Everolimus (By mouth)

Introduction:

Everolimus (e-ver-OH-li-mus)

Treats advanced (late-stage) kidney cancer.

Brand Name(s):

Afinitor

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• You may take this medicine with or without food. However, you should take it the same way (with or without food) each time.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• Swallow the tablet whole with a glass of water. Do not break, crush, or chew it. If you accidentally break or crush the tablet, wash your hands with water right away.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose. If you miss a dose of this medicine, you may still take it up to 6 hours after the time you normally take it. However, if it is more than 6 hours, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using a medicine to treat an infection or tuberculosis (such as clarithromycin, erythromycin, fluconazole, itraconazole, ketoconazole, rifabutin, rifampin, telithromycin, voriconazole, Biaxin®, Diflucan®, Ery-Tab®, Ketek®, Mycobutin®, Nizoral®, Rifadin®, Rimactane®, Sporanox®, or Vfend®), or a heart condition or high blood pressure (such as diltiazem, verapamil, Cardizem®, Calan®, Isoptin®, or Verelan®).
• Tell your doctor if you are using a medicine for HIV or AIDS (such as amprenavir, atazanavir, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir, Agenerase®, Crixivan®, Fortovase®, Invirase®, Lexiva®, Norvir®, Rescriptor®, Reyataz®, or Viracept®).
• Make sure your doctor knows if you are also using a medicine for seizures or convulsions (such as carbamazepine, phenobarbital, phenytoin, Dilantin®, or Tegretol®), or aprepitant (Emend®), dexamethasone (Decadron®, DexPak®), nefazodone (Serzone®), or St. John's Wort.
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.
• Talk to your doctor before getting flu shots or other vaccines while you are receiving this medicine. Vaccines may not work as well, or they could make you ill while you are using this medicine.

Warnings While Using This Medicine:

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control while using this medicine and for at least 8 weeks after stopping treatment. If you think you have become pregnant while using the medicine, tell your doctor right away.
• If you plan to have children, talk with your doctor before using this medicine. Some men and women using this medicine have become infertile (unable to have children).
• Make sure your doctor knows if you are breastfeeding, or if you have kidney problems, liver problems, lung or breathing problems, diabetes, high cholesterol or fats in the blood, or if you have an infection.
• This medicine may cause mouth ulcers and sores in some patients. Tell your doctor right away if you have pain, discomfort, or open sores in your mouth while you are using this medicine. You may use a special mouthwash or mouth gel to treat these ulcers. Ask your doctor what type of products to use.
• This medicine may cause a serious lung problem called noninfectious pneumonitis. Stop using this medicine and check with your doctor right away if you have chest pain, chills, a cough, fever, shortness of breath, or troubled breathing.
• This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
• This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Chest pain, shortness of breath, troubled breathing, or wheezing.
• Fever, chills, cough, sore throat, and body aches.
• Increased thirst or hunger.
• Lightheadedness, dizziness, or fainting.
• Nosebleeds.
• Pain in your arms or legs.
• Sores or ulcers in your mouth.
• Swelling in your hands, ankles, or feet.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Change or loss of taste.
• Diarrhea, nausea, vomiting, loss of appetite, or stomach pain.
• Dry mouth.
• Feeling weak or tired.
• Lack or loss of strength.
• Rash, dry skin, or itching skin.
• Trouble with sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor: