On the part of the hematopoiesis system: anemia, leukopenia, neutropenia, thrombocytopenia. Leukopenia is observed in almost all patients. The lowest level of leukocytes is observed 10-14 days after the administration of the drug. Recovery usually occurs within 21 days after administration.
On the part of the digestive system: nausea, vomiting, anorexia, diarrhea; ulcerative esophagitis and stomatitis.
From the cardiovascular system: congestive heart failure (arrhythmias, dyspnea, swelling of the feet and ankles) usually develops at a total dose of more than 550 mg / m2 (450 mg / m2 in patients who were previously exposed to the thorax, in elderly people and in patients with heart disease). Rarely - myocarditis, pericarditis.
On the part of the reproductive system: amenorrhea, azoospermia.
From the urinary system: hyperuricaemia (painful or difficulty urinating, cystitis), reddish urine staining.
Local reactions: phlebitis; when extravasation - pain at the injection site, inflammation of subcutaneous fat, necrosis of surrounding tissues.
Other: alopecia, allergic reactions, hyperpigmentation or reddening of previously irradiated skin areas, development of secondary infections, headache, fever, lower back pain and side pain.