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Neuropathy from Chemotherapy |
Neuropathy from Chemotherapy Introduction
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Chemotherapy can have adverse effects on the nervous system. Some chemotherapy such as vincristine, cisplatin, and paclitaxel have been known to cause symptoms of neuropathy such as numbness, tingling and pain in the extremities, mild weakness, and constipation. Severe nerve damage may cause impaired walking abilities, severe bladder dysfunction, and disabling sensory loss. These side effects may improve or disappear after the discontinuation of chemotherapy, but may take several months to do so.
Several medications can be given to alleviate these symptoms and are listed below. Often times, they are combined with analgesics or narcotic medications to provide maximum pain relief. Response to therapy varies with each individual and their tolerance to possible side effects. Many of these medications are used to treat other health conditions and not all medications may be appropriate for you. Speak to your physician about your treatment options.
Non-medicinal methods can also be used to help manage neuropathy. If your fingers are numb, be very careful when grasping sharp, hot, or otherwise dangerous objects. If your sense of balance or muscle strength is affected, avoid falls by moving carefully, using handrails when going up or down stairs, and using bath mats in the bathtub or shower. And always wear shoes with rubber soles (if possible) to protect your feet.
| Drug | Drug Class | Usual Dose | Adverse effects |
| Amitriptyline Desipramine Maprotiline Paroxetine Nortriptyline Venlafaxine |
Antidepressants | 10-150mg a day 10-150mg a day 50-300mg a day 10-60mg a day 10-100mg a day 18.75mg- 37.5mg once or twice daily |
Constipation, dry mouth, blurred vision, cognitive changes, rapid heart rate, urinary retention |
| Carbamazepine Valproate Gabapentin Clonazepam |
Anticonvulsants | 100mg-400mg three times a day 500mg-1000mg three times a day 100mg-1000mg three times a day 0.5mg- 4mg twice a day |
Nystagmus, dizziness, diplopia, cognitive changes, somnolence, fatigue, mood and sleep disturbance |
| Mexiletine Lidocaine |
Local Anesthetics | 100mg twice a day to 300mg three times a day | Nausea, stomach upset, dizziness |
| Baclofen | Miscellaneous | 5mg-20mg three times a day | Sedation, dizziness, ataxia, confusion, N/V |
| Clonidine | Miscellaneous | 0.3mg-1mg twice a day; max 2.4mg/day | Dry mouth, dizziness, sedation, constipation, low blood pressure |
| Glutamine | Miscellaneous | 10mg three times a day for 4 days starting 24 hours after chemotherapy | No significant adverse effects reported |
| Capsaicin | Miscellaneous | Apply topically to affected area 3 to 4 times a day | Burning (lessens with repeated use), stinging; redness |
| Tramadol | Miscellaneous | 50mg to 100mg every 4 to 6 hours, not to exceed 400mg/day | Dizziness, headache, sedation, nausea, constipation |
| Pyridoxine (vitamin B6) | Miscellaneous | 50-300mg daily | Nausea, headache |
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