Find out about the medicines that can help with diet problems, and their possible side effects.
These are mainly for people who have lost a lot of weight or have cachexia. They work well in some people but not in everyone.
You are most likely to be given these hormone drugs:
- Megesterol acetate (also called Megace)
- Medroxyprogesterone acetate (also called Depo-Provera and Provera)
They both increase appetite and food intake in people with cancer who have nutritional problems.
They might also help you put on weight, but this is unlikely in the first 4 to 6 weeks. There is also some doubt about how beneficial the weight gain really is. Most of it seems to be fat and fluid rather than muscle mass.
However these drugs are also known to increase your sense of well being - a great benefit if you are feeling very low, anxious or depressed about your cancer.
The side effects are usually very mild and you may not have any at all. But they can cause:
- nausea (feeling and being sick)
- ankle swelling from fluid retention (mild)
- tummy (abdominal) pain
- breast tenderness
- mood changes (rare)
- blood clots (rare)
- vaginal bleeding
- impotence in men
People who are diabetic need to monitor their blood sugar levels more closely when taking these drugs. They can cause your blood sugar levels to rise you might need to adjust the dose of your diabetes medication.
If you are pregnant or thinking about getting pregnant you should not take these drugs.
Anti sickness drugs (anti emetics)
Feeling and being sick is best controlled with medicines. These drugs are called anti sickness drugs, anti nausea drugs or anti emetics.
Over the past 20 years, anti sickness drugs have got much better. There are now many more to choose from. If one drug does not work for you, tell your doctor or pharmacist. They can often suggest another you can try.
If you get side effects from your anti sickness drug, let your doctor or pharmacist know as soon as possible.
Some anti sickness drugs, known as serotonin blockers, can cause headaches and constipation, and rarely, flushing of the skin and tingling of fingers or toes. These include ondansetron (Zofran) granisetron (Kytril) and tropisetron (Navoban).
Steroids such as dexamethasone can cause:
- trouble sleeping, anxiety and fidgeting
- flushing of the skin
- tingling of the hands and feet (when injected)
- pain or tingling in the vagina in women or between the legs (perineum) in men (when injected into your bloodstream) - this can be a bit alarming, but is not serious and usually lasts less than a minute
Other anti sickness medicines include haloperidol, cyclizine and lorazepam. They can cause drowsiness.
Metoclopramide (Maxalon) and prochlorperazine (Stemetil) can cause twitching in your arms, legs or face. This is rare, but more likely in children and young adults.
Domperidone (Motilium) can make your mouth dry.
Drugs for diarrhoea
The most commonly used diarrhoea drugs are:
- Codeine phosphate
- Imodium (Ioperamide)
- Lomotil (diphenoxylate)
All these drugs slow the movement of the bowel. Codeine phosphate is also a painkilling drug. But it is also used to treat severe diarrhoea because it causes constipation.
Side effects of anti-diarrhoea drugs are not common, but they can happen. Tell your doctor if any of these symptoms are severe or do not go away. These symptoms include:
- a dry mouth
- feeling and being sick
- stomach pain, discomfort or swelling
- tiredness (fatigue)
Drugs for constipation
These are called laxatives. There are different ones that work in different ways.
- Bulk forming laxatives - these work by swelling up inside your bowel, softening and increasing the amount of stool, which encourages your bowels to open.
- Stimulant laxatives - these work by speeding up bowel movement.
- Osmotic laxatives - these work by drawing more water into your bowel, making your stools softer and easier to pass.
Different laxatives have different side effects.
Bulk forming laxatives can cause wind and swelling in the stomach (abdomen). Very rarely they can block up your bowel. So, you should drink plenty of water with these drugs to help prevent it.
Other types of laxatives can cause stomach cramps and wind, and large doses can cause diarrhoea. The side effects usually go away once your bowels have opened. But if you continue to have cramping or abdominal swelling, or if you develop diarrhoea, let your doctor know immediately.
Remember if you come up in itchy lumps, like nettle rash, or have sudden wheezing, you could be having an allergic reaction to a drug. This is a rare but serious complication. If it happens to you, you need to go to hospital straight away.
Steroids are used for many different illnesses and conditions. They are made naturally in the body. Now they are also made artificially and used as medicines. They can be given as tablets, liquids or injections.
Steroids are often used to help control chemotherapy sickness in people with cancer. They can also improve appetite, food intake and your sense of well being.
They are sometimes used to help people gain weight but there can be problems if you take them long term. Much of the weight you gain on steroids is due to fluid retention.
After taking them for 3 to 4 weeks, they begin to interfere with the production of protein in your muscles. If used long term, they can cause muscle wasting. So steroids need to be used carefully under the supervision of your doctor.
The most likely side effects when you first start taking steroids are:
- difficulty sleeping, particularly if you take them late in the evening
- high blood sugar levels, especially if you are already diabetic
Painkillers are also called 'analgesics' or 'analgesia'. Severe pain can make you lose your appetite and feel sick. If your pain is under control you are more likely to feel like eating.