Care During Chemotherapy and Beyond
(e ver OH li mus)
Trade Name: Afinitor®
Everolimus is the generic name for the trade name drug Afinitor. In some cases,
health care professionals may use the trade name Afinitor when referring to the
generic drug name everolimus.
Everolimus is a targeted therapy and is classified
as an mTOR inhibitor.
What Everolimus Is Used For:
- Treatment of advanced renal cell cancer, after
sunitinib and sorafenib treatment failure.
- Advanced pancreatic neuroendocrine tumors
- Treatment of advanced hormone receptor positive, HER2-negative breast cancer in
post menopausal women, after letrozole or anastrozole treatment failure.
- Treatment of adult patients with certain types of neuroendocrine tumors (NET) of gastrointestinal (GI) or lung origin with unresectable, locally advanced or metastatic disease.
Note: If a drug has been approved
for one use, physicians may elect to use this same drug for other problems if they
believe it may be helpful.
How Everolimus Is Given:
- Everolimus is given as a tablet by mouth.
- Take at the same time each day, may be taken with or without food.
- Swallow whole with a glass of water, do not chew or crush tablets.
- Avoid contact with or exposure to crushed or broken tablets.
- There are 2 tablet strengths
- 5mg tablet; white to slightly yellow, elongated tablet with a bevelled edge and
no score, engraved with "5" on one side and "NVR" on the other
- 10mg tablet; white to slightly yellow, elongated tablet with a bevelled edge and
no score, engraved with "UHE" on one side and "NVR" on the other.
- The amount of everolimus that you will receive will be prescribed by your doctor
based on established dosing guidelines.
Important things to remember about the side effects
- You will not get all of the everolimus side effects mentioned below.
- Everolimus side effects are often predictable in terms of their onset, duration,
- Everolimus side effects are almost always reversible and will go away after therapy
- Everolimus side effects are quite manageable. There are many options to minimize
or prevent them.
The following side effects are common (occurring
in greater than 30%) for patients taking everolimus:
These are less common (occurring in 10-29%)
side effects for patients receiving everolimus:
This list includes
common and less common side effects for those taking everolimus. Side effects that
are very rare -- occurring in less than about 10 percent of patients -- are not
listed here. But you should always inform your health care provider if you experience
any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately,
day or night, if you should experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible
signs of infection)
The following symptoms require medical attention, but
are not an emergency. Contact your health care provider within 24 hours of
noticing any of the following:
- 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)
- 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)
Always inform your health care provider if you experience
any unusual symptoms.
- Before starting everolimus treatment, make
sure you tell your doctor about any other medications you are taking
(including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, or products containing aspirin
unless your doctor specifically permits this.
- Do not receive any kind of immunization or vaccination
without your doctor’s approval while taking everolimus.
- Inform your health care professional if you are
pregnant or may be pregnant prior to starting this treatment. Pregnancy category
D (everolimus may be hazardous to the fetus. Women who are pregnant or become pregnant
must be advised of the potential hazard to the fetus.)
- For both
men and women: Do not conceive a child (get pregnant) while taking everolimus. Barrier
methods of contraception, such as condoms, are recommended. Discuss with your doctor
when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that are
effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your doctor while
you are taking everolimus, to monitor side effects and check your response to therapy.
Periodic blood work will be obtained to monitor your complete blood count (CBC)
as well as the function of other organs (such as your kidneys and liver) will also
be ordered by your doctor.
How Everolimus Works:
Targeted therapy is the result
of about 100 years of research dedicated to understanding the differences between
cancer cells and normal cells. To date, cancer treatment has focused primarily
on killing rapidly dividing cells because one feature of cancer cells is that they
divide rapidly. Unfortunately, some of our normal cells divide rapidly too,
causing multiple side effects.
Targeted therapy is about identifying other features
of cancer cells. Scientists look for specific differences in the cancer cells
and the normal cells. This information is used to create a targeted therapy
to attack the cancer cells without damaging the normal cells, thus leading to fewer
side effects. Each type of targeted therapy works a little bit differently
but all interfere with the ability of the cancer cell to grow, divide, repair and/or
communicate with other cells.
There are different types of targeted therapies, defined
in three broad categories. Some targeted therapies focus on the internal components
and function of the cancer cell. The targeted therapies use small molecules
that can get into the cell and disrupt the function of the cells, causing them to
die. There are several types of targeted therapy that focus on the inner parts
of the cells. Other targeted therapies target receptors that are on
the outside of the cell. Antiangiogenesis inhibitors target the
blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.
Everolimus is an inhibitor of mTOR. mTOR inibition
blocks the translation of genes that regulate cancer cell proliferation. It
also results in reduced levels of certain cell growth factors involved in the development
of new blood vessels, such as vascular endothelial growth factor (VEGF).
Research continues to identify which cancers may be best treated with targeted
therapies and to identify additional targets for more types of cancer.
Note: We strongly encourage you to talk with
your health care professional about your specific medical condition and treatments.
The information contained in this website is meant to be helpful and educational,
but is not a substitute for medical advice.
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