Drugs Used to Treat Graft-versus-Host Disease

Drugs and other therapies used to treat patients with graft-versus-host disease can cause many side effects. 

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The drugs used to prevent and treat GVHD have many side effects. Most are temporary and end when the drug is no longer needed.

Below is a list of side effects that have been reported for each drug or therapy in ten percent or more of patients. Other less common side effects have also been reported. Consult your doctor or pharmacist for details.

New drugs and therapies are constantly being developed to prevent or treat GVHD. If a drug you are taking is not on this list, consult your doctor or pharmacist for a list of potential side effects.

Herbs, Supplements, Botanicals and Vitamins

Be careful about using herbs, supplements, botanicals and mega-doses of vitamins while taking medications for GVHD. Some can reduce the effectiveness of your GVHD medication or cause serious side effects.

For example:

  • turmeric and curcumin supplements can change how your body processes tacrolimus; when they are applied to the skin, they can cause sun sensitivity
  • and/or a rash
  • garlic supplements can decrease the effectiveness of cyclosporine and increase your risk for bleeding (cooking with garlic is fine)
  • omega-3 supplements can interfere with the effectiveness of steroids used to treat GVHD and increase the risk of bleeding
  • milk thistle can interfere with how your liver processes sirolimus and some antifungal drugs
  • St. John’s wort can interfere with the effectiveness of cyclosporine and tacrolimus, as well as some blood pressure medications

Check with your doctor before starting or continuing to use any non-prescription medicine, herb or other supplement.

Drugs Used to Treat GVHD and Their Side Effects

Drugs are listed in alphbetical order below. Click on the first letter of the drug's name to view all drugs beginning with that letter. The letters in gray do not have drugs that begin with that letter in the directory.

| A| B | C | D | E | F | G | H | I | J | K | L | M |

| N | O | P | Q | R | S | T | U | V | W | X | Y | Z |

 

Drugs and Therapies Used to Treat GVHD (in alphabetical order)

8-MOP (see methoxsalen)

8-methoxypsoralen (see methoxsalen)

A

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Abatacept (Orencia®)

  • headache
  • infection
  • nausea
  • infusion reactions, such as chills and fevers
  • high blood pressure

Afintor® (see everolimus)

Alemtuzumab (Campath®)

  • infusion reactions: rigors, fever, chills, skin rash
  • nausea, vomiting, diarrhea
  • low blood cell counts
  • difficulty breathing, cough
  • infections: pneumonia, herpes simplex, sepsis
  • headache, bone and muscle pain
  • high blood pressure, rapid heart rate

Antithymocyte Globulin (ATGAM, Thymoglobulin®)

  • infusion reactions: fever, chills, low blood pressure, skin rash
  • joint pain
  • headache
  • nausea, vomiting, diarrhea
  • night sweats
  • dizziness
  • shortness of breath
  • low platelet and white blood cell counts
  • infections

ATGAM (see anti-thymocyte globulin)

Autologous serum eye drops

  • worsening of eye discomfort
  • bacterial conjunctivitis
  • redness of the eyelids
  • corneal damage

Azathioprine (Imuran®)

  • low white blood cell count
  • infections

Azithromycin

  • diarrhea and loose stool
  • nausea
  • abdominal pain
  • cramping

B

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Belumosudil (Rezurock®)

  • infection
  • weakness
  • nausea, diarrhea
  • shortness of breath, cough
  • low white blood cell count
  • abnormal blood test for thyroid function
  • swelling caused by excess fluid
  • bleeding
  • muscle, bone, tendon or nerve pain
  • stomach pain
  • high blood pressure
  • abnormal blood test results for liver function
  • headache, fever
  • muscle spasm, joint pain
  • decreased appetite, difficulty swallowing
  • skin rash, dry skin
  • nasal congestion
  • decreased calcium in blood
  • anemia

Bortezomib (Velcade®)

  • numbness, tingling on hands and feet (peripheral neuropathy)
  • nerve pain
  • burning, prickling sensation on skin, skin rash
  • skin rash
  • constipation, nausea, diarrhea, vomiting
  • dizziness
  • lack of appetite, weight loss, stomach pain
  • low blood cell counts
  • weakness, lack of energy
  • shortness of breath
  • headache
  • fever
  • fatigue

C

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Campath® (see alemtuzumab)

CellCept® (see mycophenolate mofetil)

Cyclophosphamide

  • nausea, vomiting, diarrhea
  • mouth sores
  • kidney problems
  • bleeding from bladder
  • bloody urine
  • low blood cell counts
  • infections

Cyclosporine (Gengraf®, Neoral®, Sandimmune®)

  • kidney problems
  • headaches
  • tremors, muscle cramps
  • increased body hair
  • seizures
  • nausea, diarrhea, abdominal discomfort
  • high blood pressure
  • gum overgrowth

E

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ECP (see extracorporeal photopheresis)

Enbrel® (see etanercept)

Etanercept (Enbrel®)

  • respiratory infections
  • reactions at the site of injection
  • headache

Everolimus (Afinitor®)

  • constipation
  • slowled healing of wounds
  • nausea, vomiting, diarrhea
  • anemia
  • urinary tract infection, pain when urinating, blood in urine
  • other infections
  • high blood pressure
  • headache
  • swelling due to fluid retention
  • endocrine problems
  • abnormal kidney function test
  • stomach pain
  • fever
  • fatigue
  • difficulty sleeping
  • back and limb pain
  • low white blood cell count

