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 also receive medicines to help prevent nausea and vomiting.
It is best to take this medicine with food. You should drink plenty of fluids, 6 to 8 glasses (8 ounces each) every day, with this medicine to keep from getting dehydrated.
Swallow the capsule whole. Do not open, crush, break, or chew it.
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 vomit after taking your medicine, call your doctor or pharmacist for instructions.
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.
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 valproic acid (Depakene®) or a blood thinner such as warfarin (Coumadin®).
Tell your doctor if you are using medicines that might prolong the QT interval in the heart such as cisapride (Propulsid®), medicines for depression (such as amitriptyline, fluoxetine, nortriptyline, Elavil®, Pamelor®, Prozac®, Sarafem®, or Vivactil®), antibiotics (such as erythromycin, levofloxacin, moxifloxacin, sparfloxacin, Avelox®, Levaquin®, or Zagam®), or medicines for mental problems (such as haloperidol, mesoridazine, pimozide, prochlorperazine, quetiapine, thioridazine, ziprasidone, Compazine®, Geodon®, Haldol®, Mellaril®, Orap®, Serentil®, or Seroquel®).
Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
Make sure your doctor knows if you are breastfeeding, or if you have kidney disease, liver disease, a history of blood clots, stomach or bowel problems, or a mineral imbalance such as low potassium, calcium, or magnesium in your blood. Tell your doctor if you have a history of heart rhythm problem such as congenital long QT syndrome.
Make sure your doctor knows if you have diabetes. This medicine may cause your blood sugar to be high, so you may need to check your blood sugar and urine more often. Tell your doctor if you are using any medicines for diabetes. Carefully follow your doctor's instructions about special diets.
This medicine may cause blood clots. Tell your doctor right away if you have chest pain, shortness of breath, pain in your lower leg (calf), or start coughing up blood while using this medicine.
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.
Cancer medicines can cause nausea and/or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.
Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.