In some cases during an intravenous (IV) infusion, the drug may leak out of the vein and under the skin, where it may damage the tissue. This may cause pain, blisters, or even open sores or scarring. Tell the nurse right away if you notice redness, pain, or swelling at or near the IV site.
You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor.
This drug may cause sores in the mouth or on the lips, which often occur within the first few weeks after starting treatment. This can cause mouth pain, bleeding, or even trouble eating. Your doctor or nurse can suggest ways to reduce this, such as changing the way you eat or how you brush your teeth. If needed, your doctor can prescribe medicine to help with the pain.
This drug may increase your risk of constipation, which in some cases can be severe. Your doctor will likely prescribe a laxative or similar medicine to help prevent this from happening. Let your doctor know if constipation starts, especially if you have pain.
This drug may cause damage to certain nerves in the body, which can lead to a condition called peripheral neuropathy. This can cause numbness, weakness, pain, or feelings of burning or tingling, often in the hands or feet. These are sometimes related to being exposed to hot or cold temperatures. These symptoms can sometimes progress to include trouble walking or holding things in your hands. Let your doctor know right away if you notice any of these symptoms. If they are severe enough, this drug may need to be stopped or the dose reduced until they get better.
This drug can cause the rapid killing of tumor cells, which in some cases has led to serious kidney damage within the first 24 hours of treatment (a condition known as tumor lysis syndrome). This is more likely if you have a very large number of cancer cells in the body. If your doctor feels you might be at risk, he or she will give you medicines and/or fluids to help prevent this.
Your doctor will likely test your blood before and during your treatment, to check for the effects of the drug on blood counts or on blood chemistry. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether. Keep all your appointments for doctor visits and lab tests.
This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.
This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body’s ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.
Report any trouble breathing, shortness of breath, and tightness or swelling in your throat to your doctor right away.
Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor’s OK. This drug may affect your immune system, which could make vaccinations ineffective, or could even lead to serious infections. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.