Re: Reactions to Rituxan AND all those OTHER drugs

[Guest guest]

Hi all,

to Judy, Benedryl itself is not mandatory, and in fact is

contraindicated if severe response to it are noted.

Benedryl is not recomended for 'seniors', ie, over 60ish.

You can check the FDA warnings on this drug. It IS

advisable to take some form of propylacatic anti histamine

drug prior to Rituxan infusions. Other options are allegra

(not D, just plain old Allegra), celebrex or

fexofenadine.... you can ask your doctor. those drugs do not

have the drowsy, groggy effect, and are probably safer for

most patients. Toxic reactions to benedryl have been

reported, both on this list and elsewhere. Extreme

drowsiness is NOT desirable, and severe headache, (called

the benedryl hangover) can be quite stubborn, and last for

days in some patients. If a patient is already on an

antihistamine benedryl is probably not a good idea, at least

not without your doctors knowledge.

Other prophylactic drugs that should be included in a chemo

regime are Bactrim, and Valtrex. as risks for viral

infection, ie ebv reactivation, shingles etc are more

likely, and Bactrim as protection from PCP, and other

pneumonia's.

Some doctors add Allopurinol especially if the wbc is very

high since tumor lysis is a real risk especially in patients

with high wbc. All of these medications should be started

prior to the actual day in chair.... since reactions to any

of those need to be separated from reactions to the 'chemo'

drugs.

Patients are perhaps anxious about chemo treatments and

focus only on the main drugs, however, PLEASE get a list of

EVERY drug that will be pushed into your veins so that you

can check for interactions with any drugs you may be taking.

We assume this will be done by our physicians, however many

times these " details " are missed. Doing this ahead of time

will give you a chance to consult with your GP or any other

specialists whose care you are under to get advice on

alternate drugs that may be better for your case.

Reactions to the " OTHER " drugs are not uncommon, can be

quite serious, and may at the very least cause a patient to

have to stop therapy. Sorting this out after the fact is

much more difficult.

So far I have been fine on rituxan, but I do not take

benedryl, but allegra, which I am on regardless... NOTE, if

you are already on any allergy medication this must be

checked as overdose of these is possible. In most cases

slowing or temporarily stopping the infusion is sufficient

for the more common 'first infusion' reactions of 'shake and

bake', etc. Skin reactions can be quite severe and

serious, so this is something that may result in stopping

the treatment.

Drug interaction checkers are available on line, and are

also available on many mobile phones as APPS. Most are

free, but require registration. If you have an iphone,

ipad, blackberry, this is simple to do. Otherwise this can

be done on the FDA site. and other online locations.

Ask your infusion nurse for a list of all the drugs that

will be used EACH time you are there, getting ready for

infusions. I have seen errors in dosing, timing, and even

drugs included that I have asked to have removed. The time

to do this is before they are pushed into you.

Finally, IF you do have a reaction, ask them to stop the

infusion.... measures should be started, such as infused

drugs to reverse them, and the patient should be very

carefully monitored for the remainder of the infusion and

for at least 24 hours after.

all the best, Beth Fillman

[Guest guest]

Celebrex comes with a caution for people with blood

disorders, so it might not be advisable. Just my

recollection.

Karni

Beth Fillman wrote:

/message/15850

[Guest guest]

so sorry, meant claritin,,, not celebrex, a pain reliever of

sorts, as opposed to claritin, an antihistamine. celebrex

is contraindicated for those with bleeding disorders....

zyrtec is another possible option rather than benadryl.

yes, any drugs added, subsituted, or eliminated should be

discussed with all the doctors involved in your care.

But cross checking can and should be done by us, the

patient, since we know why we are on each one we're on.

ALL drugs CAN be contraindicated for certain conditions and

when combined with OTHER drugs as well. That's why it's

best to KNOW all about every drug, whether the MAIN chemo

drugs or OTHER, prior to starting any protocol. the

interactions checkers do a great job of just that sort of

cross checking. We all have to remember that some drugs we

may be on we've been put on by other doctors, and going off

of those may be contrary to what they might wish.

My oncologist suggested going off of a drug he felt might

conflict with one of the prophylactic drugs he ordered, but

I knew my GP had good reasons for wanting me on that drug.

There was some negotiation that went on, and it took a few

days, but it was sorted out to the satisfaction of all.

there's usually a suitable substitution for almost any drug.

the one exception, which I suppose might be for a 'blood

disorder' and that's coumadin, or any 'blood thinner'...

coumadin lists about 400 drugs which are conflicts.

best, beth fillman

Karni wrote:

> Celebrex comes with a caution for people with blood

> disorders, so it might not be advisable. Just my

> recollection.

>

> Beth Fillman wrote:

> /message/15850