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Taking IL-2 and managing its side effects
March 2007 View PDF En
español
Tips for managing IL-2 side effects
Fatigue, feeling tired
During the five-day course:
- Plan your days to include rest periods. Change your normal routine
as needed—don’t exercise or run errands.
- If you work, plan to go home immediately after and rest—rent
movies, watch TV, or simply lay around.
- To avoid losing time from work, start your course three days
before your weekend. The worst side effects will more likely fall
on those scheduled days off.
Flu-like symptoms include fever, chills, sweats, joint
pain, muscle aches, and other flu-like effects. These probably get
worse throughout the five-day course and will subside almost immediately
after it’s done. Fever, joint pain, and muscle aches generally
do not occur until two to four hours after an injection is given.
- Be prepared. If you feel feverish, lay down and stay down. This
means preparing for your five-day course. Make meals in advance
or have a supply of frozen foods on hand. Keep a supply of drugs
on hand to manage side effects. In general, make sure you have
everything you’re likely to need for five days because you
may not feel like shopping.
- Take ibuprofen (600mg every six hours) or acetaminophen (650mg
every 4–6 hours, starting one hour before IL-2 dose) throughout
the five days. Keep an icepack or cool cloth on hand to lower
fever as necessary.
- Drink lots of liquids high in electrolytes, not just water!
This includes sports drinks like Gatorade and other "salty
liquids" like chicken soup, vegetable juice (V-8 Juice),
Pedialyte, etc. Start taking more of these types of liquids a
day or so before beginning a five-day course.
- As electrolyte imbalances may be a problem, consider taking
oral magnesium and calcium supplements.
- Shakes or chills may start within a half hour to an hour of
an IL-2 injection. Keep warm with blankets, heavier clothing,
or a space heater. Antihistamines (diphenhydramine, Benadryl,
25-50mg, as needed) may be used to prevent or treat mild-to-moderate
chills. If they’re severe, the narcotics meperidine (Demerol,
Mepergan) or morphine (Duramorph, MS Cotin, MSir, Oramorph, Roxanol)
may be warranted.
Nausea, vomiting, diarrhea or loss of appetite. Nausea
and vomiting can occur within 2–3 days after starting therapy.
- For nausea or loss of appetite, consider eating more frequent
meals of small amounts of soft, bland foods like mashed potatoes,
rice and cooked cereals. Avoid spicy, greasy, or sweet foods.
Also consider using dronabinol (Marinol) or natural alternatives
like medical marijuana.
- For diarrhea, try the B.R.A.T diet (bananas, rice, applesauce,
and toast) or have bulking laxatives on hand.
- Therapies that may help prevent or manage diarrhea include
dipheoxylate/atrophine (Lomotil) or loperamide (Imodium), two
tablets with each loose stool, not to exceed eight per day. Codeine
or tincture of opium may be needed if less aggressive approaches
are unsuccessful. Avoid caffeine in coffee, teas, and sodas and
avoid alcohol.
- Anti-nausea drugs, like prochlorperazine (Compazine) 5–10mg
every 4–8 hours, as needed, with lorazepam (Ativan) 1mg
every six hours, as needed may help prevent or treat nausea.
To prevent or manage skin rash, redness, itching, and peeling
- Take lukewarm, not hot, baths or showers.
- Use mild, unscented soap (such as Basis), or non-soap cleansers
(such as Nutribiotic unscented non-soap).
- Oatmeal soaps and baths may relieve red, itchy skin.
- Pat, don’t rub, your skin with a towel to dry off.
- Use mild unscented water or oil-based lotions or creams (like
Aveeno) liberally and frequently to keep skin moist and prevent
peeling. Don’t use lotions that contain alcohol. Use lotions
a few days before and throughout the five-day course.
- Avoid being in the sun. Wear hats and cover up while in the
sun. Use sunscreen with a 15 or higher SPF rating.
- Keep antihistamines on hand to help prevent or treat skin conditions.
To manage lumps under the skin at injection site
- Bring IL-2 to room temperature for 15 minutes before injection.
Icing the injection area five minutes before and after shots helps
decrease lumps. Also, gently rubbing the area for 3-5 minutes
after injection may help. Nodules may take weeks or months to
disappear.
Mouth sores, tenderness, or discomfort
- Rinse your mouth frequently with lukewarm water or saline rinses.
- Avoid hot or spicy foods, and acidic fruits and juices. Eat
soft foods that require little chewing.
- Suck on sugar-free candy to help with dryness and soreness.
- Use a very soft toothbrush and brush gently.
- "Suspension" solutions that include anesthetics, antihistamines
and antacids may relieve oral pain and discomfort (2% solution
of kaolin pectate, Xylocaine, and Benadryl).
- If you use mouthwash, be sure it’s alcohol-free.
Dizziness, lightheadedness, large changes in blood pressure
- You can prevent changes in blood pressure by being careful when
you move from a laying to standing position. If you are lying
down, first sit up and make sure you’re not dizzy, then
move to standing position.
- If possible, keep a chair in or near the shower or bath.
Hot water may make skin conditions worse. It also lowers blood
pressure. Avoid hot showers/baths while taking IL-2.
Changes in sleep patterns, insomnia
- Changes in sleep patterns may be related to IL-2 therapy. Antihistamines
can cause drowsiness and a warm glass of milk may help.
Anxiety, depression
- For anxiety, lorazepam (Ativan) 1mg daily or mild sleeping pills
like flurazepam (Dalmane) may be useful.
- Shortly following a five-day course, IL-2 users report mild
depression. Being aware that this may be drug-related seems to
help, as well as talking to others who use IL-2. In rare cases,
attempted suicide and suicide have been documented and associated
with IL-2 use. Shore up emotional support networks to help you.
Dry eyes
- If you experience dry eyes, try using artificial tears.
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