Ricker Polsdorfer, MD
The information provided here is meant to give you a general idea of what to expect from each of these medicines. Only the most common side effects are included, so ask your doctor if there are any precautions specific to your case. Use each of these medicines as recommended by your doctor or according to the instructions provided with the medicines. If you have further questions about usage or side effects, contact your doctor.
The use of some of the most commonly prescribed medicines is designed to assist with some of the symptoms that the tumor or the treatment can cause.
Glucocorticoids (Cortisone-like Drugs, Steroids)
Narcotics and Their Derivatives
Over-the-Counter Medicine: Pain Killers
Cortisone-like drugs are used to reduce brain swelling. Swelling is common with brain tumors. Dexamethasone is most often used. It is given by mouth or by IV. Decreasing swelling associated with brain tumors is the most effective way to decrease head pain.
Typical side effects include:
Steroids also increase your risk of developing
ulcers. Often, your doctor will place you on an additional medicine to decrease this risk. Steroids are also associated with joint aching and an increased risk for osteoperosis.
Dexamethasone for brain swelling is usually used short-term, avoiding the majority of side effects. Your doctor will often taper you off the steroids slowly.
Your doctor will choose an anti-epileptic medicine based on the potential benefits and the risks of side effects. The potential interactions with your other medicine will also be considered. In any given case, one may work better than another.
Many of the anti-epileptic medicine have the potential to interact with your other medicine, including chemotherapies.
Possible side effects for carbamazepine (Tegretol) include:
Possible side effects for valproic acid (Depakene, Depakote) include:
Possible side effects for phenytoin (Dilantin) include:
Possible side effects for Levetiracetam (Keppra) include:
Nonsteroidal anti-inflammatory drugs (NSAIDs) in higher doses, including:
Each NSAID has a slightly different chemistry and side effect profile. NSAIDS are used primarily to control pain. They do not control swelling as well as the steroid drugs, and they have side effects of their own.
Possible side effects include
These drugs are addicting, and the potential for abuse is high. However, there is no substitute for narcotics in the treatment of severe pain.
Most important side effects include:
Possible side effects include:
Acetaminophen (Tylenol) is the common pain killer used for mild to moderate pain. Possible side effects include allergic reactions that damage blood cells or cause rashes. Overdoses can damage the liver. Because brain tumors grow, a medicine that works at first may not do so as the tumor enlarges. Doses may have to be increased or stronger medicines used.
Whenever you are taking a prescription medicine, take the following precautions:
About brain tumors: a primer for patients and caregivers. American Brain Tumor Association website. Available at:
http://www.abta.org/secure/about-brain-tumors-a-primer.pdf. Published 2012. Accessed June 4, 2013.
Brain tumor. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated May 28, 2013. Accessed June 4, 2013.
Brain tumor. National Cancer Institute website. Available at:
http://www.cancer.gov/cancertopics/types/brain. Accessed June 4, 2013.
5/28/2008 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php: Tremont-Lukats IW, Ratilal BO, Armstrong T, Gilbert MR. Antiepileptic drugs for preventing seizures in people with brain tumors. The Cochrane Library.
11/30/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php: US Food and Drug Administration. Propoxyphene: withdrawal—risk of cardiac toxicity. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm234389.htm. Published November 19, 2010. Accessed November 30, 2010.
Last reviewed June 2013 by Mohei Abouzied, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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