CANCER DRUGS
DRUGS INDICATION ADVERSE INTERACTION AND
EFFECTS CONTRAINDICATION
ALKYLATING AGENT Immunosuppressant Alopecia and Chloramphenicol retards the
property hemorrhagic
CYCLOPHOSPHAMIDE metabolism of cyclophosphamide
Cystitis
Mensa given along with
cyclophosphamide to inactivate
vasicotoxic metabolite of
cyclophosphamide(acrolein)
IFOSFAMIDE Congener of Less alopecia, less Mensa given along with ifosfamide
cyclophosphamide emetogenic than
to prevent haemorrhagic cystitis
cyclophosphamide
due ifosfamide toxicity
,hemorrhagic
cystitis
CHLORAMBUCIL Drug of choice for
maintaince therapy for
chronic lymphatic
leukaemeia;Hodgkin’
disease
MELPHALAN Ovarian cancer Bone marrow
suppression,
diarrhea,
pancreatitis
BUSULFAN Chronic myeloid leukemia Hyperuricaemia is
common,
pulmonary
fibrosis is a
specific adr
LOMUSTINE Cross bbb hence effective Nausea, vomiting
in meningeal leukaemias are common. Bone
and brain tumour marrow
suppression is
peculiarly delayed
Visceral fibrosis
and renal damage
can occur
DACARBAZINE Different from other Nausea, vomiting
alkylating agent. Inhibit are prominent side
RNA and protein synthesis. effects
Important indication
malignant melanoma,
Hodgkin’s disease
Folate antagonist Curative in Low dose- Salicylates,sulfonamides,dicumero
choriocarcinoma, megaloblastic
l displace it from site.
Methotrexate maintaining remission in anaemia ,high
children with acute dose –
Aspirin and sulfonamides enhance
leukaemias pancytopenia.
toxicity of Mtx by decreasing its
Rheumatoid arthritis, Desquamation and renal tubular secretion.
psoriasis bleeding may
occur in g.i.t Folinic acid rapidly reverses the
toxicity of mtx, hence dose of mtx
is increased. Thymidine also
counteract Mtx toxicity
PURINE ANTAGONIST Are highly effective Bone marrow Thioguanine follows s-methylation
antineoplastic drugs suppression
metabolic pathway hence not
Mercaptopurine Inhibit the conversion of Jaundice inhibited allopurinol hence no
inosine monophosphate to need to reduce its dose
(6-MP) adenine and guanine Hyperuriceamia
nucleotides’ which can be
Thioguanine (6-TH) reduced by
Child with acute allopurinol
leukaemia,choriocarcinoma
Azathioprine Immunosuppressant in Bone marrow Azathioprine and mercaptopurine
organ transplantation, suppression
metabolism are inhibited by
Rheumatoid arthritis, has Jaundice allopurinol( xanthine inhibitor)
marked effect on T- since are metabolized by xanthine
lymphocytes suppresses cell Hyperuriceamia
mediated immunity which can be oxidase
reduced by
allopurinol
Fludarabine Inhibits DNA polymerase. Chills, fever
vomiting after
Chronic lymphatic injection,
leukaemia and non- myelosuppression
Hodgkin’s lymphoma that and opportunistic
have recurred after
treatment.
PYRIMIDINE Solid tumor-breast, colon, Bone marrow Genetic deficiency of
urinary bladder, liver and, G.I.T toxicity.
ANTAGONIST dihydropyrimidine dehydrogenase
topical application Genetic deficiency
of predisposes to severe 5-FU toxicity
Fluorouracil (5-FU) dihydropyrimidine
dehydrogenase
predisposes to
severe 5-FU
toxicity.
Cytarabine Inhibit DNA synthesis. Bone marrow
G.I.T toxicity
VINCA ALKALOID Mitotic inhibitors, bind to Peripheral
microtubular protein. neuropathy and
Vincristine(oncovin) Prevent its polymerization alopecia. Bone
and assembly of marrow
microtubules. Inducing depression is
remission in childhood minimal.
acute
[Link],
Hodgkin’s disease, Wilms’
tumour, Ewing’s sarcoma
and carcinoma lung.
vinblastine Primarily employed with Bone marrow
other drugs in Hodgkin’s depression is more
disease and testicular prominent and
carcinoma alopecia less
compared to
vincristine
TAXANES Enhances polymerization Myelosuppression
of tubulin, mechanism and ‘stocking and
Paclitaxel opposite to that of vinca glove’ neuropathy.
alkaloid. Ovarian and Chest pain,
breast carcinoma after arthralgia,
failure of first line myalgia, mucositis
chemotherapy and relapse and edema
cases. Advanced cases of
head and neck cancer
Docetaxel Effective in breast and Major
ovarian cancer refractory
to first line drugs. toxicity is
neutropenia
Arrhythmias,
fall of BP and
heart failure
EPIPODOPHYLLOTOXI It affects DNA Alopecia,
topoisomerase 11 functions.
NS leucopenia
It affects resealing of the
DNA strand. Primary used and G.I.T
Etoposide in testicular tumour ,lung disturbances
cancer
CAMPTOTHECIN Allow single strand of DNA Major toxicity is
to break (DNA bone marrow
ANALOGUE topoisomerase 1) depression;
abdominal pain,
Topotecan Metastatic carcinoma of vomiting, anorexia
ovary and small cell lung and diarrhoea
cancer after primary
chemotherapy has failed
Irinotecan Prodrug, produces Dose limiting
cholinergic effect by toxicity is
inhibiting AChE. diarrhea;
Metastic/advanced neutropenia,
colorectal thrombocytopenia,
carcinoma,cancer haemorrhage
lung/cervix/ovary
ANTIBIOTICS Interfere with DNA Cardiotoxicity,
template function arrhythmias. CHF
Doxorubicin, is due to
cardiomyopathy.
Marrow
depression,
vomiting
Rubidomycin Interfere with DNA Cardiotoxicity,
template function arrhythmias. CHF
is due to
cardiomyopathy.
Marrow
depression,
vomiting
Actinomycin D Interfere with DNA Vomiting,
template [Link]’s stomatitis,
tumour and diarrhea,
rhabdomyosarcoma. Used desquamation of
in mtx resistant skin alopecia and
choriocarcinoma bone marrow
depression.
Mitomycin C Interfere with DNA
template function
Bleomycin Interfere with DNA
template function. Related
to glycopeptide antibiotics.
testicular tumour,oral
cavity,head and neck,ge
Mitoxantrone Analogue of doxorubicin, Bone marrow
with lower cardiotoxicity depression and
because does not produce mucosal
quinone type free radical. inflammation
