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Supportive medicines

Medicines Given With — Chemotherapy

Before and during chemotherapy, you receive several medicines that are not the cancer treatment itself. They protect you from specific side effects. Knowing what each one is for makes the day less frightening.

Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed September 2026

  • Not the cancer medicine — The drip contains several protective medicines before and alongside the chemotherapy drug.
  • Each has a named purpose — Anti-nausea, stomach protection, allergy prevention — each medicine is given for a specific reason.
  • Some come home with you — Tablets to take in the days after treatment are part of the same plan, not an afterthought.
  • Painkillers need a check first — Paracetamol and ibuprofen behave differently during chemotherapy. Ask before taking either.
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Before chemotherapy begins, you receive several medicines that protect you from side effects like nausea, allergic reactions and stomach irritation — not to treat the cancer itself. Anti-nausea drugs, a steroid and sometimes an antihistamine are the most common. Your team selects them based on which chemotherapy drugs you are receiving.

What are the medicines in the drip and what does each one do?

Ondansetron and granisetron (Emeset, Zofer, Kytril)
The most commonly given anti-nausea medicines. They block a signal in the gut and brain that triggers vomiting and are usually given before the chemotherapy starts. You may be sent home with a tablet form to continue for the next day or two.
Aprepitant and fosaprepitant (Emend)
Used when the chemotherapy drugs you are receiving carry a high risk of nausea. They block a different nausea pathway from ondansetron and the two are given together, not instead of each other. Not everyone needs this — your oncologist adds it based on your specific regimen.
Dexamethasone (Decadron, Dexona)
A corticosteroid given as a pre-medication to reduce nausea, lower the risk of an allergic reaction to the chemotherapy drug, and help the anti-nausea medicines work better. Brief difficulty sleeping or increased appetite for a day or two are common afterwards.
Pheniramine maleate (Avil)
An antihistamine given before taxane chemotherapy drugs such as paclitaxel and docetaxel, which carry a risk of hypersensitivity reactions. It is also used before certain targeted therapies. It may make you feel drowsy during the session.
Pantoprazole and omeprazole (Pantocid, Pan, Omez)
Stomach-acid suppressors given alongside steroids to protect your stomach lining. Steroids can increase acid and irritate the stomach if taken alone. You may be given one as a tablet to continue at home on the days you are also taking a steroid.
Mesna (Uromitexan)
Given only with chemotherapy drugs that include ifosfamide or high-dose cyclophosphamide. Mesna binds a toxic breakdown product in the bladder before it can cause irritation or bleeding. If you are not receiving either of those drugs, you will not need it.
Filgrastim and pegfilgrastim (Neupogen, Neukine, Neulasta)
Injections given after certain regimens to prompt your bone marrow to produce more white blood cells. Not everyone receives them — your oncologist prescribes them based on your regimen and blood count risk. Bone pain for a day or two after the injection is common.
IV saline and hydration fluids
The clear fluid you see in the drip is often plain saline or a glucose solution. It keeps you hydrated, protects your kidneys during treatment, and carries medicines safely into the vein. Some chemotherapy drugs require more hydration than others.

What happens in what order on a chemotherapy day?

  1. Blood tests are reviewed first

    Your team checks your blood counts before anything is started. If your white cells or platelets are lower than is safe, treatment may be postponed to protect you — this is not a setback, it is the plan working.

  2. Pre-medications go in before the chemotherapy

    Anti-nausea medicines, a steroid and often an antihistamine are given through your drip or as tablets. They need time to work before the chemotherapy drug is given.

  3. The chemotherapy drug follows

    The cancer medicine is given after the pre-medications. How long this takes depends on the specific drug and your regimen.

  4. The line is flushed at the end

    Saline is run through the drip after the chemotherapy to clear any remaining medicine from the tubing. This is routine and takes only a few minutes.

  5. You leave with medicines to take at home

    Anti-nausea tablets, a steroid taper or stomach-protection tablets may be sent home with you. These are part of the same treatment plan and should be taken as your team explains — not skipped because you feel well.

