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 healthcare provider if there are any precautions specific to your case. Use each of these medications as recommended by your healthcare provider or according to the instructions provided with the medication. If you have further questions about usage or side effects, contact your healthcare provider.

The use of some of the most commonly prescribed medications (listed below) is designed to assist with some of the symptoms that the tumor or the treatment can cause.

Prescription Medications

Glucocorticoids (Cortisone-like Drugs, Steroids)

  • Dexamethasone (Decadron)

Anticonvulsants

  • Carbamazepine (Tegretol)
  • Valproic acid (Depakene, Depakote)
  • Phenytoin (Dilantin)

Pain Killers

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) in higher doses
  • Indomethacin (Indocin)
  • Naproxen (Naprosyn, Anaprox)
  • Celecoxib (Celebrex)
  • Acetaminophen (Tylenol)

Narcotics and Their Derivatives

Over-the-Counter Medications: Pain Killers

  • Aspirin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) in lower doses
  • Acetaminophen (Tylenol)

Prescription Medications

Glucocorticoids (Cortisone-like Drugs, Steroids)

Cortisone-like drugs are used to reduce brain swelling, a common event in brain tumors. Dexamethasone 12-20 milligrams per day is the standard treatment, given either by mouth or intravenously.

Typical side effects include:

  • Feeling of hunger and associated weight gain
  • Acne
  • Muscle weakness
  • Insomnia
  • Agitation (less common)

Dexamethasone for brain swelling is usually used short-term, avoiding the majority of side effects.

Anticonvulsants

These three drugs are believed to be equally effective in reducing the incidence of convulsions caused by brain tumors. In any given case, one may work better than another. Tumors located outside the cortex do not cause seizures.

A 2008 review of five studies found that medication does not appear to prevent seizures in patients with brain tumors who have no history of seizures. The medications included in the study were phenytoin, phenobarbital, and divalproex sodium, which is closely related to valproic acid. *

Possible side effects for carbamazepine (Tegretol) include:

  • Bone marrow damage
  • Mental changes
  • Possibly severe skin reactions

Possible side effects for valproic acid (Depakene, Depakote) include:

  • Liver damage
  • Fetal damage if pregnant
  • Pancreatitis
  • Thrombocytopenia (persistent decrease in the number of blood platelets)
  • Weakness, sleepiness
  • Dizziness
  • Nausea, vomiting
  • Diarrhea
  • Indigestion, abdominal pain, loss of appetite
  • Visual disturbances
  • Hair loss
  • Respiratory infection

Possible side effects for phenytoin (Dilantin) include:

  • Nerve and brain dysfunctions
  • Rashes
  • Nausea, vomiting
  • Diarrhea or constipation
  • Liver and bone marrow damage
  • Gum swelling
  • Respiratory inflammations

Pain Killers

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

    There are currently twenty NSAIDs on the market, either as prescription, over-the-counter, or both, each having a slightly different chemistry and side effect profile. NSAIDS are used primarily to control pain. They do not control intracranial edema or swelling as well as the steroid drugs, and they have side effects of their own. The newer and more expensive selective NSAIDs, celecoxib and rofecoxib, are expected to produce fewer gastrointestinal problems.

    These drugs reduce inflammation by other pathways than the cortisone class of drugs. Since they do not interfere with the body’s defenses against infection, they are safer to use in the presence of infection.

    Possible side effects include

    • Stomach irritation, ulceration, and bleeding
    • Allergic reactions
    • Kidney damage
    • Liver damage

Narcotics and Their Derivatives

The first three are usually effective for mild to moderate pain. Those listed from morphine to oxycodone are used to relieve intense pain. These drugs are addicting, and the potential for abuse is high. However, there is no substitute for narcotics in the treatment of severe pain. They are tightly controlled by the Federal Drug Enforcement Agency (DEA).

Most important side effects include:

  • Dizziness
  • Sleepiness
  • Nausea and vomiting
  • Constipation
  • Allergic reactions

Over-the-Counter Medications: Pain Killers

Aspirin is really the first of the NSAIDs and acts in exactly the same way as the rest of them. There are minor differences among the available agents in terms of dosing intervals, frequency of certain side effects, and other characteristics. In addition to aspirin, there are currently twenty NSAIDs on the market, either as prescription, over-the-counter, or both, each having a slightly different chemistry and side effect profile. The newer and more expensive selective NSAIDs, celecoxib and rofecoxib, are expected to produce fewer gastrointestinal problems.

These drugs reduce inflammation by other pathways than the cortisone class of drugs. Since they do not interfere with the body’s defenses against infection, they are safer to use in the presence of infection.

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 it is the nature of brain tumors to grow, a medicine 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 Healthcare Provider

  • 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

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your healthcare provider.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your healthcare provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.