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Doctors Hospital of Augusta
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Medications for Non-Hodgkin 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.

Prescription Medications

  • Antiemetics
  • Corticosteroids
  • Opioids
  • Blood Stem Cell Support Drugs
  • Antibiotics

Over-the-Counter Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

  • Ibuprofen
  • Naproxen

Prescription Medications

Antiemetics

Common names include:

  • Prochlorperazine
  • Odansetron
  • Granisetron
  • Metoclopramide

Antiemetics are given to help treat nausea and vomiting that may be caused by chemotherapy, radiation therapy, 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 a serious neurological condition known as tardive dyskinesia in those who take metoclopramide for longer than 3 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
Opioids

Common names include:

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

Opioids 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. 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.

The most common side effects of opioids include:

  • Lightheadedness
  • Drowsiness
  • Nausea or vomiting
  • Constipation
Blood Stem Cell Support Drugs

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 2-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
Antibiotics

Common names include:

  • Amoxicillin
  • Clarithromycin
  • Erythromycin
  • Tetracyline
  • Doxycycline
  • Ciprofloxacin

Some specific bacterial infections are associated with lymphomas that affect the stomach, lungs, or intestines. Antibiotics are used to fight the infection. In some cases, it may also help with treating the associated lymphoma. Antibiotics are usually taken by mouth. If the infection is serious, they can be given by IV. For some infections, a combination of antibiotics may work best. Talk to your doctor if you are or think you are pregnant, or breastfeeding. Some antibiotics may need to be avoided during pregnancy. It is important to take all of the antibiotics as prescribed, even when you are feeling well.

Common side effects include:

  • Diarrhea
  • Skin rash
  • Headache
  • Nausea or vomiting
  • Abdominal pain
  • Lightheadedness
  • Sensitivity to sunlight (tetracycline)
  • Tendonitis (ciprofloxacin)
  • Seizures (ciprofloxacin)

Serious side effects associated with clarithromycin include:

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

  • Clarithromycin. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233406/Clarithromycin. Updated September 27, 2016. Accessed October 6, 2016.

  • FDA's MedWatch safety alerts. US Food and Drug Administration website. Available at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm142815.htm. Updated October 14, 2014. Accessed March 28, 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.

  • Helicobacter pylori infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114484/Helicobacter-pylori-infection. Updated October 4, 2016. Accessed October 6, 2016.

  • 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.

  • Non-Hodgkin lymphoma (NHL). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116014/Non-Hodgkin-lymphoma-NHL. Updated May 5, 2016. Accessed October 6, 2016.