Anyone successfully reduce or eliminate chemo premeds?

1982M

Good morning,

I'm on a 12 week taxol and 3 week Herceptin schedule. I had my first week with 10mg dexamethasone and 25mg Benadryl. I particularly don't like the Benadryl.

I've read some protocols just give premeds for taxol the first two times and if no reaction occurs they taper it off. I meet with my oncologist after the third treatment and was going to inquire if that would be an option. I did get flushed the day after my taxol and Herceptin. It happened many hours post infusion. I never got a fever but was definitely warm in the night and pink in the am. I'm not sure if that would mean I should keep the premeds. My face and chest were warm and red but only the day after.

I wanted to hear different experience or opinions. I don't want to compromise my care or make things harder on myself, but if I can receive the chemo with less other medications I would be willing to consider it.

Thanks for sharing insight and experiences!

AMG2

I think I've seen people mention they've been able to tolerate taxol without premeds. My first session was pretty reaction intense, and I had to have 2 doses each of dexamethasone and benadryl, but even so, the premeds were reduced to just dexamethasone the second, third and fourth weeks. I was fine for 2 and 3, but I had another anaphylactic reaction toward the end of the fourth session, and the plan is to add benadryl back to the 5th. I did find the sessions without benadryl to be much less taxing, but I don't know how much of that was benadryl vs having reactions that made me need extra premeds.

My chemo nurses have been very careful about watching for reactions no matter what premed I've been given. It seems like their aim is to reduce the premeds as best they can, but to adjust as needed.

Hope that helps.

1982M

Thanks AMG2,

I’m sorry you had a reaction the 4th time. That would be a not nice experience and very taxing…

MinusTwo

I had TCHP so not exactly the same. But I refused Benedryl after the first session. I was happy to take the dexamethazone ahd day before. And because i cut the dose in half, I spread it out for 3 days after.

Anonymous

I had Taxol, my oncologist wouldn't eliminate the premeds (Benadryl and steroid) but she did reduce them to the lowest dose after my first few sessions because I kept after her.

1982M

Thanks! I’ll see if I can eliminate the Benadryl or reduce it at least. Maybe they can reduce the dexamethasone too. Or titrate it down a wee bit.

SpecialK

The dexamethasone is likely what is causing the warmth and flushed face. It usually happens about a day later and can last for a couple of days. Kind of feels like a sunburn on the face and chest. I have had steroids for other reasons, injected for allergic reactions and also for knee pain - I always get the red flushed face.

1982M

Thank you special K! That’s exactly what it felt like. I’m grateful it lasted only the first post chemo day.

Anonymous

For the Taxol infusion, my MO reduced dexamethasone from 10 mg to 8 mg and Benadryl from 25 mg to 12.5 mg. I added Reactine, an antihistamine.

I didn't try to reduce it further because I read some people experienced anaphylactic shock.

WC3

I had Taxotere and I'm not sure of the differences in premeda between Taxol and Taxotere but I did have the dexamethasone, which I hated but my care team said was necessary, and the IV Benadryl. I did get flush a day or two after infusions but for me this was from dexamethasone withdrawl. I was able to determine this because it happens any time I've taken or been given dexamethasone regardless of chemotherapy.

One thing about dexamethasone is that it also has some anti-emetic properties. I tried to skip a day after chemo dose once and developed nausea as a consequence.

1982M

Thanks WC3,

I was worried maybe about the nausea end of it. I had minimal nausea this round just on the first few days. I’d be more willing to keep the dexamethasone and if I can forgo the Benadryl. Ugh.

MinusTwo

I tapered my dexamethodone based on advise from a friend & from this site. Instead of two pills for 3 days I took: 1 the day before chemo, two the day of chemo, and one for the next two or 3 days (can't remember) My MO was fine with this. I absolutely would NOT take any benedryl after that first infusion.

1982M

I’ll take the Benadryl this time, but I’m going to ask to skip it after tomorrow if I am deemed too be ok. I’ll ask if I can taper the dexamethasone too and see what the medical oncologist says.

Did you feel like it was ok without the premeds?

MinusTwo

Yes - other than the dexamethasone - I took no pre-,meds, But remember - we are all different & have unique systems so be careful.

1982M

yes for sure. I asked the nurse if they ever wean people off premeds and she was absolutely adamant they never, ever do. It’s not the worse thing in the world. I have three kids and my youngest is 4. I feel like the day of infusion I’m so groggy it’s a bit tough, especially on her. My husbands very helpful but I just don’t love them seeing me like that and me feeling like that- I think it’s mostly the Benadryl that does it.

Only 10 more infusion left which means only 10 days of Benadryl. I’m sure I can push through, but will still ask the med onc. for sure.

MinusTwo

1982 - it's really your decision whether to take any given drug or not. I compromised by keeping a bottle of children's benadryl in my pack - but it makes me drowsy & groggy too. Since I drove myself to chemo infusion treatments, I couldn't drive home with the benadryl on board - even after the 6+ hours in the chair.