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Pain/Heme/Onc 3
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| Generic | Brand | Category | Indications | Side Effects | US Box Warning | US Box Warning (PT2) | Other Notes |
|---|---|---|---|---|---|---|---|
| methotrexate (PO, IV, IT) | Trexall | Antimetabolite (folic acid antagonist) | Rheumatoid arthritis, Crohn's Disease, psoriasis, various hematologic and solid tumors | stomatitis, diarrhea, nausea, vomiting, thrombocytopenia, leukopenia, increased hepatic transaminases, pulmonary fibrosis (rare) | Serious toxicity; use only for life-threatening neoplastic disease, severe psoriasis, or severe RA. Pregnancy: may cause fetal death/congenital abnormalities; avoid. Severe/fatal bone marrow suppression, aplastic anemia&GI toxicity w/NSAIDs. | Hepatotoxicity; acute/chronic interstitial pneumonitis; hypersensitivity. IT/high-dose therapy: use preservative-free formulation to prevent CNS toxicity or metabolic acidosis. | folic acid supplementation may be taken during use to reduce hematologic, gastrointestinal, and hepatic side effects |
| cisplatin (IV, IT, IP) | Kemoplat | Antineoplastic agent, platinum-based compound | Advanced bladder, ovarian, and testicular cancer; various cancers | bone marrow suppression, nausea/vomiting, nephrotoxicity, neurotoxicity, ototoxicity | may cause severe myelosuppression, severe nausea/ vomiting (requires highly effective antiemetic premedication), renal toxicity, and dose-related neuropathy | ||
| doxorubicin (IV) | Adriamycin | Antineoplastic agent, anthracycline | Adjuvant therapy for breast cancer, various cancers | cardiomyopathy, alopecia, nausea, vomiting, bone marrow suppression | may cause cardiomyopathy, myelosuppression, secondary malignancies; extravasation can result in severe local tissue injury and necrosis | may cause red discoloration of urine, tears, sweat, and saliva | |
| pembrolizumab (IV), pembrolizumab/ berahyaluronidase alfa-pmph (SC) | Keytruda(IV), Keytruda Qlex (SC) | Antineoplastic agent, monoclonal antibody | Various cancers | peripheral edema, immune-related adverse events (pruritus, skin rash, endocrine/metabolic abnormalities, diarrhea, increased liver enzymes, increased serum creatinine, dyspnea), nausea, vomiting, hematuria, anemia, fatigue, musculoskeletal pain | |||
| anastrozole (PO) | Arimidex | Aromatase inhibitor | Hormone receptor-positive breast cancer | fatigue, rash, flushing, hot flashes, arthralgia, nausea, vomiting, hypertension, peripheral edema, osteoporosis | cardiovascular side effects (i.e., hypercholesterolemia, CAD); fetal toxicity (CI in pregnancy) | ||
| tamoxifen (PO) | Soltamox | Selective estrogen receptor modulator (SERM) | Hormone receptor-positive breast cancer | hot flashes/night sweats, vaginal bleeding/discharge, decreased bone density (in premenopausal females) | increased risk for uterine or endometrial cancer and thromboembolic events | contraception should be used in premenopausal females due to teratogenicity of the drug; do not use with warfarin or history DVT/PE |