Care Specialists Program | Personalized Support for Oral Oncology Patients - Prime Therapeutics
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Oral Oncology
Oral Oncology medication
Oral oncology medications treat different forms of cancer. You may take them by mouth as tablets, capsules or liquid. Oral oncology medications may give you more control over your treatment and more time for your daily work and social activities. They may also remove the travel time and costs associated with an infusion clinic. Plus, oral oncology medications may lower your chance of infection or pain from having an IV line placed in you during infusion therapy.
Understanding the risk and benefits of oral oncology medication.
Knowing the status of your condition and the importance of taking your medication as directed will help you take control of your therapy. Missing treatment will affect your results.
Tell your doctor, pharmacist and Health Coach what medications you are taking.
This includes prescriptions, over-the-counter medications and herbal supplements.
Have ongoing dialogs with your doctor, pharmacist and Health Coach.
Taking part in your treatment plan can be a very empowering experience for you.
Properly store your medication.
Check with your doctor, pharmacist or Health Coach for how to keep your medication safe. The same goes if you have to dispose of it. Don’t throw your oral oncology medications in the trash or anywhere that leads to a public water supply (such as down the sink or toilet). Any unused medication should be returned to your doctor’s office.
Follow a routine to track when to take your medication therapy.
Check with your pharmacist if you can use a daily or weekly pillbox organizer. Some medications should be kept in their original containers.
Set a reminder to take your medication.
Create an alarm on your cell phone so you take your medications as scheduled.
Keep a medication diary.
This practice is extremely useful in planning a successful chemotherapy experience. Make sure to track your dose, how and when it is taken, and special instructions (such as with food). Also note the following:
- Side effects. Talk to your doctor, pharmacist or Health Coach quickly, as certain side effects can be serious.
- Contact numbers for your oncology team and Health Coach.
- Missed doses. Contact your doctor or pharmacist for instructions.
- Upcoming doctor appointments, lab tests and refills. Write down any questions you may want to ask at those appointments.
Access support systems.
Friends, family, your doctor, pharmacist and Health Coach are all there to guide and support you. Your references and links page lists other sources of support available to you. Bringing a friend or family member to office visits can be helpful as well.
Find ways to lower stress.
Meditation, yoga, walking or light exercise (with approval from your doctor), or simply a warm bath may help relieve stress.
Maintain healthy habits.
Plan rest periods into your day, and eat a well-balanced diet. Also avoid alcohol and smoking. How you care for your body can affect how well your body recovers from oral oncology treatment.
Although some side effects of oral oncology medications are fleeting and minor, others signal potentially serious problems. Alert your doctor right away if you suffer from any of the following symptoms during chemotherapy treatment:
- A fever of 100.5° or greater
- Bleeding or unexplained bruising
- A rash or allergic reaction, such as swelling, severe itching, or wheezing
- Intense chills
- Unusual pain, including intense headaches
- Shortness of breath
- Prolonged diarrhea or vomiting
- Blood in your stool or urine
- Darkening of urine
Blood problems
Chemotherapy can change the amount of certain blood cells you have in your body. This includes red blood cells, white blood cells and platelet cells. Not having enough red blood cells is called anemia, which can cause fatigue, shortness of breath and dizziness. Having low white blood cells is called neutropenia and can raise your risk of infections. If your blood is not clotting well or if you bruise more easily, you may have low platelet function. Your doctor can prescribe medications for these conditions.
Your doctor should perform blood tests on you regularly to monitor these blood cell levels and find any problems early. Some chemotherapy medications can accumulate in the liver and kidneys, so your doctor may also want to test your kidney and liver functions.
Diarrhea or constipation
You may have loose stools or hard bowel movements during chemotherapy. Let your caregiver know if you have diarrhea four times in any 24-hour period or if you have not moved your bowels for several days.
Fever
Although having a fever is common with certain oral oncology medications agents, your doctor should still be alerted right away if it is a fever of 100.5° or greater. Check with your doctor or pharmacist if you may take any fever reducers.
