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Medications to Treat Side Effects of Melanoma Treatment

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 them if any of these medications are appropriate for you.

Prescription Medications

Antiemetics

  • Prochlorperazine
  • Ondansetron
  • Granisetron
  • Metoclopramide

Opioids

  • Hydromorphone
  • Morphine
  • Fentanyl
  • Methadone
  • Oxycodone
  • Oxymorphone
  • Hydrocodone and acetaminophen
  • Oxycodone 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
  • Ondansetron
  • Granisetron
  • Metoclopramid

Antiemetics, are given to help treat nausea and vomiting that may be caused by chemotherapy, radiation therapy, 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 3 months
Opioids

Common names include:

  • Hydromorphone
  • Morphine
  • Fentanyl
  • Methadone
  • Oxycodone
  • Oxymorphone
  • Hydrocodone and acetaminophen
  • Oxycodone 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.

Percocet and vicodin are examples of combination medication. An opioid analgesic and acetaminophen used together may provide better pain relief than either medication used alone. In some cases, lower doses of each medication 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 with your doctor while you taking one of the combination products.

The most common side effects of opioids include:

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

Blood Stem Cell Support Drugs

Common names include:

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. This may be important when you have anemia, or low red blood cell levels. Epoetin is quite effective, but it has 2-week delay between the injection and when your red blood cell count really starts to come back. Since this medication has been linked to increased risk of death in cancer patients, your doctor will weight the benefits and risk carefully before giving this medication. 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 a heart attack or stroke. This risk is especially important for those with cardiovascular disease or its risk factors.

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.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.

Revision Information

  • Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med. 2003(20);349:1943-1953.

  • Epoetin Alfa. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233424/Epoetin-Alfa. Updated July 7, 2016. Accessed October 20, 2016.

  • Filgrastim. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T908702/Filgrastim. Updated June 20, 2016. Accessed October 20, 2016.

  • Granisetron. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233458/Granisetron. Updated September 27, 2016. Accessed October 20, 2016.

  • Gourlay DL, Heit HA, Almahrezi A. Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Med. 2005;6(2):107-112.

  • Larson AM, Polson J, Fontana RJ, et al. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology. 2005;42(6):1364-1372.

  • Metoclopramide. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233319/Metoclopramide. Updated September 27, 2016. Accessed October 20, 2016.

  • Ondansetron. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233417/Ondansetron. Updated September 27, 2016. Accessed October 20, 2016.

  • Prochlorperazine. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233073/Prochlorperazine. Updated September 27, 2016. Accessed October 20, 2016.

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

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