Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital in Nepal.

Use of cancer chemotherapeutic drugs is associated with several adverse drug reactions (ADRs) ranging from mild nausea to fatal myelosuppression. Data regarding safety profile of cancer chemotherapy is lacking in Nepal. To study the pattern of ADRs caused by cancer chemotherapeutic drugs in Manipal Teaching Hospital (MTH), Pokhara, Nepal. Hospitalized patients treated with cancer chemotherapy drugs from 1st January to 30th June 2006, was studied retrospectively. Necessary information was collected from the patients' hospital records. Total 60 patients underwent chemotherapy among which 25 (41.67%) developed ADRs. More than half (60 %) were male and 40 % were of age group 61-70 years. The mean SD age was 57.8 +/- 11.54 years. More than half of the patients (56%) who developed ADRs were on adjuvant chemotherapy. Alkylating agents were responsible for the ADRs in nearly half of the patients (52%) followed by antimetabolites (20%). Cisplatin was the individual drug responsible for 44% of the ADRs. The onset of the ADR was within a day in 44% of the patients. Thirty six percent of patients developing ADRs stayed in the hospital for 1-4 days. Hematological system was affected primarily (40.47% of the patients), followed by the gastrointestinal tract (33.33%). Grade I neutropenia was the most common ADR affecting 28.6% of the patients, followed by emesis (21.4%). Increased dose of antiemetics was needed in 38.5% of the patients to manage the ADRs. Levamisole was the drug used primarily (30.43%) for managing ADRs. Male patients and age group 61-70 years were highly predisposed to ADRs. Cisplatin was the common drug responsible for ADRs. Levamisole was commonly used in managing the ADRs. Similar studies covering more patients form different regions are needed to validate our findings.