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Prednisolone
| Adverse event | Brief description of minimum grade | National Institutes of Health common toxicity criteria grade |
|---|---|---|
| Gastrointestinal | ||
| Gastric irritation or ulcer | Requiring medical management | 2 (or higher) |
| Nausea | Oral intake significantly reduced | 2 (or higher) |
| Vomiting | 2 or more episodes in 24 hours over pre-treatment | 2 (or higher) |
| Weight gain | ≥ 20% weight gain | 3 (or higher) |
| Cardiovascular | ||
| Hypertension | Requiring therapy or more intensive therapy than previously | 3 (or higher) |
| Fluid retention | Symptomatic, limiting function, unresponsive to therapy or requiring drug discontinuation | 3 (or higher) |
| Central nervous system past psychiatric history is not a contraindication | ||
| Insomnia | Frequent insomnia interfering with activities of daily living | 3 (or higher) |
| Mood alteration | Severe mood alteration interfering with activities of daily living | 3 (or higher) |
| Personality or behaviour | Disruptive to patient or family, requiring mental health intervention | 3 (or higher) |
| Restlessness | Severe | 3 (or higher) |
| Dermatological | ||
| Acne or dermatological conditions | Severe | 3 (or higher) |
| Purpura or bruising | Generalised or mucosal petechiae | 3 (or higher) |
| Impaired healing | Requiring medical management | 2 (or higher) |
| Laboratory | ||
| Hyperglycaemia | Glucose 13.9 mmol per L or higher | 3 (or higher) |
| Hypertriglyceridaemia | > 5-10 x upper limit of normal | 3 (or higher) |
| Hypokalaemia | < 3.0 mmol per L | 3 (or higher) |
| Endocrine | ||
| Cushingoid appearance | Present | 3 (or higher) |
| Disordered menstruation | Very irregular over pre-treatment | 2 (or higher) |
| Ocular | ||
| Cataracts | Symptomatic visual loss requiring treatment or interfering with function | 3 (or higher) |
| Glaucoma | Increase in intraocular pressure with retinal changes | 2 (or higher) |
| Musculoskeletal | ||
| Osteoporosis or fracture | Symptomatic, interfering with activities of daily living | |
| Avascular necrosis | Symptomatic, interfering with function | 2 (or higher) |
| Myopathy | Symptomatic, interfering with function | 2 (or higher) |
| Miscellaneous | ||
| Immunosuppression | Severe, requiring treatment withdrawal | |
| Impaired healing | Symptomatic, interfering with activities of daily living | |
| Growth retardation | ||
Azathioprine
| Adverse event | Brief description of minimum grade | National Institutes of Health common toxicity criteria grade |
|---|---|---|
| Neoplasms | ||
| New malignancy | Serious malignancy present | 4 |
| Gastrointestinal | ||
| Nausea | Oral intake significantly reduced | 2 (or higher) |
| Vomiting | 2 or more episodes in 24 hours over pre-treatment | 2 (or higher) |
| Diarrhoea | Increase of more than 4 stools per day over pre-treatment, or incontinence | 2 (or higher) |
| Stomatitis | Painful erythema, oedema or ulcers but can eat or swallow | 2 (or higher) |
| Abdominal pain | Severe pain, analgesia interfering with activities of daily living | 3 (or higher) |
| Pancreatitis | Abdominal pain with pancreatic enzyme elevation | 3 (or higher) |
| Hepatic | ||
| Bilirubin | > 1.5 x upper limit of normal | 2 (or higher) |
| Hepatic enzymes | > 2.5 x upper limit of normal | 2(or higher) |
| Dermatological | ||
| Rash | Rash with associated symptoms over less than 50% of body surface | 2 (or higher) |
| Alopecia | Pronounced hair loss | 3 (or higher) |
| Pulmonary | ||
| Pneumonitis | X-ray changes, requiring steroids and diuretics | 2 (or higher) |
| Miscellaneous | ||
| Hypersensitivity | Rash, drug fever >38 °C, aches, etc. | 2 (or higher) |
| Immunosuppression or atypical infection | Severe or systemic infection requiring intravenous antimicrobial treatment or hospitalisation | 3 (or higher) |
| Haematological | ||
| Leukocytes | < 2 x 109 per L | 3 (or higher) |
| Haemoglobin | < 80 g per L | 3 (or higher) |
| Thrombocytes | < 50 x 109 per L | 3 (or higher) |
Mercaptopurine
| Adverse event | Brief description of minimum grade | National Institutes of Health common toxicity criteria grade |
|---|---|---|
| Haematological | ||
| Leukocytes | < 2 x 109 per L | 3 (or higher) |
