by Abouzied M

Medications for Non-Hodgkin’s Lymphoma

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 after 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 if any of these medications are appropriate for you.

Over-the-Counter Medications

  • Ibuprofen
  • Naproxen

Prescription Medications

Anti-nauseants
Common names include:
  • Prochlorperazine
  • Odansetron
  • Granisetron
  • Metoclopramide
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.
Some side effects include:
For prochlorperazine:
  • Blurred vision, change in color vision, or difficulty seeing at night
  • Fainting
  • Loss of balance control
  • 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, especially with high doses
  • Drowsiness
  • Restlessness
  • Increased risk of serious neurological condition known as tardive dyskinesia in patients who take metoclopramide for longer than three months
Corticosteroids
Common names include:
  • Dexamethasone
  • Prednisone
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
  • Swelling caused by tumors or treatment
Common side effects include:
  • Increased appetite
  • Indigestion
  • Nervousness or restlessness
Painkillers—Narcotics
Common names include:
  • Hydrocodone
  • Morphine
  • Oxycodone
  • Fentanyl
  • Oxymorphone
  • Methadone
  • Hydrocodone and acetaminophen
  • Oxycodone and acetaminophen
Narcotics act on the central nervous system to relieve pain. These drugs can be very effective; however, they must be used with great caution because they can be mentally and/or physically addicting. If you are going to take one of these drugs for a long period of time, your doctor will closely monitor you.
Vicodin and Percocet is a 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.
The most common side effects of narcotics include:
  • Lightheadedness
  • Drowsiness
  • Nausea or vomiting
  • 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. Low red blood cell levels can lead to anemia. Therefore, epoetin helps reduce your risk of anemia. Epoetin is effective, but it has a two-week delay between the injection and when your red blood cell count 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
  • 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
  • Swelling caused by tumors or treatment
Common side effects include:
  • Stomach cramps, pain, or discomfort
  • Lightheadedness
  • Headache
  • Heartburn, indigestion, nausea, or vomiting

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.
  • Ask what the results and side effects could be. 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 don’t run out.

References

Ballantyne J, Mao J. Opiod therapy for chronic pain. N Engl J Med. 2003;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 April 30, 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, et al. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology. 2005;42(6):1364.

Non-Hodgkin lymphoma. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated April 29, 2013. Accessed April 30, 2013.

Non-Hodgkin lymphoma. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/non-hodgkin. Accessed April 30, 2013.

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

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