The information provided here is meant to give you a general idea of what to expect from each of these medications. 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 medications as recommended by your doctor or according to the instructions provided with the medications. If you have further questions about usage or side effects, contact your doctor.
The use of some of the most commonly prescribed medications is designed to assist with some of the symptoms that the tumor or the treatment can cause.
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: Feeling of hunger and associated weight gainAcneMuscle weakness called steroid myopathy—most noticeable when rising from a seated position or going up stairsInsomniaIncreased blood sugarIncreased blood pressureRestlessness—less common
Steroids also increase your risk of developing
. 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
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.
Levetiracetam (Keppra) (not approved as a single agent by the FDA)Carbamazepine (Tegretol)Valproic acid (Depakene, Depakote)Phenytoin (Dilantin)
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: Bone marrow damageMental status changesRashes/possibly severe skin reactionsHyponatremia—low sodium level in the blood
Possible side effects for valproic acid (Depakene, Depakote) include: Liver damageFetal damage if pregnantPancreatitisThrombocytopenia—persistent decrease in the number of blood plateletsWeakness, sleepinessLightheadednessNausea, vomitingDiarrheaIndigestion, abdominal pain, loss of appetiteVisual disturbancesHair lossRespiratory infectionWeight gainRashes
Possible side effects for phenytoin (Dilantin) include: Mental status changesRashesNausea, vomiting
constipationLiver and bone marrow damageGum swellingRespiratory inflammations
Possible side effects for Levetiracetam (Keppra) include: Mental status changesIrritabilityLoss of contact with reality known as psychosisRashes
NSAIDs in higher doses, including: Indomethacin (Indocin)Naproxen (Naprosyn, Anaprox)Celecoxib (Celebrex)
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: Stomach irritation, ulceration, and bleedingAllergic reactionsKidney damageLiver damage
CodeinePentazocine (Talwin)MorphineMeperidine (Demerol)Fentanyl (Duragesic)Hydromorphone (Dilaudid)MethadoneOxycodone (Oxycontin)
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: LightheadednessSleepiness/SomnolenceNausea and vomitingItchinessConstipationAllergic reactionsDecreased respiratory driveOverdose—can lead to death
NSAIDs in higher doses
Indomethacin (Indocin)Naproxen (Naprosyn, Anaprox)Celecoxib (Celebrex)Acetaminophen/Paracetamol (Tylenol, Panadol)
Possible side effects include: Stomach irritationUlcerationBleedingAllergic reactionsKidney damageLiver damage
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 medication that works at first may not do so as the tumor enlarges. Doses may have to be increased or stronger medications used.
The desired effect is not achievedAn undesired effect appearsIf you are taking aspirin or other NSAIDs and experience new stomach symptoms
Whenever you are taking a prescription medicine, take the following precautions: Take your medicines as directed. Do not change the amount or the schedule.Do not stop taking them without talking to your doctor.Do not share them.Ask what results and side effects to expect. Report them to your doctor.Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medicines and herb or dietary supplements.Plan ahead for refills so you don’t run out.
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:
Accessed June 4, 2013.
5/28/2008 DynaMed's Systematic Literature Surveillance:
Tremont-Lukats IW, Ratilal BO, et al. 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:
Published November 19, 2010. Accessed November 30, 2010.
Last reviewed May 2014 by Mohei Abouzied, 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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