Classification: Alkylating Agent
About: Streptozocin (Zanosar®)
Streptozocin exerts its anti-cancer affect by a process called alkylation. Alkylation damages the DNA of cells, which prevents them from dividing, and causes them to die. Since cancer cells, in general, divide faster and with less error-correcting than healthy cells, cancer cells are more sensitive to this damage.
How to Take Streptozocin
Streptozocin is given by intravenous (into a vein) infusion. The dose is based on your body size and is typically given for 5 consecutive days, repeated every 6 weeks. It can also be administered weekly. Your provider will determine the best schedule for your specific treatment.
Even when carefully and correctly administered by trained personnel, this drug may cause a feeling of burning and pain. There is a risk that this medication may leak out of the vein at the injection site, resulting in tissue damage that can be severe. If the area of injection becomes red, swollen, or painful at anytime during or after the injection, notify your care team immediately. Do not apply anything to the site unless instructed by your care team.
Possible Side Effects of Streptozocin
There are a number of things you can do to manage the side effects of streptozocin. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:
Nausea and/or Vomiting
Talk to your oncology care team so they can prescribe medications to help you manage nausea and vomiting. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try saltines, or ginger ale to lessen symptoms.
Call your oncology care team if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.
This medication can cause kidney problems, including an increased kidney failure, which your oncology care team may monitor for using blood tests. Notify your healthcare provider if you notice decreased urine output, blood in the urine, swelling in the ankles, or loss of appetite.
Your oncology care team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods and absorbs fluid, which can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange sections, boiled potatoes, white rice, products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses on non-alcoholic, un-caffeinated fluid a day to prevent dehydration.
This medication can cause liver toxicity, which your oncology care team may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you have pain in your abdomen, as these can be signs of liver toxicity.
Your blood counts can be affected by this treatment, though the effect is usually mild. This can cause lower numbers of the following cells:
- White blood cells (WBC): important for fighting infection. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4 or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
- Red blood cells: responsible for carrying oxygen to the tissues in your body. You should let your doctor or nurse know if you experience any shortness of breath, difficulty breathing or pain in your chest. If the count gets too low, you may receive a blood transfusion.
- Platelets: help your blood clot, so when the count is low you are at a higher risk of bleeding. Let your doctor or nurse know if you have any excess bruising or bleeding, including nose bleeds, bleeding gums or blood in your urine or stool.
Less common, but important side effects can include:
- Low Blood Sugar (Hypoglycemia): This medication can cause low blood sugar levels in patients with and without diabetes. Your oncology care team will monitor your blood sugar. Contact your care team if you experience pale skin, shakiness, sweating, hunger, or irritability as these can be symptoms of low blood sugar. Diabetics should monitor their blood sugar closely.
- Confusion & Lethargy: Until you know how this medication will affect you, exercise caution when driving or operating machinery.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.