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Medications for Brain Tumors

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 are designed to assist with some of the symptoms that the tumor or the treatment can cause.

Prescription Medications

Corticosteroids

  • Dexamethasone

Anticonvulsants

  • Levetiracetam
  • Carbamazepine
  • Valproic acid
  • Phenytoin

Pain Relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) in higher doses:

  • Indomethacin
  • Naproxen
  • Celecoxib

Opioids

Over-the-counter Pain Relievers

  • Aspirin
  • NSAIDs in lower doses
  • Acetaminophen

Prescription Medications

Corticosteroids
  • Dexamethasone

Corticosteroid drugs are used to reduce brain swelling. Swelling is common with brain tumors. Dexamethasone is most often used. It is given by mouth or IV. Decreasing swelling associated with brain tumors is the most effective way to decrease head pain.

Possible side effects include:

  • Feeling of hunger and associated weight gain
  • Acne
  • Muscle weakness (steroid myopathy)—most noticeable when rising from a seated position or going up stairs
  • Insomnia
  • Increased blood sugar
  • Increased blood pressure
  • Restlessness (less common)

Steroids also increase your risk of developing ulcers. Often, your doctor will place you on an additional medication to decrease this risk. Steroids are also associated with joint aching and an increased risk for osteoporosis.

Medications to control brain swelling are usually used short-term, avoiding the majority of side effects. Your doctor will often taper you off the corticosteroids slowly.

Anticonvulsants
  • Levetiracetam
  • Carbamazepine
  • Valproic acid
  • Phenytoin

Anticonvulsants are chosen based on the potential benefits and the risks of side effects. The potential interactions with your other medication will also be considered. In any given case, one may work better than another.

Many of these medications have the potential to interact with your other medications, including chemotherapies.

Possible side effects for carbamazepine include:

  • Bone marrow damage
  • Mental status changes
  • Rashes/possibly severe skin reactions
  • Low sodium level in the blood—hyponatremia

Possible side effects for valproic acid include:

  • Liver damage
  • Fetal damage if pregnant
  • Pancreatitis
  • Persistent decrease in the number of blood platelets—thrombocytopenia
  • Weakness, sleepiness
  • Lightheadedness
  • Nausea, vomiting
  • Diarrhea
  • Indigestion, abdominal pain, loss of appetite
  • Visual disturbances
  • Hair loss
  • Respiratory infection
  • Weight gain
  • Rashes

Possible side effects for phenytoin include:

  • Mental status changes
  • Rashes
  • Nausea, vomiting
  • Diarrhea or constipation
  • Liver and bone marrow damage
  • Gum swelling
  • Respiratory inflammations

Possible side effects for levetiracetam include:

  • Mental status changes
  • Irritability
  • Loss of contact with reality—psychosis
  • Rashes
Pain Relievers

NSAIDs in higher doses, including:

  • Indomethacin
  • Naproxen
  • Celecoxib

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 bleeding
  • Allergic reactions
  • Kidney damage
  • Liver damage
Opioids
  • Codeine
  • Pentazocine
  • Morphine
  • Meperidine
  • Fentanyl
  • Hydromorphone
  • Methadone
  • Oxycodone

There is no substitute for opioids in the treatment of severe pain. However, these drugs are addicting and the potential for opioid abuse is high.

Possible side effects include:

  • Lightheadedness
  • Sleepiness/Somnolence
  • Nausea and vomiting
  • Itchiness
  • Constipation
  • Allergic reactions
  • Decreased respiratory drive
  • Overdose—can lead to death

Over-the-counter Pain Relievers

  • Aspirin
  • NSAIDs in lower doses
  • Acetaminophen

Possible side effects include:

  • Stomach irritation
  • Ulceration
  • Bleeding
  • Allergic reactions
  • Kidney damage
  • Liver damage

Acetaminophen 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.

When to Contact Your Doctor
  • The desired effect is not achieved
  • An undesired effect appears
  • If you are taking aspirin or other NSAIDs and experience new stomach symptoms

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.

Revision Information

  • 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. Accessed August 17, 2015.

  • Astrocytoma and oligodentroglioma in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 17, 2015. Accessed August 17, 2015.

  • Brain and spinal cord tumors in adults. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003088-pdf.pdf. Accessed August 17, 2015.

  • Brain and spinal cord tumors in children. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003089-pdf.pdf. Accessed August 17, 2015.

  • Meningioma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 30, 2015. Accessed August 17, 2015.

  • 5/28/2008 DynaMed's Systematic Literature Surveillance: http://www.ebscohost.com/dynamed. Tremont-Lukats IW, Ratilal BO, Armstrong T, Gilbert, MR. Antiepileptic drugs for preventing seizures in people with brain tumors. Cochrane Database Syst Rev. 2008;(2):CD004424.

  • 11/30/2010 DynaMed's Systematic Literature Surveillance: http://www.ebscohost.com/dynamed. US Food and Drug Administration. Propoxyphene: withdrawal—risk of cardiac toxicity. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm234389.htm. Updated September 6, 2013. Accessed August 17, 2015.