Benadryl or Decadron as pretreatment?

[heblaj01]

I noticed most posts reporting on pretreatment to Herceptin indicate that Benadryl was the drug chosen by the onc.
The headaches & weakness which appear associated with Benadryl seem to confirm the opinion of a local pharmacist when asked to compare Benadryl to Decadron. He was in favor of Decadron as a better drug to control side effects of Herceptin (such as allergies) & with less side effects of its own ( in doses of 10mg every 3 weeks).

Has anyone been told why Benadryl was selected?

Is it prefered for those on weekly Herceptin (lower dose) as opposed to those on every 3 week higher doses?

[Andi]

I take my herceptin every three weeks without any premeds.

[marymary]

I'm certainly not a Pharmacist but I've taken both Benadryl & Decadron in my life. Decadron is a steroid. The root of all steroids is testosterone. Testosterone causes hunger, Decadron is absolutely an appetite stimulant. Like many women, I was unhappy about the weight gain associated with Decadron. Decadron gives energy. You may run around for a couple of days performing all sorts of previously unthinkable tasks. Decadron can cause insomnia. I needed lots of Atavan to get any sleep at all while on Decadron. Suddendly, the Decadron wears off, leaves your system and bam, you can't get up off the couch. I would become teary eyed and let-down. It really was a wild ride. I knew just how a junkie must feel.

I think Benadryl is an antihistimine. It causes some sleepiness. If you can get by with Benadryl, and I most certainly could not, then by all means go for it. I should add that I was so very allergic to Taxotere that I needed i.v. Decadron with each and every infusion, sorry I don't know what the dose was, so perhaps your symptoms would not be so remarkable.

Mary

[tousled1]

I had Decadron as a pre-med (pill form day before, day of and day after 2x a day) when I was receiving my Taxatore. The Decardon made me "wired", I would develop "moon face", a lot of bone/joint pain, sleepless nights/days (had to take Ambiern CR - Lunesta didn't work). After a few days I felt like I crashed - couldn't get enough sleep. I started Herceptin today and got Benadryl as my pre-med (IV). Other than falling asleep during infusion and having a headache after, no problems. I will take Benadryl over Decadron any day!

[Chelee]

You will normally find people that are JUST doing the WEEKLY herceptin don't have any pre-meds. Its usually when your getting a full cycle chemo regimen that they make sure you take the decadron, benedryl, tagament, etc.

But I do weekly herceptin and I know many down at my center do too....and most do their herceptin without any pre-meds...with the exception of tylenol because sometimes it will give you a headache.

I personally like to take the benedryl because the two times I tried it without...I felt a bit nauseated, and weak. When I have the benedryl it doesn't happen? (Maybe it was a freak thing those two times I did it without...but now I am afraid to not take it.)

The head of my infusion center says most do NOT take any pre-meds with JUST herceptin...it ususual isn't a needed. But everyone is different. I don't know anyone that has taken decadron for JUST herceptin? If people do it..I just have not heard of it before?

You mentioned headaches and weakness WITH benadryl? I have never heard of benadryl doing that. (I learn something new every day.)

I don't know why a pharmacist would think decadron would be a better way to control side affects from herceptin? I have been on herceptin since the beginning of Feb of this year...and its a piece of cake after having Taxotere, Carbpotin...or like others have had "AC", Taxol, and so on.

Herceptin doesn't have to many side affects that you can't tolerate with too many problems. It can dry out your nose and make it crusty. Gets a little sore at times...but I have noticed the longer I have been on it..I have less problems now. But again...we are all so different...what affects one..won't to someone else.

I know if I had to make a choice and both would work equally for me...I would ALWAYS choose benadryl over decadron. I hate taking that stuff!

[Sandy H]

I took only tylenol with the herceptin but was told by the nurse that I could refuse it. I take it at home and that way I don't have to wait the 30 minutes in the clinic. As for the benadryl with chemo I take it oral because I had it IV once and my head pounded for 3 days and I couldn't sleep and felt terrible. It doesn't do it with the oral. We are all different. hugs, Sandy

[marymary]

You were talking about pre-treatment for Herceptin only. I don't receive any pre-treatment for Herceptin. When I saw Decadron was recommended I just immediately thought Taxol/Taxotere etc.

Good luck with Herceptin. It is a great drug.

