Patient Handout: Everolimus (Afinitor)

What is Everolimus?

Everolimus, sold under the brand name Afinitor, is a medication used to treat certain types of cancer and other conditions, including:

• Advanced or metastatic breast cancer (in combination with other treatments)
• Renal cell carcinoma (kidney cancer)
• Neuroendocrine tumors of the pancreas
• Subependymal giant cell astrocytoma (a type of brain tumor in people with tuberous sclerosis)

Everolimus works by inhibiting a protein called mTOR (mechanistic target of rapamycin), which is involved in cell growth, proliferation, and survival. By blocking mTOR, Everolimus helps to slow the growth of cancer cells and reduce the size of tumors.

How Does Everolimus Work?

Everolimus is an oral medication that targets a protein in cells that controls processes such as cell growth and division. By inhibiting mTOR, Everolimus disrupts the cancer cells’ ability to grow and divide, thereby helping to control tumor progression. It is often used in combination with other medications like aromatase inhibitors or chemotherapy to increase its effectiveness.

How is Everolimus Taken?

• Form: Everolimus is taken as a tablet by mouth.
• Dosage: The exact dosage will be determined by your healthcare provider based on your condition. Common doses range from 5 mg to 10 mg daily.
• Administration: Take Everolimus once a day, at the same time each day, to help you remember. You can take it with or without food.
• Swallow the Tablet: Swallow the tablet whole with a glass of water. Do not crush, chew, or break the tablet.

Important Tip: Avoid taking grapefruit or grapefruit juice while on Everolimus, as it can interfere with the metabolism of the medication.

Possible Side Effects

Like all medications, Everolimus can cause side effects. Some side effects may be serious, and you should contact your healthcare provider if you experience any of the following symptoms.

Common Side Effects:

• Mouth sores (stomatitis): Everolimus can cause painful sores or ulcers inside the mouth. This can make it difficult to eat or drink.
• Fatigue: Many patients feel more tired than usual. If fatigue interferes with your daily activities, let your doctor know.
• Diarrhea: Diarrhea is a common side effect. Drink plenty of fluids and notify your doctor if diarrhea becomes severe or persistent.
• Nausea or Vomiting: You may feel nauseous or vomit, especially when first starting treatment. Anti-nausea medications may help manage these symptoms.
• Rash: A rash may develop, often on the face or upper body. Report any rash to your healthcare provider.
• Loss of appetite: Some people experience a decreased appetite. This can sometimes lead to weight loss.

Serious Side Effects:

• Infections: Everolimus can weaken the immune system, making it easier for infections to occur. Seek immediate medical attention if you develop signs of an infection, such as fever, chills, or sore throat.
• Lung Problems: Everolimus can cause lung problems, including pneumonia. Symptoms to watch for include cough, shortness of breath, or fever.
• Liver problems: Signs of liver issues include yellowing of the skin or eyes (jaundice), dark urine, or abdominal pain. Notify your doctor if you experience any of these symptoms.
• Kidney problems: Everolimus can affect kidney function, so your doctor will monitor your kidney function with regular blood tests. Symptoms of kidney issues include swelling in your legs or ankles, or changes in urination.
• Low blood counts: Everolimus can lower the number of white blood cells, red blood cells, or platelets in your blood, increasing the risk of infections, anemia, or bleeding. Symptoms of low blood counts may include unusual tiredness, easy bruising, or unexplained fevers.

Precautions Before Taking Everolimus

Before starting Everolimus, inform your healthcare provider if you:

• Have a history of lung, liver, or kidney problems: These conditions can affect how Everolimus works or increase the risk of side effects.
• Are pregnant, planning to become pregnant, or breastfeeding: Everolimus can harm an unborn baby. Women who are pregnant or planning to become pregnant should not take Everolimus. Effective contraception is required during treatment. It is not known if Everolimus passes into breast milk, so you should not breastfeed while taking this medication.
• Have diabetes: Everolimus may affect blood sugar levels, especially in people with preexisting diabetes. Your doctor may need to monitor your blood sugar more closely.
• Are taking other medications: Certain drugs can interact with Everolimus and increase the risk of side effects. Let your doctor know about all prescription and over-the-counter medications, vitamins, and herbal supplements you are taking.
• Have had a recent vaccination: Live vaccines may not be safe during Everolimus treatment. Speak with your doctor before receiving any vaccines.

What to Avoid While Taking Everolimus

• Grapefruit and Grapefruit Juice: Avoid consuming grapefruit or grapefruit juice as they may increase the amount of Everolimus in your body, leading to an increased risk of side effects.
• Infections: Since Everolimus can weaken your immune system, avoid exposure to infections. Wash your hands frequently, and avoid close contact with people who are sick.
• Live Vaccines: Live vaccines should be avoided while taking Everolimus. Talk to your doctor before receiving any vaccinations during treatment.

Regular Monitoring

Your healthcare provider will monitor your health regularly while you are on Everolimus. This may include:

• Blood Tests: Everolimus can affect blood counts, liver, kidney, and blood sugar levels, so regular blood tests will be performed to monitor these functions.
• Lung Function: If you experience respiratory symptoms, your doctor may perform tests to check for any lung problems.
• Infection monitoring: Due to the risk of infections, your doctor will be on the lookout for any signs of infection during your treatment.

When to Contact Your Doctor

Contact your healthcare provider if you experience any of the following:

• Signs of infection: Fever, chills, sore throat, or unusual tiredness.
• Lung problems: Cough, shortness of breath, or fever.
• Liver problems: Yellowing of the skin or eyes (jaundice), dark urine, or upper stomach pain.
• Kidney problems: Swelling in your legs, ankles, or feet, or changes in urination.
• Severe mouth sores: Difficulty eating or drinking due to mouth pain.
• Unusual bleeding or bruising: This may be a sign of low platelet count.

Disclaimer:

This handout is for educational purposes only and should not be considered medical advice. Always follow the instructions provided by your healthcare provider regarding treatment and care. For personalized advice, consult your healthcare provider or pharmacist.