Technical info on the Chemo

Cytoxan ®

Generic Name: Cyclophosphamide

Other Trade Name: Neosar®

Cyclophosphamide is the generic name for the trade name drug Cytoxan or Neosar. In some cases, health care professionals may use the trade name Cytoxan or Neosar when referring to the generic drug name cyclophosphamide.

Drug Type: Cyclophosphamide is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug. This medication is classified as an “alkylating agent.” (For more detail, see “How Cyclophosphamide Works” section below).

What Cyclophosphamide Is Used For

  • Cancers treated with cyclophosphamide include: Hodgkin’s and non-Hodgkin’s lymphoma, Burkitt’s lymphoma, chronic lymphocytic leukemia (CLL), chronic myelocytic leukemia (CML), acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), t-cell lymphoma (mycosis fungoides), multiple myeloma, neuroblastoma, retinoblastoma, breast cancer, ovarian cancer, and conditioning regimens for bone marrow transplantation

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Cyclophosphamide Is Given

  • The amount of cyclophosphamide that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.
  • Cyclophosphamide can be given by a number of different routes. The route that it is given depends on the dosage, the condition being treated, as well as the purpose it is being used for.
  • It is usually given through a vein by injection or infusion (intravenous, IV) or by mouth in tablet form, depending upon diagnosis.
  • Cyclophosphamide is also approved to be given by a shot into a muscle (IM), into the abdominal lining (intraperitoneal, IP), or into the lining of the lung (intrapleural).
  • Tablets should be given with food or after meals. Tablets should not be cut or crushed.

Side Effects

Important things to remember about the side effects of cyclophosphamide:

  • Most people will not experience all of the cyclophosphamide side effects listed.
  • Cyclophosphamide side effects are often predictable in terms of their onset, duration, and severity.
  • Cyclophosphamide side effects will improve after therapy is complete.
  • Cyclophosphamide side effects may be quite manageable. There are many options to minimize or prevent the side effects of cyclophosphamide.

The following side effects are common (occurring in greater than 30%) for patients taking cyclophosphamide:

  • Low blood counts: Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
    • Onset: 7 days
    • Nadir: 10-14 days
    • Recovery: 21 days
    • Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
  • Hair loss: Temporary – usually begins 3-6 weeks after the start of therapy. Hair will grow back after treatment is completed although the color and/or texture may be different.
  • Nausea and vomiting: more common with larger doses, usually beginning 6-10 hours after therapy.
  • Poor appetite
  • Discoloration of the skin or nails

The following are less common side effects (occurring in 10-29%) for patients receiving cyclophosphamide:

Delayed Effects of Cyclophosphamide:

  • There is a slight risk of developing a blood cancer such as leukemia or myelodysplasia after taking cyclophosphamide. Talk to your doctor about this risk.

Note: Not all side effects are listed above. Side effects that are very rare – occurring in less than about 10 percent of patients – are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

 

Taxotere

Generic Name: Docetaxel

Drug Type:

Taxotere is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug.  Taxotere is classified as a “plant alkaloid,” a “taxane” and an “antimicrotubule agent.”  (For more detail, see “How Taxotere Works” section below).

What Taxotere Is Used For:

  • Approved in treatment of breast cancer, non-small cell lung cancer, advanced stomach cancer, head and neck cancer and metastatic prostate cancer.
  • Also being investigated to treat small cell lung, ovarian, bladder, and pancreatic cancers, soft tissue sarcoma and melanoma.

Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Taxotere Is Given:

  • Taxotere is given through a vein (intravenously, IV)
  • There is no pill form of Taxotere
  • Premedication with a corticosteroid pill starting a day prior to Taxotere infusion for 3 days is given to reduce the severity of fluid retention and allergic reactions.  Your doctor will prescribe the exact regimen.
  • The amount of Taxotere that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated.  Your doctor will determine your dose and schedule.

