Streptozocin (Zanosar ®)
Streptozocin may be used along with other chemotherapy drugs.
This information should ideally be read with our general information about chemotherapy and the type of cancer you have.
How streptozocin is given
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You will usually have streptozocin in the chemotherapy day unit. A chemotherapy nurse will give it to you. During treatment, you will usually see a cancer doctor, a chemotherapy nurse or a specialist nurse. This is who we mean when we mention doctor or nurse in this information.
Before or on the day of your treatment, a nurse or a person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that it is okay for you to have chemotherapy.
You will also see a doctor or nurse before you have chemotherapy. They will ask you about how you have been feeling. If your blood results are alright on the day of the treatment, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Your nurse will give you anti-sickness drugs and, sometimes, a steroid as an injection into a vein. The steroid also helps to prevent sickness.
Your treatment will be given in one of the following ways:
a short thin tube that the nurse puts into a vein in your arm or hand (cannula)
a fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line)
a fine tube that goes under the skin of your chest and into a nearby vein (central line).
Your nurse will give you streptozocin as a drip (infusion) into your cannula or line. They will usually run the drip through a pump. This gives you the treatment over about an hour.
When the streptozocin is being given
Some people may have side effects while they are having the chemotherapy:
Streptozocin may cause an allergic reaction while it’s being given. Your nurse will check you for this. If you have a reaction, they will treat it quickly.
You’ll be monitored closely during treatment. Tell your nurse or doctor if you feel unwell or have any of the following symptoms:
feeling itchy, flushed or short of breath
swelling of your face or lips
pain in your tummy, back or chest.
Pain along the vein
If you have pain along the vein where your treatment is being given, tell your nurse straight away. They will check your vein and slow the drip to ease the pain.
The drug leaks outside the vein
If this happens when you’re having streptozocin, it can damage the tissue around the vein. This is called extravasation. If you have any stinging, pain, redness or swelling around the vein, tell the nurse straight away. Extravasation is not common. If it does happen, it’s important that it’s dealt with quickly.
If you get any of these symptoms after you get home, contact the doctor or nurse straight away on the number they gave you.
Your course of streptozocin
You will have streptozocin chemotherapy as a course of several sessions (or cycles) of treatment over a few months. The number of cycles will depend on the type of cancer you have. Your doctor or nurse will tell you more about this and the number of cycles you are likely to have.
Before you go home, the nurse or pharmacist will give you anti-sickness drugs. Take all your tablets exactly as your nurse or pharmacist has explained.
Possible side effects of streptozocin
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We explain the most common side effects of streptozocin here. But we don’t include all the rare ones that are unlikely to affect you.
You may get some of the side effects we mention but you are very unlikely to get all of them. If you are having other chemotherapy drugs as well as streptozocin, you may have some side effects that we don’t list here. Always tell your doctor or nurse about the side effects you have.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist has explained. This means they will be more likely to work better for you. Your nurse will give you advice about managing your side effects. After your treatment is over, the side effects will start to improve.
Serious and life-threatening side effects
Sometimes, cancer drugs can result in very serious side effects. Rarely, these may be life-threatening. Your cancer doctor and nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
More information about this drug
We are not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information you can visit the electronic Medicines Compendium (eMC).
Risk of infection
Chemotherapy can reduce the number of white blood cells in your blood. This will make you more likely to get an infection. When the number of white blood cells is low, it’s called neutropenia.
Contact the hospital straight away on the number you’ve been given if:
your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your chemotherapy team
you suddenly feel unwell, even with a normal temperature
you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
The number of white blood cells usually increases steadily and returns to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cell numbers are still low, your doctor may delay your treatment for a short time.
Bruising and bleeding
Rarely, streptozocin can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. If you have any bruising or bleeding you can’t explain, tell your doctor. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin.
Anaemia (low number of red blood cells)
Chemotherapy can reduce the number of red blood cells that carry oxygen around the body. But this isn’t common with streptozocin.
This may happen in the first few days after chemotherapy. Your doctor can prescribe effective anti-sickness drugs to help prevent or reduce sickness or vomiting. They may also give you a steroid drug to help.
If the sickness is not controlled, or if you vomit twice or more in 24 hours, contact the hospital on the number they gave you as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you. Some people may need to go to hospital for a short time so the doctors and nurses can control their sickness. Some anti-sickness drugs can make you constipated. If this is a problem, tell your doctor or nurse.
Raised or reduced blood sugar levels
Streptozocin may change your blood sugar levels. Your nurse will check your blood regularly for this. They may also test your urine for sugar. They can show you how to do this at home.
Symptoms of a raised blood sugar level are feeling thirsty, needing to pass urine more often and feeling tired. If you have these symptoms, tell your doctor or nurse. Symptoms of a low blood sugar level are feeling dizzy, sweating and feeling confused. If you have these symptoms, have a sugary drink and contact the hospital on the number you’ve been given.
If you have diabetes, you may need to check your blood sugar levels more often. Your doctor will talk to you about how to manage this. You may need to change your dose of insulin or diabetes tablets.
Feeling tired is a very common side effect of chemotherapy. You will probably feel very tired and need a lot of rest.
Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery. You may find our information on coping with fatigue helpful.
Streptozocin may cause changes in the way your kidneys work, although this will return to normal when the treatment finishes. You are very unlikely to notice any problems. Your doctor will take regular blood samples to check your kidneys are working properly. Your nurse will ask you to drink plenty of fluids.
Your urine will also be checked every week for a build-up of protein. It will also be checked for four weeks after you finish your treatment.
Streptozocin may cause changes in the way your liver works, although it will return to normal when the treatment finishes. You are very unlikely to notice any problems. Your doctor will take regular blood samples to check your liver is working properly.
Effects on the nervous system
Streptozocin can affect the nervous system and cause mood changes, such as confusion. If you notice that you’re feeling confused, don’t drive or operate machinery. Talk to your nurse or doctor and they can advise you about what might help.
Streptozocin can cause diarrhoea. This can usually be easily controlled with medicine. If it is severe or if it continues, tell your doctor. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.
It is important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Other information about streptozocin
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Blood clot risk
Cancer increases the chances of a blood clot (thrombosis) and chemotherapy can increase this risk even more. A clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. If you have any of these symptoms, contact your doctor straight away. A blood clot is serious but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can be harmful to take when you are having streptozocin. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Streptozocin can affect your fertility. If you are worried about this, talk to your doctor before treatment starts.
Your doctor will advise you not to get pregnant or father a child during treatment. This is because the drugs may harm a developing baby. It is important to use contraception during and for a few months after chemotherapy. You can discuss this with your doctor or specialist nurse.
If you have sex within the first couple of days of having chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluid.
Women are advised not to breastfeed during treatment and for a few months after treatment. This is in case there is chemotherapy in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Give them the contact details for your cancer doctor.
If you think you need dental treatment, talk to your cancer doctor or nurse. You should always tell your dentist you are having chemotherapy.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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