This page tells you about the chemotherapy drug streptozocin and its possible side effects. There is information about
Streptozocin is a chemotherapy drug used to treat pancreatic cancer and carcinoid tumour. It has the brand name Zanosar. It is not licensed in the UK but you may have it as part of research trials.
Streptozocin is a clear liquid. You have it into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having chemotherapy into a vein.
You usually have streptozocin for 5 days every 6 weeks. Or you may have it weekly for 6 weeks. Each treatment usually takes about 1 to 2 hours. The treatment plan depends on which type of cancer you have.
Some people can't have streptozocin. Your doctor is not likely to recommend it if you are not well enough to spend more than half the day up and about. It may also not be possible for you to have it if you have significant kidney or liver problems.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with streptozocin. You can use the links to find out more about each side effect. Where there is no link, please go to our information about cancer drug side effects or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having streptozocin with other medicines.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of these.
- Tiredness (fatigue) during and after treatment – you may feel drowsy and possibly confused. Most people find their energy levels are back to normal from 6 months to a year after their treatment ends
- Feeling or being sick occurs in 9 out of 10 people (90%). It is most likely to start within 2 to 4 hours of having treatment. It lasts for up to 12 hours but is usually controlled with anti sickness injections and tablets
- Kidney problems happen to about 5 out of 10 people (50%). You may notice a drop in your urine output or swelling in your ankles and feet. These changes usually go back to normal once the treatment ends
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Diarrhoea is usually controlled with medicines from your doctor or nurse. Let them know if it gets severe or lasts for more than 3 days
- Changes in liver function that are unlikely to cause symptoms. The liver should go back to normal once your treatment is over
- Changes to sugar levels in your blood – your doctor will check this with regular blood tests. If you are diabetic, you will have to take extra care in checking your blood sugar. Low blood sugar may cause weakness, sweating, headaches and confusion. High blood sugar may cause thirst, hunger and passing more urine than normal
- Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your nurse straight away
- Women may stop having periods (amenorrhoea) but this may only be temporary
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
Between 1 and 10 in every 100 people have one or more of these effects.
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- A sore mouth or mouth ulcers
- Sadness or depression
- Dizziness, shakiness, or feeling light headed – let your doctor or nurse know if you have this
- Numbness or tingling around the mouth
- Fits (seizures)
Rarely, another cancer can develop many years after streptozocin treatment.
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Other medicines and supplements
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don't breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at yellowcard.mhra.gov.uk.
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