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Note - this is the old version of the guide.. click HERE for the current version!
Common Medications
Information on most medications can be found in the Physician's Desk Reference at your local library,
or from RXMED,
The Mayo Clinic, and The University of Washington. These resources list rare side effects that will not be listed in the
brief descriptions below. You can check some drug interactions on PlanetRX.
Always keep track of what medications you are on, what dosages you take, and when you take your medicine. These
records are especially important when changing medications. Always let your doctor know all medications you are taking
when you change any one of them.
Steroids
Steroids are prescribed for brain tumor patients to reduce
edema, which is swelling inside the skull. The most common
steroid prescribed for brain tumors is dexamethasone, which goes under the trade name
decadron. Most, if not all, brain tumor patients are put on
dexamethasone sometime during their disease. Dexamethasone is a steroid
that is similar to, but more powerful than, anti-inflammatories like hydrocortisone.
Although swelling is a natural part of the body's response to the tumor,
swelling does not have a negative effect on the tumor. On the other hand,
swelling can harm normal
brain and lead to greater symptoms from the tumor, so it is important to control edema.
Dexamethasone has several side effects that are
important for patients to be aware of. Because it suppresses part
of the body's immune response, dexamethasone makes patients more susceptible to
infections. Even minor symptoms that could be attributed to something
like an ear infection should be reported to your doctor. Dexamethasone
is a corticosteroid, which is not the kind of steroid that weight
lifters take. Although it can cause fluid retention and puffiness
in the face, dexamethasone can cause weight loss and loss of muscle.
If you lose weight while on dexamethasone or if you are planning to be
on a special diet while taking dexamethasone, let your doctor know.
Although exercise may help decrease muscle loss, dexamethasone can also
weaken bones so check with your doctor before starting any exercises. Because
dexamethasone can upset your stomach, you will likely be given an antacid to take with it. Finally,
dexamethasone can affect a patient's mood. Except in extreme cases of steroid-induced
psychosis, it can be difficult to
distinguish dexamethasone induced mood changes from those that come naturally
from a diagnosis of a brain tumor. The latter feelings may be helped
by counseling and/or psychiatric drugs. Unfortunately, there is no
known treatment for steroid induced mood changes, but they usually clear
up over time or after the drug is stopped.
No patient likes taking dexamethasone. If
you experience discomfort, discuss your concerns with your doctor.
He or she may be able to alleviate side effects either through other treatment
or by altering your steroid dose. Under no circumstances should you
lower your dose or stop taking dexamethasone on your own. When you
take dexamethasone, your body stops producing its own corticosteroids.
You must taper off of dexamethasone under a doctor's supervision in order
to allow your body to recover and to avoid a dangerous withdrawal.
There are other corticosteroids similar to dexamethasone, such
as prednisone and prednisolone. These steroids are not as strong as dexamethasone.
The side effects are the same as dexamethasone, but they may be less severe. Other
anti-edema agents, such as human corticotropin releasing factor (hCRF), are being studied
but are not generally used for patients with brain tumors.
Anticonvulsants
The most commonly prescribed antiseizure medication is dilantin.
Dilantin is the trade name of the drug phenytoin. Dilantin is an anti-seizure
medication that patients with brain tumors are put on if there is a high risk of seizures.
People metabolize dilantin differently, so while you are on dilantin your doctor
may ask you to have blood drawn periodically to make sure you are getting
the right dose of the drug. Over time, dilantin can cause decreases in certain
nutrients, such as folic acid and calcium, so ask your doctor or pharmacist if there
are dietary concerns you should know about, especially if you have other
medical conditions or are pregnant. Dilantin is metabolized in the
liver by enzymes that metabolize many other drugs. Therefore, dilantin
can interact with a lot of medications. If you are taking other medications,
including over-the-counter or natural supplements or birth control pills,
make sure your doctor knows about them. Side effects of dilantin can include
muscle fatigue, dizziness, and loss of coordination. Dilantin may also cause tooth and gum problems, so proper oral hygiene is important while taking it.
There are several other common antiseizure medications. Neurontin is the
trade name for the drug gabapentin. Side effects of neurontin include sleepiness, fatigue,
lack of coordination, double vision, tremors, and involuntary eye movements. Therefore, you may
not be allowed to drive a car or operate dangerous equipment while on neurontin, even if you are seizure-free.
Neurontin has less interaction with other medications than dilantin does. However,
neurontin does interact with certain antacids, such as Maalox, so check with
your doctor about whether you should avoid certain products around the time you take
neurontin. Tegretol is the trade name of carbamazepine, which is an anti-convulsive also used to treat
manic-depression and other psychiatric disorders. It may act as an antidepressant. Blood tests
must be done while you are on tegretol because in rare cases dangerous bone marrow suppression
may occur. If you develop a rash while on tegretol, report it to your doctor because you may need
to be taken off of the medication. Other side effects include drowsiness, nausea, and double vision.
