Not all chemotherapy drugs cause nausea. If your treatment has the potential to cause this symptom, you will receive IV medications before your treatment to prevent nausea. If your treatment has the potential to cause nausea after you go home, the doctor will prescribe a medication for you to have available at home. The nurse will call in this prescription to your pharmacy. Do not wait until you experience symptoms of nausea to get your prescription filled. Take the medication as directed on the bottle at the first signs of nausea.

If you are still experiencing nausea or vomiting 24 hours after taking these medications, notify the physician or his nurse. It is advisable on the day you get your chemotherapy that you avoid eating a large meal before or after treatment. Eating small amounts frequently (every 2 hours) may help alleviate symptoms of nausea.

Some patients may receive a medication called Dexamethasone along with other nausea medication before the chemotherapy treatment. It works along with the nausea medication to increase appetite and decrease nausea. Not all patients will receive this drug. Dexamethasone can also make some people feel nervous or jittery, elevate blood sugars, or cause difficulty sleeping. Feeling nervous or anxious can increase the symptoms associated with chemotherapy. Your doctor may prescribe a drug called Ativan or Lorazepam to help you relax. It may help to take Ativan 1 or 2 mg before bed on the night of your treatment, and every 6 hours after, for 24 hours, only as needed.

If you are experiencing diarrhea, frequent bowel movements, or watery stools, you may take Imodium AD two tablets. Repeat with one tablet after every loose stool, up to eight tablets per day. Dehydration can occur if the diarrhea is not controlled. Notify your physician if you are having diarrhea uncontrolled by the medication for longer than 24 hours.

Some chemotherapy medications, as well as pain medications, can cause constipation. To prevent constipation, we recommend taking Senokot-S, or Peri-Colace, two tablets at bedtime. This may be increased to two tablets morning and night if no improvement.

Senokot-S and Peri-Colace can be purchased at any grocery or drug store. If you go longer than two days without a bowel movement, take Milk of Magnesia 30 cc, or a laxative that works for you, every 6 hours until you have results. Do not take enemas or use suppositories if your blood counts are low. Constipation can be a serious problem if left untreated.

We may also administer a medication, called a colony stimulating factor, which can raise your body temperature as it works to stimulate your immune system. This is perfectly normal and indicates the medication is working. However, if you get a temperature of 101.5 or above, please notify your physician.

Your weekly blood counts will help determine if your white blood cell count is going down or if it is low. The nurse will phone you if your counts are low enough to require medications to help your count return to normal. A fever (101.5 or above), or a shaking chill can be a sign of infection if it occurs when your blood counts are low. Call your doctor if you have a fever during this time.

If your temperature is less than 101.5, you may take Tylenol 1000 mg every 4 hours as needed for comfort.

If your mouth or gums become sore, please let your doctor or nurse know. This could be a side effect of the chemotherapy, or an infection. You may need an antibiotic or antifungal agent, depending on your symptoms. It can also be an indication that we need to alter the dose of your chemotherapy. There are several prescription medications available to ease the pain associated with these infections.

To help prevent sore mouth, rinse with a solution of 8 oz. of water, 1 teaspoon salt and 1 teaspoon of baking soda. Rinse, gargle and repeat 4 times a day.