Side Effects:

Important things to remember about Taxotere side effects:

  • Most people do not experience all of the Taxotere side effects listed
  • Taxotere side effects are often predictable in terms of their onset and duration
  • Taxotere side effects are almost always reversible and will go away after treatment is complete
  • There are many options to help minimize or prevent Taxotere side effects
  • There is no relationship between the presence or severity of Taxotere side effects and the effectiveness of Taxotere.
  • Taxotere side effects and their severity depend on how much Taxotere is given.  In other words, high doses of Taxotere may produce more severe side effects).

The following Taxotere side effects are common (occurring in greater than 30%) for patients taking Taxotere:

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 4-7 days
Nadir: 5-9 days
Recovery: 21 days

  • Fluid retention with weight gain, swelling of the ankles or abdominal area.
  • Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated doses. This should be reported to your healthcare provider.
  • Nausea
  • Diarrhea
  • Mouth sores
  • Hair loss
  • Fatigue and weakness
  • Infection
  • Nail changes (color changes to your fingernails or toenails may occur while taking Taxotere. In extreme, but rare, cases nails may fall off. After you have finished Taxotere treatments, your nails will generally grow back.)

These Taxotere side effects are less common, meaning they occur in 10-29 percent of patients receiving Taxotere:

  • Vomiting
  • Muscle/bone/joint pain (myalgias and arthralgias)
  • Low platelet count (This can increase your risk of bleeding)
  • Increases in blood tests measuring liver function.  These return to normal once treatment is discontinued. (see liver problems)

Infusion-related Taxotere side effects (symptoms which may occur during the actual treatment) include:

  • Allergic reactions (rash, flushing, fever, lowered blood pressure).  Happens rarely, usually occurs in the first or second infusion.  Frequency is reduced by premedication with corticosteroid starting one day before infusion.  You will be monitored closely during the infusion for any signs of allergic reaction.
  • Infusion site reactions (uncommon and generally mild, consist of darkening of the vein, inflammation, redness or dryness of the skin, or swelling of the vein).

Not all Taxotere side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

 

Neulasta

Generic name: Pegfilgrastim
Other names: G-CSFGranlocyte – Colony Stimulating Factor

Chemocare.com uses generic names in all descriptions of drugs. Neulasta is the trade name for Pegfilgrastim. G-CSF and Granlocyte – Colony Stimulating Factor are other names for Pegfilgrastim. In some cases, health care professionals may use the trade name Neulasta or other names G-CSF and Granlocyte – Colony Stimulating Factor when referring to the generic drug name Pegfilgrastim.

Drug type:  Neulasta is a biologic response modifier. It is classified as a colony stimulating factor.  (For more detail, see “How this drug works” section below).

What This Drug Is Used For:

  • This medicine is used to stimulate the growth of “healthy” white blood cells in the bone marrow, once chemotherapy is given.  White blood cells help the body to fight infection. This is not a chemotherapy drug.
  • This medication is usually given at least 24 hours after chemotherapy to stimulate the growth of new, healthy, white blood cells (WBC).
  • Pegfilgrastim is a longer acting form of filgrastim and the manufacturer recommends that it should not be given within 14 days prior to chemotherapy.
  • Pegfilgrastim is given as a single injection.

Note:  If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How This Drug Is Given:

  • This medicine can be given as a shot underneath the skin (subcutaneous [SQ]), in pre-filled syringes. The dose of pegfilgrastim depends upon why you are receiving this drug.
  • The amount of this medication you will receive also depends on many other factors, including your height and weight, your general health or other health problems, and the type of cancer you have.  Your doctor will determine your dose and schedule.

Side Effects:

Important things to remember about the side effects of pegfilgrastim:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • Pegfilgrastim is a support medication. The following list includes side effects attributed to pegfilgrastim.  Other side effects experienced were attributed to the chemotherapy and/or the disease.

The following side effects are common (occurring in greater than 30%) for patients taking pegfilgrastim:

  • Note: There are no common side effects of pegfilgrastim

These side effects are less common side effects (occurring in about 10-29%) of patients receiving pegfilgrastim:

  • Pain (bone pain)
  • Blood test abnormalities (temporary elevation in lactate dehydrogenase)
  • These will return to normal once treatment is discontinued
  • Tenderness at the site of injection

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

 

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