Flu-like syndrome

Oral administration of mesalamine may cause abdominal pain, nausea, headache dizziness, fever, and weakness. The adverse reactions associated witii rectal administration are less than those seen witii oral administration, but headache abdominal discomfort, flu-like syndrome, and weakness may still occur. Olsalazine administration may result in diarrhea, abdominal discomfort, and nausea Sulfasalazine is a sulfonamide witii adverse reactions the same as for the sulfonamide drugs (see Chap. 6). 

These drugp are usually well tolerated. Occasionally a transient burning sensation, rash, dry skin, scaling, or flu-like syndrome may occur. 

Myelosuppression alopecia moderate emetogen worse with high dose (greater than 1 g/m2) or IT administration diarrhea mucositis flu-like syndrome with fever and arthralgias rash often followed by desquamation on palms and soles... 

Dacarbazine (DTIC) -atypical alkylating agent, noncell cycle dependent -bone marrow suppression -nausea and vomiting -vesicant if extravasated -flu-like syndrome -fever... 

Procarbazine -alkylating agent cell cycle independent -bone marrow suppression—prolonged -nausea and vomiting—severe tolerance often develops with repeated dosing -mucocutaneous effects (mucositis, stomatitis, diarrhea) -rash, hives, photosensitivity -interstitial pneumonitis -CNS toxicity—seizures, lethargy, headache, ataxia -flu-like syndrome -azoospermia and amenorrhea almost universal... 

While rDNA techniques offer exciting possibilities, there are many unanswered questions about the potential toxicity that each new product represents. For example, acute clinical toxicities of interferons (IFNs) include flu-like syndrome, fever, chills, malaise, anorexia, fatigue, and headache. Chronic dose-limiting toxicities include neutropenia, thrombocytopenia, impairment of myeloid maturation, reversible dose-related hepatotoxicity, some neurological toxicity (stupor, psychosis, peripheral neuropathy) and gastrointestinal toxicity. Some of these toxicities would be difficult to ascertain in rodents, and, in fact, may be species-specific. 

Adverse reactions occurring in 3% or more of patients include the following Dry mouth, headache, dizziness, somnolence, abdominal pain, constipation, dyspepsia, xerophthalmia (extended- and immediate-release) diarrhea, fatigue, flu-like syndrome (immediate-release). 

Fligh doses of rifampin (greater than 600 mg) given once or twice weekly have resulted in a high incidence of adverse reactions including the following Flu-like syndrome hematopoietic reactions cutaneous, Gl, and hepatic reactions shortness of breath shock renal failure asymptomatic elevations of liver enzymes rash. Rifabutin... 

Most short-term applications of EPO are non-renal related, and generally display very few side-effects i.v. administration can sometimes prompt a transient flu-like syndrome, while s.c. administration can render the site of injection painful. This latter effect appears, however, to be due to excipients present in the EOP preparations, most notably the citrate buffer. EPO administration can also cause bone pain, although this rarely limits its clinical use. 

Patients should be warned that rifampicin colors urine, tears and other body fluids reddish-orange. Adverse effects further include rashes and pruritus and gastrointestinal complaints like nausea, anorexia and diarrhoea. With intermittent therapy a probably allergic hypersensitivity reaction can occur which mostly manifests itself as a flu-like syndrome with fever but can also result in nephritis and acute tubular necrosis. Elevation of serum transaminase levels occur frequently but clinical hepatitis is rare. Fatal outcome has been reported however. 

Muromonab is a mouse monoclonal antibody against the CD3 receptor of T-lymphocytes. Its activity is based on inhibition of interactions between antigen-presenting cells and T-cells. By preventing antigen presentation it suppresses T-cell activation and proliferation. The indication for muromonab is the treatment of acute graft rejection after kidney, liver and hart transplantations. Its adverse effects consist of those symptoms that are initiated by the release of cytokines and lymphokines as a result of the reaction of muromonab with CD3 positive T-lymphocytes. These symptoms may vary from a mild flu-like syndrome to serious cardiac, pulmonale and neurological reactions. 

Interferon gamma is an activator of macrophages. Its anti-viral activity is limited compared to that of interferon alfa. Human recombinant interferon gamma restores, at least in part, macrophage cytotoxicity and with that decreases the incidence of infections in patients with chronic granulomatous diseases. Its adverse effects consist mainly of flu-like syndrome skin rashes may occur. 

Rash, diaphoresis, hypertension, hematuria, vomiting, urinary incontinence, headache, flu-like syndromes, photosensitivity... 

Adverse effects include asthenia, flu like syndrome, back pain, dry mouth, increased appetite, constipation, weight gain, peripheral edema, myalgia, sorrmolence, dizziness, abnormal dreams, abnormal thinking, tremor, confusion, dyspnea and urinary frequency. 

Adverse effects include skin rash, drug fever, nausea, vomiting, peripheral neuropathy, fatigue, hepatitis and jaundice, haemolytic anaemia, diarrhoea, drowsiness, ataxia, headache, flu like syndrome and stomatitis. 

Shortly after the introduction of CPZ, jaundice was noted to occur in about one of every 200 patients. Subsequently, its incidence inexplicably decreased to one in 1,000, although accurate data are often lacking. Jaundice is most often seen about 1 to 5 weeks after the initiation of therapy and is usually preceded by a flu-like syndrome (malaise, abdominal pain, fever, nausea, vomiting, and diarrhea), resembling mild gastroenteritis or infectious hepatitis. Important clinical factors include the following ... 

