Adverse effect	Onset	Evaluation	Treatment
Diarrhea	Seven to 10 days after start of chemotherapy	Stool bacterial culture	If Clostridium difficile positive, use metronidazole (Flagyl) If C. difficile negative, use an antimotility agent such as loperamide (Imodium) or diphenoxylate/atropine (Lomotil)
		Stool C. difficile antigen
		Fecal occult blood testing
Alopecia	Seven to 10 days after start of chemotherapy	—	Shave remaining hair from head; wear wigs or scarves
Chemotherapy-induced anemia	Several weeks after start of chemotherapy	Rule out other causes of anemia (e.g., bleeding, hemolysis, nutritional deficiency)	Recombinant erythropoietin (epoetin alfa [Epogen], darbepoetin alfa [Aranesp]) if hemoglobin is less than 11 g per dL (110 g per L)