According to the World Health Organization (WHO), adverse reactions are classified according to this developmental frequency as follows: very often (> 1/10), often (> 1/100, <1/10), infrequently (> 1/1000, <1/100), rarely (> 1/10000, <1/1000) and very rarely (<1/10000); frequency is unknown - according to available data, it was not possible to establish the frequency of occurrence.
On the part of the blood system and lymphatic system very often: myelosuppression (dose-limiting), neutropenia, thrombocytopenia, leukopenia, agranulocytosis, anemia, pancytopenia. The most significant drop in the number of leukocytes is usually observed from 9 to 14 days (up to 25 days), platelets - from 7 to 17 days of treatment.
On the part of the immune system very often: immunosuppression with an increase in the incidence of infectious diseases; rarely: generalized allergic reactions, anaphylactic shock; frequency unknown: development of secondary infections, sepsis.
Endocrine disorders frequency is unknown: an increase in the total thyroxine (T4) and triiodothyronine (T3) in blood plasma,without increasing the content of free T4 and thyroid-stimulating hormone (TSH) and without clinical signs of hyperthyroidism.
From the side of nutrition and metabolism very often: hyperuricemia.
From the side of the nervous system infrequently: nystagmus, headache, vertigo, transient reversible cerebral syndrome (ataxia, confusion, extrapyramidal motor and cortical disorder), drowsiness, euphoria, optic neuritis; very rarely leukoencephalopathy with symptoms such as ataxia, speech impairment, disorientation, myasthenia gravis, aphasia, convulsions, coma (field application fluorouracil in high doses or in patients with deficiency dihydropyrimidine dehydrogenase), cerebral infarction (prikombinirovannoy therapy with mitomycin or tsisplastinom) .
From the senses Uncommon: conjunctivitis, excessive lacrimation duct stenosis, blepharitis, ectropion, photophobia, optic neuritis, ocular motility restriction (s), visual disturbances, cortical blindness (at high doses)
From the side of the cardiovascular system very often: ischemic changes on the ECG; often: pain in the heart; infrequently: arrhythmias,ischemia, myocardial infarction, myocarditis, dilated cardiomyopathy, lowering of arterial pressure, cardiogenic shock, heart failure; rarely: violation of peripheral, cerebral circulation, Raynaud's syndrome, thrombophlebitis, thromboembolism; very rarely: angina pectoris, cardiac arrest, sudden cardiac death.
From the respiratory, thoracic and mediastinal organs very often: nosebleeds, bronchospasm, cough, shortness of breath.
From the digestive system very often: decreased appetite, inflammation and / or ulceration of the mucous membrane of the gastrointestinal tract (including stomatitis, esophagitis, pharyngitis, proctitis), diarrhea, nausea, vomiting, anorexia; infrequently: dehydration, bleeding from the gastrointestinal tract, damage to liver cells, impaired liver function; very rarely: cholecystitis, liver necrosis (including fatal); frequency unknown: heartburn, taste change.
From the genitourinary system is infrequent: renal failure, reversible suppression of the function of the sexual glands, leading to amenorrhea or azoospermia.
From the skin and subcutaneous tissues very often: alopecia (reversible), syndrome palmar-plantar erythrodesisia (sensation of tingling in the hands and feet with the subsequent appearance of pain, flushing, swelling and flaking of the skin); infrequent: hyperpigmentation or depigmentation of the skin in the form of bands near the veins, dry skin, skin cracks, erythema, pruritus, rashes, telangiectasias, changes (onycholysis, pain and thickening of the nail bed, paronychia) and nail plate convergence (rarely), photosensitivity;
General disorders and disorders at the injection site are very common: increased fatigue, fever, weakness; frequency unknown: thrombophlebitis at the site of administration.