Upset stomach/reflux
Check with your doctor, pharmacist or Health Coach before taking over-the- counter medications. These medications can interact with your chemotherapy and make them less effective.
Fatigue
After chemotherapy, you may feel very tired. This can happen over time or suddenly. Fatigue can occur for days, weeks or months.
Hair loss
Hair loss may occur anywhere on your body. It can happen at the start of therapy or several weeks later. It will usually grow back after you finish your treatment.
Flu-like symptoms
You may have chills, a fever, or muscle and joint aches for a few days after starting chemotherapy.
Mouth sores and throat problems
Discuss treatments with your doctor or pharmacist if you get sores in your mouth, have difficulty swallowing and/ or develop white patches in the throat. Maintain good oral hygiene and use alcohol-free mouthwash. Your doctor can prescribe certain oral rinses that provide relief.
Nausea and Vomiting
This is a common side effect of chemotherapy. Your doctor can help ease these symptoms with several medications. Contact him or her if you vomit more than once in a 24-hour period or if you also have diarrhea.
Nerve and muscle problems
These issues are called peripheral neuropathy. Chemotherapy can cause your nerves to hurt, feel weak, burn or tingle, especially in your hands and feet. These symptoms often go away after chemotherapy ends, but they may be permanent. Tell your doctor if you are experiencing these symptoms. Certain medications can help decrease the effects of peripheral neuropathy.
Pain
Chemotherapy may cause painful side effects. Tell your doctor about any pain that does not go away or gets worse.
Poor appetite
You may not feel like eating during chemotherapy treatment. Ask your doctor what you can do to maintain a healthy diet. Some medications can help increase appetite if needed.
Problems with memory or mood
Chemotherapy can often leave you feeling depressed or confused. Talk to your family, friends, and your doctor and or Health Coach. They can suggest ways to help you cope with your treatment. They can also recommend medications you can take along with counseling.
Sexual problems
Chemotherapy can affect sexual organs. Women’s periods may change or stop completely. They may also have vaginal dryness, which may cause pain during intercourse. They may also experience “hot flashes,” or warmth that spreads through the body suddenly due to hormones. Women should not undergo chemotherapy if they are pregnant, thinking about getting pregnant or breastfeeding. Men may have trouble achieving or sustaining an erection. Both men and women may be unable to have a child after chemotherapy.
Skin problems
Dry skin often occurs with chemotherapy. A rash is also a common reaction, as is itching, redness and sensitivity to the sun. Your nails may also peel, become yellow or cracked.
Oral Therapies Used for Cancer Treatments
Description
Everolimus is commonly used to treat breast cancer, pancreatic tumors, kidney cell cancer, and certain brain cancers.
Dosing and Administration
The recommended dosage of everolimus may be based on body surface area (BSA) depending on the cancer type and other treatments used in combination. It is usually taken once per day with or without food.
Drug Interactions
Everolimus should not be used together with strong CYP3A4/P-gP inducers (e.g., phenytoin, carbamazepine, rifampin, and St. John’s wort) or strong and moderate CYP3A4/P-gP inhibitors (e.g., atazanavir/ritonavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, posaconazole, saquinavir, telithromycin, voriconazole). If concomitant use is unavoidable, dose adjustments may be necessary. Tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
Stomatitis, infections, rash, fatigue, diarrhea, edema, abdominal pain, nausea, fever, asthenia, cough, headache and decreased appetite.
Description
Melphalan is an alkylating agent that treats multiple myeloma and ovarian cancer.
Dosing and Administration
The recommended dosage of melphalan depends on the specific type of cancer and other treatments used in combination. It is generally taken for five days and then repeated every four to five weeks.
Drug Interactions
There are no known drug/drug interactions with oral melphalan to date, but make sure to tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
Decreased blood counts, diarrhea, nausea, mouth sores, skin rash, and hair loss.
* [G] indicates that a generic version of this product is available.
Oral Oncology Drugs not provided by Magellan Rx Specialty Pharmacy are not listed.
Description
Anastrozole is an aromatase Inhibitor indicated to treat breast cancer. Women of premenopausal endocrine status, including pregnant women, should not use this drug.