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Which painkillers are safe to take during chemotherapy?

Paracetamol (Crocin, Calpol) is generally safer than ibuprofen or aspirin during chemotherapy — but it is not straightforward even then. Paracetamol can mask a fever, and fever during chemotherapy can be an early sign of a serious infection that needs urgent assessment, not a painkiller.

Ibuprofen, aspirin, diclofenac and other NSAIDs increase the risk of bleeding. When platelet counts are already reduced by chemotherapy, that risk is greater. They also irritate the stomach lining, which is already under strain from treatment.

Ask your oncology team before taking any painkiller, including medicines you have used safely for years. Tell them what you are treating — headache, joint pain, or something else — so they can tell you what is appropriate at your current blood count.

What should you tell your team about other medicines you are taking?

Tell your team everything — prescribed medicines, vitamins, supplements, and anything from an Ayurvedic, Unani or homeopathic practitioner. Some plant-based compounds act on the same liver enzymes that process chemotherapy drugs and can change how much of the drug reaches the cancer.

This is not a judgement on what you believe or what has helped you before. It is because your team cannot manage an interaction they do not know about. Bringing a written list to your first appointment is the simplest way to cover everything.

Your regular long-term medicines — for blood pressure, diabetes, thyroid and others — usually continue during chemotherapy. Ask your team specifically about each one on the first day, and flag any new prescription from another doctor before you start it.

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Common questions

Frequently asked questions

Why am I being given a steroid if I do not have inflammation?

Dexamethasone is given before chemotherapy as a protective pre-medication, not because you have inflammation. It reduces nausea, lowers the risk of an allergic reaction to the chemotherapy drug, and helps your anti-nausea medicines work more effectively. The amount used this way is far smaller than what someone prescribed it for a condition like arthritis would take. Brief difficulty sleeping and increased appetite for a day or two afterwards are common and expected.

Can I take ibuprofen or aspirin for pain during chemotherapy?

Ask your team before taking either. NSAIDs like ibuprofen and aspirin increase the risk of bleeding, which matters more during chemotherapy when your platelet count may already be reduced. They also irritate the stomach lining. Paracetamol is generally the safer starting point, but even that needs a check first — fever during chemotherapy is a different situation from ordinary pain, and masking it with a painkiller delays a call your team needs to receive.

What is the injection they give me after chemotherapy to boost my blood counts?

That is likely a G-CSF injection — filgrastim (Neupogen, Neukine) or the longer-acting pegfilgrastim (Neulasta). It prompts your bone marrow to produce more white blood cells faster after chemotherapy has reduced them. Not everyone receives one. Your oncologist prescribes it based on the regimen you are on and how much your counts are expected to fall. Bone pain for a day or two after the injection is common and a sign that it is working.

Why does my arm feel warm or burn when the drip is running?

A mild warmth or cool sensation as medicines enter the vein is common and usually harmless — it is the fluid and medicine mixing with your blood. Tell the nurse straight away if you feel a sharp burning, pain spreading up the arm, or swelling at the drip site. Those signs mean the needle may have moved out of the vein, and the drip should be stopped and checked before continuing.

Can I take my regular medicines — for blood pressure, diabetes or thyroid — on chemotherapy day?

Usually yes, but confirm with your team on the first day of treatment. Most long-term medicines continue unchanged during chemotherapy. Some diabetes medicines may need temporary adjustment when you are also taking a steroid, because steroids can raise blood sugar for a day or two. Blood thinners may need closer monitoring if your platelet count falls. Bring a written list of everything you take to your first appointment and mention any new prescription from another doctor before starting it.

Is it safe to take Ayurvedic, herbal or homeopathic medicines alongside chemotherapy?

Tell your team what you are taking before you continue it during chemotherapy. Some plant-based compounds act on the same liver enzymes that process chemotherapy drugs, which can change how much of the medicine reaches the cancer or increase the risk of side effects. This is not a comment on what you believe or on what has helped you before. It is because chemotherapy drugs operate within narrow ranges, and your team can only manage an interaction they know about. They can advise once they know what is involved.

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