Nilotinib (Tasigna®)

Pronounced: [nye-LOE-ti-nib]

About Your Medication

  • Nilotinib is an oral medicine that your doctor prescribed for the treatment of your cancer.Please take your nilotinib as directed by your prescriber.

How to Take Your Medication

  • Take your nilotinib at approximately the same time each day
  • Take on an empty stomach - at least 1 hour before or 2 hours after eating
  • Swallow nilotinib tablets whole with water. Do not break, chew, or dissolve tablets.
  • If you miss a dose of your nilotinib, take the medicine as soon as you remember on that day. Do not take two doses on the same day to make up for a missed dose.

Tell Your Healthcare Provider if you have any trouble taking your nilotinib, including:

  • Trouble swallowing pills
  • Forgetting to take doses
  • Trouble affording your medications
  • Throwing up pills
  • Side effects

Important Precautions

  • Nilotinib may be harmful to an unborn child. If sexually active with a partner that is pregnant or who may become pregnant during and for several weeks after treatment, two forms of contraception must be used (a condom and another effective form of birth control).
  • It is not known whether nilotinib passes into breast milk. Nursing mothers should discuss with their healthcare providers whether to discontinue nursing or to discontinue nilotinib.
  • Nilotinib has been associated with an increased risk of liver injury. Your cancer clinic will check liver enzymes regularly to monitor for this.
  • Nilotinib has been associated with fluid retention. Monitor for rapid weight gain or swelling.
  • QT prolongationis an abnormal heart rhythm associated with nilotinib. The cancer clinic will monitor your heart rhythm intermittently.

What foods and drugs may interact with my nilotinib?

Please talk to your healthcare provider at your cancer clinic before starting or stopping any medications, vitamins, or herbal supplements, because some of these may interact with your nilotinib. Some examples of products that interact with nilotinib include:

  • Grapefruit or grapefruit juice
  • Certain anti-infectives such as rifampin (Rifadin®)
  • Anti-seizure medicines, including carbamazepine (Tegretol®), phenobarbital (Luminal®), and phenytoin (Dilantin®)
  • Some medications for mood, like St. John’s Wort and nefazodone (Serzone®)
  • Certain antifungals, such as itraconazole (Sporanox®), ketoconazole (Nizoral®), posaconazole (Noxafil®), and voriconazole (Vfend®)
  • Antibiotics like clarithromycin (Biaxin®) and telithromycin (Ketek®)

Storage, Handling, and Disposal

It is important to keep these safeguards in mind when storing and handling oral anticancer therapy to keep you and your caregivers safe.

  • Keep your nilotinib in a safe place, away from other family members’ medications and away from any food or drinks.
  • Store the medication at room temperature in a dry location – avoid storing your medication in the bathroom.
  • Store nilotinib in its original container with the lid tightly closed.
  • Keep the medication out of reach from children and pets.
  • Return expired, damaged, or unused nilotinib to a pharmacy or hospital for disposal. Do not discard into the garbage or toilet, or anywhere that children or pets may have access.

Nilotinib (Tasigna®) Side Effect Summary

This list does not include all possible side effects of nilotinib. If you have an unusual symptom, call the clinic. Below are the most common side effects:

  • Edema – swelling/rapid weight gain

What are your symptoms? / What can you do…
Mild swelling, only visible when looking closely, not interfering with activities /
  • Ask your clinic about special stockings
  • Wear loose clothing and shoes that are not too tight
  • Keep your legs elevated when you are sitting or resting
  • Weigh yourself regularly
  • Avoid salty foods, including canned soups, chips, bacon, and ham. Don’t add extra salt or soy sauce to your food. Check food labels for sodium content, and try to limit yourself to less than 2 grams of sodium per day.

Moderate swelling, clearly visible, not interfering with daily activities /
  • Try to manage using the measures listed above
  • If you have rapid weight gain (more than 5 pounds in one week), call the clinic
  • If you have any difficulty breathing or chest tightness, call 911 or proceed to your local emergency room

Severe swelling, interfering with your daily activities /
  • Call the clinic
  • If you have any difficulty breathing or chest tightness, call 911 or proceed to your local emergency room

  • Rash – an itchy or red appearance on the skin. It is common to develop a rash while receiving nilotinib treatment.

What are your symptoms? / What can you do…
Mild Rash – covering less than 10% of your body (an entire leg is about 10% of your body surface area); no symptoms such as itching, burning or tightness /
  • Avoid direct sunlight (cover exposed areas of skin and use sunscreen)
  • Use antihistamines (anti-itch) medicines prescribed by the clinic
  • Apply non-scented lotion to areas of dry skin
  • The clinic may provide you with additional prescription creams or lotions to apply to the rash

Moderate Rash - covering about 10%-30% of your skin (an entire leg is about 10% of your body surface area); with or without symptoms such as itching, burning or tightness; limiting some of your daily activities, but able to care for yourself /
  • Try to manage using the measures listed above
  • The clinic may provide you with additional oral medications to help manage the rash
  • If not improved within a few days, or you are unable to care for yourself, Call the clinic

Severe Rash – covering more than 30% of your skin (an entire leg is about 10% of your body surface area); with or without symptoms such as itching, burning or tightness; limiting your ability to care for yourself /
  • Call the clinic

  • Fatigue – lack of energy or feeling sleepy

What are your symptoms? / What can you do…
Mild fatigue (slightly worse than before you started taking the drug) /
  • You may need to adjust your schedule to manage fatigue. Plan out the day, and prioritize activities, so you have time to rest.
  • You should schedule periods of rest into your day, and try to rest before you feel tired. Frequent, short rests are helpful.
  • Stay active – regular mild/moderate exercise can boost your energy level. Try incorporating walking or other activities into your daily routine.
  • Try not to over-exert yourself. Ask for help from family or friends with difficult tasks.