Dosing and Administration
The recommended dosage of anastrozole is one tablet once daily.
Drug Interactions
Anastrozole should not be used together with tamoxifen. Concomitant use with other estrogen-containing products may make anastrozole less effective. Tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
Hot flashes, tiredness, nausea, depression, trouble sleeping and pain.
* [G] indicates that a generic version of this product is available.
Oral Oncology Drugs not provided by Magellan Rx Specialty Pharmacy are not listed.
Description
Exemestane is used to treat breast cancer. Exemestane should not be used in pregnant women due to fetal toxicity.
Dosing and Administration
The recommended dosage of exemestane is one tablet once daily after a meal.
Drug Interactions
Concomitant use of exemestane with a CYP3A4 inducer (e.g., phenytoin, carbamazepine, rifampin, St. John’s wort) may reduce the effectiveness of exemestane. Tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
Nausea, tiredness, joint pain, headache, insomnia, hot flushes, and increased sweating.
Description
Cabozentinib is kinase inhibitor used to treat thyroid cancer. Cabozentinib is associated with risk for developing stomach ulcers and bleeds. Monitor carefully for any signs of dark and tarry stool.
Dosing and Administration
Concomitant use of cabozentinib with a CYP3A4 inhibitor (e.g., atazanavir/ritonavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, posaconazole, saquinavir, telithromycin, voriconazole) may cause severe toxicities, and use with a CYP3A4 inducer (e.g., phenytoin, carbamazepine, rifampin, St. John’s wort) may reduce the effectiveness of cabozentinib. Tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Drug Interactions
Stomach upset, nausea, diarrhea, constipation, stomach ulcers or bleeding, urinary tract infection, insomnia, abnormal blood tests, increased risk of infection, lymphoma or other cancer.
Side Effects
Diarrhea, stomach discomfort, decreased appetite, nausea, tiredness, hair color changes, constipation, liver toxicities, and decreased blood count.
Description
Cyclophosphamide is an alkylating agent used to treat various cancers. The most common ones include: acute myeloid leukemia (AML), chronic lymphoid leukemia (CLL), breast cancer, non-Hodgkin’s disease, and Mental Cell Lymphoma.
Dosing and Administration
The recommended dosage of cyclophosphamide is based on body weight depending on the cancer type, other treatments used in combination, and tolerability. It can be taken as a daily therapy or may be divided in doses over four to five days.
Drug Interactions
Alcohol may increase cyclophosphamide-induced vomiting and nausea, and decrease the effectiveness of this drug. Tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
Nausea, vomiting, hair loss and decreased blood counts.
Description
Estramustine is used to treat prostate cancers.
Dosing and AdministrationThe recommended dosage of estramustine is based on body weight. It can be taken 3 or 4 divided doses daily.
Drug Interactions
There are no known drug/drug interactions with estramustine, but make sure to tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
Nausea, diarrhea, GI discomfort, breast tenderness, edema, leg cramps, shortness of breath.
Description
Vismodegib is indicated to treat metastatic basal cell skin cancer. Vismodegib should not be used in pregnant women due to fetal toxicity. Contraception is strongly advised to prevent pregnancy while on therapy.
Dosing and Administration
The recommended dosage of vismodegib is one tablet once daily.
Drug Interactions
There are no significant drug/drug interactions with vismodegib, but make sure to tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
Diarrhea, constipation, nausea, swelling, tremors, high blood pressure, new-onset diabetes after transplant (NODAT), kidney issues, increased risk of infection, lymphoma or other cancer.
Description
Etoposide is indicated to treat various types of cancer including testicular cancer and lung cancer. Etoposide should not be used in pregnant women due to fetal toxicity.
Dosing and Administration
The recommended dosage of etoposide is based on body surface area (BSA). It is typically given in divided doses twice daily.
Drug Interactions
Dose adjustments may be necessary when etoposide is used with cyclosporine A. Tell your care providers about all medicines you take, including prescriptions and non-prescription medications, vitamins, and herbal supplements.
Side Effects
GI discomfort, liver toxicities, and increase in blood pressure.
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