Extracorporeal Photopheresis (ECP)

  • sensitivity to sunlight and other sources of UV light
  • skin redness
  • fever
  • low blood pressure
  • rapid heart rate
  • low red cell and platelet count
  • iron deficiency
  • fatigue

G

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Gengraf® (see cyclosporine)

Gleevec® (see Imatinib mesylate)

I

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Ibrutinib (Imbruvica®)

  • fatigue
  • bruising
  • rash
  • diarrhea, nausea
  • low platelet count
  • muscle spasms
  • mouth sores
  • pneumonia
  • brittle nails
  • abnormal heart rhythm

IL-2 (see interleukin-2)

Imatinib mesylate (Gleevec®)

  • nausea, vomiting, diarrhea, abdominal pain
  • muscle cramps, muscle pain, joint pain
  • swelling, weight gain
  • low blood counts
  • liver inflammation
  • infections
  • rash

Imbruvica® (see ibrutinib)

Imuran® (see azathioprine)

Infliximab (Remicade®)

  • infections
  • nausea
  • infusion reactions
  • diarrhea
  • liver enzyme abnormalities

Interleukin-2 (IL-2, Proleukin®)

  • infusion reactions: fever, chills, low blood pressure
  • flu-like symptoms, general aches and pains
  • redness on the face and body
  • rash
  • nausea, vomiting, diarrhea
  • low blood counts
  • confusion, drowsiness or temporary memory loss
  • fast heart beats
  • low urine output
  • swelling of face, ankles or legs
  • difficulty breathing

J

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Jakafi®/Jakavi® (see ruxolitinib)

L

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Lyrica (see pregabalin)

M

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Methotrexate (Rheumatrex®)

  • mouth sores
  • skin redness
  • nausea, vomiting, diarrhea
  • elevated uric acid
  • kidney problems
  • liver problems
  • low blood counts

Methoxsalen (Oxsoralen®, 8-MOP, 8-methoxypsoralen) with ultraviolet A light

  • nausea
  • itching of the skin
  • sensitivity to the sun

Muromonab-CD3 (Orthoclone®, OKT3)

  • fever, chills
  • breathing difficulty, wheezing
  • chest pain
  • nausea, vomiting, diarrhea
  • tremor
  • headache

Mycophenolate mofetil (MMF, CellCept®)

  • nausea, vomiting, diarrhea
  • bleeding
  • increased risk of infection
  • high blood sugar, high cholesterol
  • anemia
  • low calcium and magnesium
  • high potassium
  • cough, breathing issues

Myfortic® (see mycophenolate mofetil)

N

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Neoral® (see cyclosporine)

Neurotin® (see gabapentin)

Nipent® (see pentostatin)

O

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OKT3 (see Muromonab-CD3)

Ontak® (see Denileukin diftitox)

Orencia® (See abatacept)

Orthoclone® (see Muromonab-CD3)

Oxsoralen® (see methoxsalen)

P

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Pentostatin (Nipent®)

  • nausea, vomiting, diarrhea
  • rash
  • fatigue
  • fever, chills
  • infections
  • neurological toxicity
  • muscle pain
  • low white blood cell count

Pilocarpine (Salagen®)

  • flushing
  • nausea
  • increased urine frequency
  • increased sweating
  • nasal congestion, runny nose, sneezing

Prednisone and Prednisolone

  • osteoporosis (weak and brittle bones)
  • joint deterioration
  • infection
  • cataracts
  • weight gain
  • moon face
  • mood swings
  • depression
  • high blood sugar
  • high blood pressure
  • gastric ulcers
  • muscle weakness
  • bleeding

Prograf® (see tacrolimus)

Proleukin® (see interleukin-2)

Psoralen with ultraviolet A light

  • nausea
  • itching of the skin

PUVA (see psoralen with ultraviolet A light)

R

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Rapamune® (see sirolimus)

Remicade® (see infliximab)

Rezurock® (see belumosudil)

Rheumatrex® (see methotrexate)

Rituximab (Rituxan®)

  • infusion reactions: fever, chills, rigors, low blood pressure
  • rash, itching skin
  • swelling of soft tissues
  • infections
  • muscle pain
  • diarrhea, nausea, vomiting
  • low blood counts
  • low immunoglobulin levels
  • reactivation of hepatitis B

Rituxan® (see rituximab)

Ruxolitinib (Jakafi®/Jakavi®)

  • low blood counts
  • bruising
  • dizziness
  • headache
  • elevated liver enzymes
  • elevated cholesterol

S

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Salagen® (see pilocarpine)

Sandimmune® (see cyclosporine)

Sirolimus (Rapamune®)

  • increased risk of infection
  • increased risk of bleeding
  • elevated level of glucose (sugar) in the blood
  • elevated level of triglycerides (blood fats)
  • swelling
  • fever
  • headache
  • low blood counts
  • kidney problems
  • constipation, diarrhea
  • sepsis, infection

T

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Tacrolimus (Prograf®)

  • kidney problems
  • headaches
  • tremors
  • nausea, diarrhea, abdominal discomfort
  • high blood sugar
  • high cholesterol
  • high potassium, low magnesium and phosphate

Thymoglobulin® (see antithymocyte globulin)

U

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Velcade® (see bortezomib)

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Next Page: Coping with the Stress of GVHD

Updated July 2023

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