On the part of the hematopoiesis system: most often leukopenia, granulocytopenia (the lowest level is observed 5-10 days after the last administration, the complete recovery usually occurs within the next 7-14 days); less often - thrombocytopenia, anemia.
On the part of the digestive system: stomatitis, pharyngitis, decreased appetite, nausea, vomiting, constipation, diarrhea, abdominal pain, paralytic intestinal obstruction, hemorrhagic enterocolitis, bleeding from previously diagnosed gastrointestinal ulcers.
From the nervous system: paresthesia, decrease or loss of deep tendon reflexes, peripheral neuritis, depression, headache, convulsions, dizziness, diplopia, weakness, pain in the jaw region, neuritis of the VIII pair of cranial nerves (partial or total deafness, dizziness, nystagmus).
From the cardiovascular system: increased blood pressure; myocardial ischemia, including angina pectoris or myocardial infarction (usually with simultaneous use with bleomycin and cisplatin); microangiopathy (Raynaud's syndrome with concomitant use of bleomycin);
From the respiratory system: bronchospasm (usually, with simultaneous use with mitomycin) with acute respiratory failure, cyanosis, dyspnea and often with the formation of pulmonary infiltrates and pneumonitis.
From the skin and skin appendages: alopecia, urticaria.
Local reactions: pain or redness at the injection site, phlebitis; when the product gets under the skin - inflammation of the subcutaneous fat, and, possibly, necrosis.
Other: hyperuricemia, uric acid nephropathy; weakness, increased fatigue, myalgia, ossalgia, pain in the area of tumor nodes; azoospermia and amenorrhea (sometimes irreversible). When appointing doses above recommended, the syndrome of inadequate secretion of antidiuretic hormone is noted.