Depakote and depakene are the trade names for two
combinations that include valproic acid or valproate. Depakote interacts with many drugs, so
be sure your doctor knows all the drugs you are taking. You may also need periodic blood
tests to check drug levels and the health of your liver. Side effects may include nausea/vomiting,
sleepiness, weakness, cramps, changes in weight, and low blood cell counts. A newer drug for
seizure control is lamictal. Lamictal will interact with other drugs, so make sure your
doctor knows what else you are taking. Ask your doctor whether or not you can drink alcohol while
on lamictal. Side effects include rash, dizziness, double vision, and tiredness. Report any
rash to your doctor. Finally, some doctors prescribe phenobarbitol or the newer drug primidone
to control seizures.
Phenobarbitol is a barbiturate, which is a strong depressants. Barbiturates are potentially addictive, and
your doctor will probably only prescribe it as a last resort.
Antinausea Medications
Most, but not all, nausea associated with brain tumors can be controlled with medication. However, the
type of medication that will be effective depends on the cause of the nausea. Therefore, it
is important that you communicate with your doctor about any problems you have with nausea.
Zofran is the trade name of the drug ondansetron. It can control nausea caused by
chemotherapy or radiation. Zofran is usually administered as an IV 30 minutes before chemotherapy
is given or 1-2 hours before radiation is given. Additional oral doses are given after treatment
and as needed. Zofran is mild, especially
when compared to chemotherapy or radiation. It's main side effects are
headache, fatigue, diarrhea, or constipation. It also may cover up stomach
problems or exacerbate preexisting liver disease. Zofran only
works on nausea caused by cancer treatments. In particular,
do not take it for motion sickness. Zofran is only effective for
a couple of hours, so if you have nausea after this time consult
with your doctor about adding another anti-nausea medication.
Kytril is a newer medicine that acts similar to Zofran. It can last much longer than
zofran, even up to 12 hours. Unfortunately, it is usually more expensive than zofran. The side effects of kytril are similar to zofran but also may include abdominal pain.
Compazine is the trade name of prochlorperazine, which is an antinausea drug in a family
called the phenothiazines. The phenothiazines are antipsychotic agents that can be used to
treat other disorders. Other phenothiazines used to treat nausea include chlorpromazine,
perphenazine, and triflupromazine. Compazine may be given orally, as an IV, or as a suppository. If you are given compazine to take home, do not store it in your refrigerator or in other cool, moist environments. Side effects
of compazine can include drowsiness, low blood pressure, dizziness, constipation, dry mouth,
blurred vision, and sensitivity to light. Because of the potential for interaction, ask your
doctor before using other medications or alcohol while on compazine. Compazine also has the
potential to cause irreversible tardive
dyskenesia, which is invlountary movements or twitches of the face, tongue or arm muscles.
Haldol is another antipsychotic used to control nausea and has similar side effects and risks
as compazine. Neither of these should be used without a detailed discussion with your doctor about
the possible risks and benefits.
Anti-depressants
There are many antidepressants that may be prescribed to patients with brain tumors. Antidepressants may be prescribed by a psychiatrist. If you are prescribed an antidepressant by your primary care provider or by a brain tumor doctor like a neurologist or neuro-oncologist, it may be worth asking that doctor whether some form of therapy or counseling could be helpful as well.
One common category of antidepressants is the selective seratonin reuptake inhibitors (SSRI), such as Zoloft, Paxil, and Prozac. The side effects of these medications may include sleepiness, tremor, diarrhea, nausea, insomnia, increased sweating, weight loss, and decreased sexual ability. The sexual side effects of one antidepressant may go away if you switch to another antidepressant. Alternatively, there are drugs that sometimes work specifically to help with antidepressant-induced sexual dysfunction. Taking these medicines with food may be easier on the stomach, and Zoloft
should be taken with food regardless.
Some brain tumor patients take St. John's Wort for depression. Some European countries, such as Germany, have approved this herb for treating depression. In the US, herbal supplements are not regulated, and any company can sell St. John's Wort over-the-counter. Before taking any herbal supplement, you should ask about it's purity and quality. You must also decide what dose you want to take, how often you want to take it, and if you want to take anything else with it. Your doctor or pharmacist may be able to help you with these questions, but if not make sure you find a source you trust.
Anticoagulants
Coagulation is the process of blood clotting to stop bleeding. Certain brain tumor patients,
especially those undergoing surgery, may be at high risk for dangerous blood clots forming inside
the body. If your doctor considers you to be at risk, he or she may prescribe anti-coagulants,
commonly called blood thinners, to prevent clotting. Typically, you will receive heparin (lovelox)
through an IV and/or warfarin/coumadin orally over time. While you are on anti-coagulants, be
careful about avoiding normal cuts and scrapes, as they will take much longer to stop bleeding than
normal. Report any unususal signs of bleeding to your doctor. Warfarin interacts with many
other kinds of medications, including alcohol and aspirin; do not take other medications without
your doctor's approval. Your doctor may take periodic blood samples to be sure that the levels
of warfarin are correct. Do not change your diet while on warfarin, as many dietary factors
including vitamin K affect drug levels. You may want to carry a bracelet or ID indicting you
are on anticoagulants in case you are in an accident.
NOTE: The Table Of Contents has links to other parts of this website for articles on specific noteworthy brain tumor treatments.
If there are medications you would like added here, let us know.
Last Updated: 6/5/00
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