Mary

[Bev]

No premeds for herceptin only. Yeah! With taxol and herceptin did both benadryl and decadron. Benadryl gave me a wierd rush, heart palps, most people get tired. I could live w/o this. Decadron made my face flush for 3 days. I could eat for an hour and my rude stomach would growl thru the whole meal. Gained 10 # over 12 weeks. These drugs prevent adverse reactions to the chemo agents. Although I don't want an adverse reaction, I wish the docs would work to lower the dose of premeds during chemo. I think the premeds are worse than the chemo for some. BB

[Marily]

I started my first dose of Herceptin 5 years ago and was given pre meds .. after that had nothing until a few months ago after I had an "allergic reaction" to the Herceptin..First we tried it with Decadron and was "not me for three and 1/2 days. My husband wanted to take me back and get the real me. I was bouncing off the walls and did not sleep for the whole three days. We than went to Benedryl Iv with tylenol and I got sleepy from the waist up and dancing legs from the waist down..but less headache, they added atavan,that made me sleep all the rest of the day. We cut the dose to 1/2 and I did better and held off the atavan even though I still was having restless legs. I did not like to loose a whole day sleeping. I tried 1/4 of the Benedryl iv dose and had problems with mouth sores, and abdominal problems and started having cramping in my legs again, Now have gone back to 5 mgm iv Benedryl and dancing..along with the tylenol ( I do get a headache but not bad with the tylenol) I will see what happens, I took this yesterday again. I just do not want that allergic reaction again! Marily

[heblaj01]

From the extreme differences in reactions to Benadryl or Decadron so far reported in the previous posts it is difficult to draw any definite conclusions.

What is also lacking are the doses of the premeds used by each one. I assume that the doses are higher for those on chemo than Herceptin alone which may explain some strong reactions.
Chemo may also alter the immune system in unpredictable ways in different individuals resulting in different sensitivities to premeds.

In the single case of an elderly lady (90 years old) I was alluding to in the
first post of this thread, the dose of Decadron has been 10mg intravenously immediately before Herceptin (6mg/kg) for the 3 infusions so far given (at 3 week intervals).
I believe her onc not only prescribes Decadron generaly but in her case may have specificaly do so to reduce risk of falls a risk which might be greater with the drowsiness associated with Benadryl

No side effect from the Decadron in her case.No weight gain. Only one instance of brief nose bleed & slight weakness from Herceptin as sole treatment.
She never had chemo or radiation.
She takes self prescribed Omega-3 fish oil (2g per day) & CoQ10 (200mg) in addition to medications for other non malignant ailments.(Thyroid, osteoporosis....)

[MJo]

I take a benedryl tablet myself before my every three week herceptin treatment. I have asthma. I also had anaphalaxic shock at age 20 from an allergic reaction to penicillan. After I was diagnosed I started reading up on Herceptin and became petrified when I read that you could get an allergic reaction. I read the reactions happen often to people who have mouse allergies, because the petrie dish where they grow the herceptin is lined with mouse embryos. So I asked my allergist to test me for mouse allergy. I tested negative. I told the oncologist and I got Herceptin without pre-meds. No problem except a mild cough. But for peace of mind, I take a benedryl before treatment.

Ok...just out of curiosity and please pardon my ingnorance. Why is the petrie dish where they grow the Herceptin lined with mouse embryos?

Thanks,

Karen

[MJo]

RE: Why do they line the petrie dish with mouse embryos?

I don't know. I read it in the descriptions of Herceptin on the internet. Maybe some of the scientists on the board could explain. Two of the oncs in the medical practice where I go thought I was being paranoid getting tested for an allergy to mouse protein. One onc thought I did a good thing. As a lifetime asthmatic, I'm always worried about allergic reactions. MJo

[Lee]

I get my herceptin infusion every 3 wks, and get no premeds. I hated them, particularly the Decadron.

I am on weekly taxol, carboplatin chemo and herceptin. I get decadron and benadryl and tylenol as pre meds. I am doing great on these meds.

hi, i tested positive for her 2 metatastic breast cancer in january of 2010. i went through bthe treatments of AC and herceptin. i am now starting herceptin once every three weeks. how are you in your treatments and diagnosis?

[tricia keegan]

Hi Cheryl,

The post you're responding to is four years old, try sending the poster a pm in case she does'nt see this!