels. 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. Since this medicine has been linked to increased risk of death in cancer patients, your doctor will weight the benefits and risk carefully before giving this medicine. 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 filgrastim and epoetin are given by injection in your doctor's office.

Common side effects include:

For filgrastim:

  • Bone pain
  • Nausea or vomiting

For epoetin:

  • Nausea or vomiting
  • Pain in joints or muscles
  • Bone pain
  • Weight loss
  • Insomnia
  • Headache
  • Depression
  • Difficulty swallowing

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 during your treatment.

Common side effects include:

  • Stomach pain, or discomfort
  • Lightheadedness
  • Headache
  • Heartburn
  • Nausea or vomiting

NSAIDs may cause an increased risk of serious cardiovascular thrombotic events like myocardial infarction and stroke. This risk is especially important for patients with cardiovascular disease or risk factors for cardiovascular disease.

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your doctor.
  • Do not share them with anyone else.
  • Know what effects and side effects to expect, and report them to your doctor.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.

Revision Information

  • Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med. 2003 Nov 13; 349:1943-1953.

  • FDA's MedWatch safety alerts: March 2009. US Food and Drug Administration website. Available at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm142815.htm. Updated August 9, 2012. Accessed April 4, 2013.

  • Epoetin Alfa. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 18, 2013. Accessed April 8, 2013.

  • Filgrastim. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated January 18, 2013. Accessed April 8, 2013.

  • Granisetron. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 18, 2013. Accessed April 8, 2013.

  • Gourlay DL, Heit HA, et al. Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Med. 2005;6(2):107.

  • Larson AM, Polson J, Fontana RJ, et al; Acute Liver Failure Study Group. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology. 2005;42(6):1364.

  • Metoclopramide. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 18, 2013. Accessed April 8, 2013.

  • Ondansetron. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated February 28, 2013. Accessed April 8, 2013.

  • Prochlorperazine. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 18, 2013. Accessed April 8, 2013.

  • White WB.Cardiovascular risk, hypertension, and NSAIDs. Curr Rheumatol Rep. 2007 Apr;9(1):36-43.

  • Wong M, Chowienczyk P, et al.Cardiovascular issues of COX-2 inhibitors and NSAIDs. Aust Fam Physician. 2005 Nov;34(11):945-948.