| Haemoglobin | < 80 g per L | 3 (or higher) |
| Thrombocytes | < 50 x 109 per L | 3 (or higher) |
| Neoplasms | ||
| New malignancy | Serious malignancy present | 4 |
| Gastrointestinal | ||
| Nausea | Oral intake significantly reduced | 2 (or higher) |
| Vomiting | 2 or more episodes in 24 hours over pre-treatment | 2 (or higher) |
| Diarrhoea | Increase of more than 4 stools per day over pre-treatment, or incontinence | 2 (or higher) |
| Stomatitis | Painful erythema, oedema or ulcers but can eat or swallow | 2 (or higher) |
| Abdominal pain | Severe pain, analgesia interfering with activities of daily living | 3 (or higher) |
| Pancreatitis | Abdominal pain with pancreatic enzyme elevation | 3 (or higher) |
| Hepatic | ||
| Bilirubin | > 1.5 x upper limit of normal | 2 (or higher) |
| Hepatic enzymes | > 2.5 x upper limit of normal | 2 (or higher) |
| Dermatological | ||
| Rash | Rash with associated symptoms over less than 50% of body surface | 2 (or higher) |
| Alopecia | Pronounced hair loss | 3 (or higher) |
| Pulmonary | ||
| Pneumonitis | X-ray changes, requiring steroids and diuretics | 2 (or higher) |
| Miscellaneous | ||
| Hypersensitivity | Rash, drug fever >38 °C, aches, etc. | 2 (or higher) |
| Immunosuppression or atypical infection | Severe or systemic infection requiring intravenous antimicrobial treatment or hospitalisation | 3 (or higher) |
Methotrexate
| Adverse event | Brief description of minimum grade | National Institutes of Health common toxicity criteria grade |
|---|---|---|
| Alimentary tract | ||
| Diarrhoea | Increase of more than 4 stools per day over pre-treatment, or incontinence | 2 (or higher) |
| Nausea | Oral intake significantly decreased and symptoms that don't respond to at least 2 of the following:
A minimum of 3 doses of methotrexate should have been trialled | 2 (or higher) |
| Stomatitis | Painful erythema, oedema or ulcers but able to eat or swallow | 2 (or higher) |
| Vomiting | 2 or more episodes in 24 hours over pre-treatment | 2 (or higher) |
| Blood | ||
| Haemoglobin | < 80 g per L | 3 (or higher) |
| Clinical haemorrhage | Requiring transfusion | 3 (or higher) |
| Leukocytes | < 2 x 109 per L | 3 (or higher) |
| Phlebitis | Present | 2 (or higher) |
| Thrombocytes | < 50 x109 per L | 3 (or higher) |
| Central nervous system | ||
| Ataxia | Mild symptoms interfering with function but not interfering with activities of daily living | 2 (or higher) |
| Hearing | Tinnitus or hearing loss not requiring treatment | 2 (or higher) |
| Incoordination | Mild symptoms interfering with function but not interfering with activities of daily living | 2 (or higher) |
| Mood alteration | Moderate mood alteration interfering with function but not interfering with activities of daily living | 2 (or higher) |
| Vision | Symptomatic and interfering with function but not interfering with activities of daily living | 3 (or higher) |
| Dermatological | ||
| Alopecia | Pronounced hair loss | 2 (or higher) |
| Rash | Rash with associated symptoms over less than 50% of body surface | 2 (or higher) |
| Hepatic | ||
| Bilirubin | > 1.5 x upper limit of normal | 2 (or higher) |
| Elevated transaminases |
| 2 (or higher) |
| Elevated serum alkaline phosphatase | 2.5 x upper limit of normal | 2 (or higher) |
| Respiratory | ||
| Pneumonitis/pulmonary infiltrates | Radiographic changes requiring steroids/diuretics | 2 (or higher) |
| Pulmonary fibrosis | Requiring steroids/diuretics | 2 (or higher) |
| Cough (severe) | Severe cough/coughing spasm that is poorly controlled or unresponsive to treatment. Evidence of reversal on treatment withdrawal | 3 (or higher) |
| Renal | ||
| Renal impairment | Creatinine clearance <30 mL/min | 3 (or higher) |
| Other | ||
| Allergic reaction | Urticaria, drug >38 °C or bronchospasm | 2 (or higher) |
| Infection | Severe, systemic infection, requiring IV antimicrobial treatment or hospitalisation | 3 (or higher) |
| Headaches (severe) | Severe pain (requiring compound analgesics) where pain/analgesics severely interfere with activities of daily living | 3 (or higher) |
| Nodulosis (following introduction of methotrexate therapy) | Development of multiple new nodules causing significant local pressure symptoms and distress to the patient | |