Moderate fatigue (difficulty performing some of your normal daily activities) /
  • Try to manage using the measures listed above.
  • If it does not get better after a few days, call the clinic

Severe fatigue (severely interfering with your normal daily activities or inability to get out of bed) /
  • Call the clinic

  • Decrease in Blood Cell Counts (white blood cells, red blood cells, platelets). This can cause you to be more at risk of infection, fatigue, and bleeding.

What Can I Do? / When to Call the Clinic?
  • Wash hands regularly
  • Avoid close contact with others who are sick
  • Avoid activities with a high potential for injury and bleeding (contact sports, etc.)
  • The clinic will monitor your labs regularly. Make sure not to miss clinic visits or lab draws
/
  • Temperature of 100.5˚F or higher- CONTACT THE CLINIC IMMEDIATELY
  • Any signs of infection
  • Unusual tiredness or weakness
  • Shortness of breath, difficulty breathing
  • Unusual bleeding or bruising

  • Headache

What are your symptoms? / What can you do…
Mild headache (slightly worse than before you started taking the drug) /
  • Please use an over-the-counter pain medicine as directed by your cancer clinic

Moderate headache (difficulty performing some of your normal daily activities) /
  • Try to manage using the measures listed above.
  • If it does not get better after a few days, call the clinic

Severe headache (severely interfering with your normal daily activities or inability to get out of bed) /
  • Call the clinic

  • Diarrhea – frequent and/or watery bowel movements

What are your symptoms? / What can you do…
Mild diarrhea – stools are more loose/watery or you are having 1-3 more stools per day than usual /
  • Stay well hydrated
  • Avoid fatty, greasy, spicy foods that may increase your risk for diarrhea
  • Avoid caffeine and alcohol
  • Eat small, frequent meals; foods that are easy on the stomach include bananas, rice, applesauce, and toast
  • Use your antidiarrheal medicine, loperamide (Imodium®) 4 mg at the onset of diarrhea, then 2 mg every 2 hours until diarrhea-free for 12 hours
  • If diarrhea is not improving after 48 hours of treatment with your antidiarrheal medicine, or you are having trouble staying hydrated, call the clinic

Moderate diarrhea - you are having 4-6 more stools per day than usual; you are still able to perform your normal daily activities /
  • Try to manage using the measures listed above.
  • If diarrhea is not improving within 24 hours, or you are having trouble staying hydrated, call the clinic

Severe diarrhea – you are having 7 or more stools per day than usual, or you are having trouble staying hydrated or performing normal daily activities, or you are not making it to the bathroom in time /
  • Stop taking the nilotinib and call the clinic

  • Nausea and Vomiting – queasy sensations or actually throwing up food or stomach contents

What are your symptoms? / What can you do…
Mild Nausea or Vomiting – loss of appetite without a change in eating habits; or vomiting 1-2 times in 24 hours /
  • Stay well hydrated
  • Eat smaller, more frequent meals and snacks; avoid eating on an empty stomach
  • Avoid fried, greasy, salty, sweet, or spicy foods
  • Use anti-nausea medicine prescribed by the clinic

Moderate Nausea or Vomiting – eating less than usual but not losing weight or becoming dehydrated; or vomiting 3-5 times within 24 hours /
  • Try to manage using the measures listed above and take your anti-nausea medicine regularly
  • If not improved within 48 hours, or you are unable to stay hydrated or eat, Call the clinic

Severe Nausea or Vomiting – not being able to eat or stay hydrated; or vomiting more than 6 times within 24 hours /
  • Call the clinic

  • Liver dysfunction

What Can I Do? / When to Call the Clinic?
  • The clinic will monitor your labs to assess
/
  • Yellowing of eyes or skin

Below are some less common side effects of nilotinib.

Less Common Side Effects / What Can I Do? / When to Call the Clinic?
Increase in blood sugar /
  • The clinic will monitor your labs to assess
  • IF you have diabetes, talk with your cancer clinic about monitoring
/
  • IF you have diabetes & measure your blood sugar, ask the clinic what blood sugar level is too high for you.
  • If you feel confused, have increased urination, blurry vision, or are very tired & unable to perform normal activities

Alopecia
(hair loss)
Change in Heart Rhythm (sometimes QT prolongation) /
  • The clinic will monitor your heart rhythm to assess
/
  • Heart palpitations, any episodes of fainting or passing out

Pancreatitis /
  • The clinic will monitor your labs to assess
/
  • If you have persistent nausea,
vomiting, and abdominal or back pain

Who to Call With Questions?

If you are having an emergency, call 911

Who to Call With Questions?

If you are having an emergency, call 911


Who to Call With Questions?

If you are having an emergency, call 911

Who to Call With Questions?

If you are having an emergency, call 911

Copyright 2017 Michigan Oncology Quality Consortium, All rights reserved. V.12-14 MOQC-7.31.2018

MOQC makes no representations or warranties and explicitly disclaims the appropriateness or applicability of the MOQC Content to any specific patient's care or treatment. Any clinician seeking to treat a patient using the MOQC Content is expected to use independent medical judgment in the context of individual clinical circumstances of a specific patient's care or treatment.