by Wood D

Medications for Lung Cancer

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

  • Prochlorperazine (Compazine)
  • Odansetron (Zofran)
  • Granisetron (Kytril)
  • Metoclopramide (Octamide, Metoclopramide Intensol, Reglan)
  • Dexamethasone (Cortastat, Dalalone, Decadrol, Decadron, Decaject, Dexacorten, Dexamethasone Intensol, Dexasone, Dexone, Hexadrol, Mymethasone, Primethasone, Solurex)
  • Prednisone (Cordrol, Deltasone, Liquid Pred, Meticorten, Orasone, Prednicot, Prednisone Intensol, Pred-Pak, Sterapred)
  • Hydrocodone (Dilaudid)
  • Morphine (Kadian, MS Contin, Avinza, Oramorph SR, Roxanol)
  • Oxycodone (Oxyfast)
  • Methadone
  • Fentanyl (Duragesic)
  • Oxymorphone (Opana)
  • Oxycodone and acetaminophen (Percocet)
  • Hydrocodone and acetaminophen (Vicodin)
  • Tapentadol (Nucynta)
  • Filgrastim (Neupogen)
  • Epoetin (Epogen, Procrit)

Over-the-Counter Medications

  • Ibuprofen (Advil, Bayer Select Ibuprofen, Dolgesic, Excedrin IB, Genpril, Haltran, Ibren, Ibuprohm, Medipren, Midol IB, Motrin, Nuprin, Q-Profen, Rufen, Trendar)
  • Naproxen (Aleve, Anaprox, Naprelan, Naprosyn)

Prescription Medications

Anti-nauseants
Common names include:
  • Prochlorperazine (Compazine)
  • Odansetron (Zofran)
  • Granisetron (Kytril)
  • Metoclopramide (Octamide, Metoclopramide Intensol, 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 . Prochlorperazine can be taken by mouth, injection, or a suppository. Ondansetron and Granisetron can be taken orally or as injections; Metoclopramide is usually given by injection.
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 patients who take Metoclopramide for longer than three months
Corticosteroids
Common names include:
  • Dexamethasone (Cortastat, Dalalone, Decadrol, Decadron, Decaject, Dexacorten, Dexamethasone Intensol, Dexasone, Dexone, Hexadrol, Mymethasone, Primethasone, Solurex)
  • Prednisone (Cordrol, Deltasone, Liquid Pred, Meticorten, Orasone, Prednicot, Prednisone Intensol, Pred-Pak, Sterapred)
Corticosteroids help to minimize inflammation and to 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
Painkillers—Narcotics
Common names include:
  • Hydrocodone (Dilaudid)
  • Morphine (Kadian, MS Contin, Avinza, Oramorph SR, Roxanol)
  • Oxycodone (Oxyfast)
  • Methadone
  • Fentanyl (Duragesic)
  • Oxymorphone (Opana)
  • Oxycodone and acetaminophen (Percocet)
  • Hydrocodone and acetaminophen (Vicodin)
  • 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 a combination medication. A narcotic analgesic 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 physician while you are taking one of the combination products.
The most common side effects of narcotics include:
Blood Stem Cell Support Drugs
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. 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 Filgrastim and Epoetin are given by injection in your doctor's office.
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 (Advil, Bayer Select Ibuprofen, Dolgesic, Excedrin IB, Genpril, Haltran, Ibren, Ibuprohm, Medipren, Midol IB, Motrin, Nuprin, Q-Profen, Rufen, Trendar)
  • Naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
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
  • Dizziness, drowsiness, or lightheadedness
  • Headache
  • Heartburn, indigestion, 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

If you are taking medications, follow these general guidelines:
  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Know what the results and side effects are. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you do not run out.

References

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. Published March 23, 2009. Accessed August 4, 2009.

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

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

Lung cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/lung. Accessed October 7, 2008.

United States Pharmacopeial Convention. USP DI. 21st ed. Englewood, CO: Micromedex; 2001.

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.

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