Pamidronate, 60-90 mg, infused over 2-4 hours, and zole-dronate, 4 mg, infused over at least 15 minutes, have been approved for the treatment of hypercalcemia of malignancy and have largely replaced the less effective etidronate for this indication. The effects generally persist for weeks, but treatment can be repeated after a 7-day interval if necessary and if renal function is not impaired. Some patients experience a self-limited flu-like syndrome after the infusion. Repeated doses of these drugs have been linked to renal deterioration and osteonecrosis of the jaw, but this adverse effect is rare. 

Altretamine Same as above Ovarian cancer Nausea and vomiting Myelosuppression, peripheral neuropathy, flu-like syndrome... 

Cytokine release syndrome, ranging from a mild, self-limited, flu-like syndrome to a less-frequently reported severe, life-threatening shocklike reaction, has been associated with first few doses... 

The impact of a new formulation of low-dose micronized medroxyprogesterone plus 17-beta-estradiol on lipid profiles in menopausal women has been studied for 12 months. Total cholesterol concentrations fell 8.4%, low-density lipoprotein cholesterol fell 18%, and high-density lipoprotein cholesterol increased 6.9% total triglycerides increased 12%. The most frequently reported adverse events were menorrhagia, breast tenderness, cervical polyps or cysts, bloating, fatigue or lethargy, influenza or a flu-like syndrome, back pain, headaches, irritability, and depression (34). 

Typical side effects are constitutional in nature, including a flu-like syndrome within 6 hours after dosing in more than 30% of patients that tends to resolve upon continued administration. Other potential adverse effects include thrombocytopenia, granulocytopenia, elevation in serum aminotransferase levels, induction of autoantibodies, nausea, fatigue, headache, arthralgias, rash, alopecia, anorexia, hypotension, and edema. Severe neuropsychiatric side effects may occur. Absolute contraindications to therapy are psychosis, severe depression, neutropenia, thrombocytopenia, symptomatic heart disease, decompensated cirrhosis, uncontrolled seizures, and a history of organ transplantation (other than liver). Alfa interferons are abortifacient in primates and should not be administered in pregnancy. 

Procarbazine 50-200 mg/d orally Nausea and vomiting, flu-like syndrome, drug interactions Bone marrow depression, central nervous system depression, leukemogenic... 

Adverse effects The most common of these are headache, diarrhea, and nausea. Other untoward effects are weight loss, allergic reactions including a flu-like syndrome, skin rash, alopecia, and hypokalemia. Leflunomide is teratogenic in experimental animals, and is therefore contraindicated in pregnancy, and in women of childbearing potential. It should be used with caution in patients with liver disease, because it is cleared by both biliary and renal excretion. Cholestyramine increases the clearance of leflunomide. 

Acute neuropsychological disturbances are usually associated with the flu-like syndrome and include headache, fatigue, and weakness, drowsiness, somnolence, subtle impairment of memory or concentration, and lack... 

Adverse reactions for these multiaction drugs include burning, foreign body sensation, dry eye, and pruritus. Systemic side effects may include headache, flu-like syndrome, and rhinitis. Most common to all these drugs is headache and burning and stinging. Table 13-7 delineates the various adverse reactions. 

Oral bropirimine (3 g/day thrice weekly for 1 year) has been compared with weekly intravesical Bacillus Calmette-Guerin (2 cycles of 6 weeks) in 55 patients with newly diagnosed bladder carcinoma (3). Whereas the response to treatment was not significantly different between the two groups, adverse effects resulted in more withdrawals with BCG than bropirimine (14 versus 4%). Bropirimine produced more frequent systemic reactions (in particular diarrhea, fever, flu-like syndrome, headache, nausea/vomiting) but less frequent and less severe local comphcations. 

The general toxicity of interferon beta is very similar to that of interferon alfa (2), with no apparent differences between the two recombinant preparations with any route of injection (SEDA-20, 332) (3-6). In multiple sclerosis, fatigue and a transient flu-like syndrome responsive to paracetamol or the combination of paracetamol plus prednisone have been observed in about 60% of patients during the first weeks of treatment, and tachyphylaxis usually developed after several doses (7). Patients with chronic progressive disease are more likely to discontinue treatment because of adverse effects (8). 

The antitumor properties of muramyl tripeptide are thought to be related to its immunoenhancing effects, in particular on the monocyte/macrophage system. Its most common adverse effect is a flu-like syndrome, usually during the first administration. In one trial in nine patients, four had mild to moderate respiratory distress, two of whom had pre-existing asthma and symptoms suggestive of asthma exacerbation (1). 

Linear IgA dermatosis with erythema multiforme-Uke clinical features has been reported in a 19-year-old man several days after completion of a 5-day-course treatment with sulfadimethoxine (500 mg bd) for a flu-like syndrome (134). Treatment with methylprednisolone (150 mg) with gradnal dosage rednction was started. Slow improvement was followed by a flare-up after reduction to 80mg/day. Therapy was changed to dapsone 100 mg/day, and there was a dramatic improvement. 

In 255 children with atopic dermatitis, tacrolimus 0.1% ointment caused transient skin burning and itching as the most common adverse events (65). Two patients required hospital admittance to control skin infections. A flu-like syndrome was the major non-topical adverse event. 

Adverse effects include a flu-like syndrome at the start of therapy that decreases in severity as treatment progresses. Interferon beta-1 a is a potential abortifacient and an inhibitor of cytochrome P-450. 

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