Everolimus (Afinitor®)

How does this medicine work?

Everolimus (eh-veh-ROH-lih-mus) is a cancer medicine known as an mTOR inhibitor. It works by blocking cancer cells from growing and dividing.

How should I give it?

Everolimus is given by mouth as a tablet. It should be taken with water at approximately the same time each day. You should swallow the capsules whole. Do not crush or chew tablets.  

If unable to swallow tablets, dissolve tablets completely in small glass of water (approximately 2 tablespoons) by gently stirring immediately prior to drinking. Rinse the glass with the same volume of water and drink the rinse to ensure the entire dose is administered.

Store medication in original container at room temperature out of reach of children and pets.

Are there any precautions about food or other medicines?

The medication should be taken at roughly the same time each day to keep a steady level in the bloodstream.  Everolimus may be taken with or without food but avoid taking the drug with grapefruit since this may increase the drug level in your blood and increase your risk of side effects.

Care should be taken when handling Everolimus. When preparing dose choose a workspace away from food, windows, and fans. Wash hands and put on gloves. Take dose right away with water.

Drink a full glass of water with each dose to avoid becoming dehydrated.

Check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

What should I do if a dose is missed?

*If your child is on a study protocol please call clinic to talk with a case manager if a dose is missed.

If a dose is missed, give it as soon as you remember, unless it has been 6 hours or more since the missed dose, then skip the dose and continue with the regular schedule. Never give a double dose.

If your child vomits (throws up) within 30 minutes after receiving a dose, give it again. If your child vomits the second dose, do not repeat it again.

If your child misses or vomits more than one dose, please call the clinic.

What are the side effects?

Common

• Mouth sores, dry mouth
• Diarrhea, nausea or vomiting
• Weight loss
• Tiredness or weakness
• Skin problems such as itching, dry skin, acne-like rash, blistering of palms and soles
• Nail changes such as ingrown finger and toe nails
• Headache, confusion
• Upper respiratory infection (cough, sinus, shortness of breath)
• Low blood cell counts, increased risk of infection
• Change in taste
• Swelling of feet, ankles, legs
• Joint and or muscles aches and pains
• Increased liver and kidney lab values

Occasional       

• Dehydration
• Constipation
• Stomach virus
• Irritability
• Increased blood pressure
• Changes in electrolyte levels in the bloodstream
• Irregular menstrual cycle or hormone levels
• Blood clots
• Changes in sleep pattern
• Fever
• Kidney failure
• Urinary tract infection

Rare               

• Chest pain
• Irregular heart beat or heart attack
• Hair loss
• Seizure
• Diabetes
• Pancreatitis or inflammation of the pancreas
• Inflammation or bleeding of the gut, stomach pain or cramping
• Development of a new cancer
• Changes in ability to have children
• Bleeding

When should I call the clinic?

Call the clinic if you experience any of the following:

• Fever, chills
• Nausea (interferes with ability to eat and unrelieved with prescribed medication)
• Vomiting (vomiting more than 4-5 times in a 24 hour period)
• Diarrhea (4-6 episodes in a 24-hour period)
• Skin changes not controlled by recommended measures
• Unusual bleeding or bruising
• Black or tarry stools, or blood in your stools
• Blood in the urine
• Pain or burning with urination
• Extreme fatigue (unable to carry on self-care activities)
• Mouth sores (painful redness, swelling or ulcers)
• Signs of an allergic reaction:

            - Wheezing or chest tightness

            - Fever

            - Itching

            - Swelling of face, lips, tongue or throat

            - Trouble breathing-call 911

Always inform your health care provider if you experience any unusual symptoms.

What else do I need to know?

• Your child will have regular blood tests while on this medication to make sure all of the body’s organs are working properly.
• Practice good hygiene and skin care while on this medication.
• Avoid sun exposure or wear sunscreen and lip balm SPF 30 or higher and protective clothing in the sun.
• If your child has nausea while on this medication, they should take anti-nausea medications as prescribed by their doctor.

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