Everolimus (Generic Name)
Other Names: Afinitor®, Zortress®
About This Drug
This drug is used to treat cancer. It is given by mouth (orally).
Possible Side Effects (More Common)
- Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk for infection, make you tired and weak, and raise your risk of bleeding.
- Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
- Skin changes, such as a rash (which may look like acne), redness, itching, dry skin, cracked skin, peeling skin, or signs of possible infection. This drug may also affect the skin around your nails (cuticles).
- This drug may affect how your kidneys work. Your kidney function will be checked as needed.
- Changes in your liver function. Your doctor will check your liver function as needed.
- Increased cholesterol and triglyceride levels. Blood tests will be used to check your cholesterol and triglycerides as needed.
- Electrolyte changes. Blood tests will be used to check your electrolytes as needed.
- Respiratory problems. You may get an infection or inflammation of your sinuses and lungs, nasal congestion, cough and trouble breathing.
Possible Side Effects (Less Common)
- High blood pressure. Your doctor will check your blood pressure as needed.
- Changes in the tissue of the heart. Some changes may happen that can cause your heart to have less ability to pump blood. Your heart function will be checked as needed.
- Stomach pain
- Changes in bowel movements. Some patients experience loose bowel movements (diarrhea), while other patients have trouble having bowel movements (constipation).
- Nausea and throwing up (vomiting)
- Changes in the way food and drinks taste
- Decrease in appetite (decreased hunger)
- Increase or a decrease in blood sugar levels. You may become diabetic.
- Fatigue and weakness
- Personality change
- Trouble sleeping
- Feeling dizzy
- Back, arm, and leg pain.
- Swelling (fluid retention) in the legs, ankles, or feet
- Skin changes. Your skin may get lighter or darker, or lose some color.
- Hair changes. Hair may lose some hair color. There may be hair thinning or moderate hair loss.
- Hand-and-foot syndrome. The palms of your hands or soles of your feet may tingle or become numb, painful, swollen, or red. Rarely, blistering and severe skin reactions happen.
- Blood clots (rare). A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause shortness of breath, pain when breathing, and/or chest pain.
- Increased risk of skin cancer.
Serious allergic reactions including anaphylaxis are rare. While you are taking this medicine, tell your nurse right away if you have any of these symptoms of an allergic reaction:
- trouble catching your breath
- feeling like your tongue or throat are swelling
- feeling your heart beat quickly or in a not normal way (palpitations)
- feeling dizzy or lightheaded
- flushing, itching, rash, and/or hives
Treating Side Effects
- Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
- Wear dark sunglasses and use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
- Do not use sunlamps of tanning beds.
- Ask your doctor or nurse about medicine to help stop or lessen nausea, throwing up, loose bowel movements, constipation, headaches, and pain.
- Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth and dentures and rinsing your mouth with a mixture of ½ teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
- If you have mouth sores, avoid mouthwash that contains alcohol. Also avoid alcohol and smoking because they can irritate your mouth and throat.
- If you get a rash or reddened skin do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
- Take this medicine at the same time each day
- This medicine can be taken with or without food.
- Take everolimus with a full glass of water. Swallow the medicine whole. Do not break, crush, or chew the tablets
- Store this medicine in the original container at room temperature
- Missed dose: If you miss a dose, take it as soon as you remember. If it has been more than 6 hours since you missed the dose, skip that dose and take the next scheduled dose on time. Do not take 2 doses at once. Do not take extra doses.
Food and Drug Interactions
- Do not eat grapefruit or drink grapefruit juice while taking this medicine. Grapefruit and grapefruit juice may raise the levels of everolimus in your body. This could make side effects worse.
- Avoid the use of St. John’s Wort while taking everolimus as this may lower the levels of the drug in your body, which can make it less effective.
- Check with your doctor before starting any other herbal medication, as there may be serious drug interactions.
- Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are a lot of known drug interactions with everolimus. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.
When to Call Your Doctor
Call your doctor or nurse right away if you have any of these symptoms:
- Fever of 100.5 F (38 C) or higher
- Easy bleeding or bruising
- Wheezing or trouble breathing
- Severe headache
- Blurred vision or other changes in eyesight
- Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
- Nausea that stops you from eating or drinking
- Throwing up more than three times a day
- Stomach pain
- Severe rash or itching
- Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
- Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
- Skin wound that will not heal
Call your doctor or nurse as soon as possible if you have any of these symptoms:
- Pain, numbness, tingling, swelling, or blisters on the palms of the hands or soles of feet
- Sores, rash, reddened areas, or itching of the skin that is not relieved by prescribed medicines
- Swelling in the legs, ankles or feet
- Arm or leg that is swollen, red, warm, and/or painful
- Pain, nausea, throwing up, loose bowel movements, or constipation that is not relieved by prescribed medicines
- Pain in your mouth or throat that makes it hard to eat or drink
- Lasting loss of appetite or fast weight loss (such as 5 pounds in 1 week)
- Extreme tiredness or weakness that interferes with daily activities.
Sexual Problems and Reproduction Concerns
- Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
- In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
- In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
- Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
- Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
- Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used by both men and women during your cancer treatment and for at least 8 weeks after treatment is done.
- Breast Feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.
Revised August 2014