temsirolimus

High blood sugar 

• You may feel thirsty and pee more often.
• Your doctor may check your blood sugar level. You may be advised to change your diet or take medication to treat high blood sugar.
• Check your blood sugar regularly if you have diabetes.

Increased cholesterol or fat levels in the blood

Your doctor may check your cholesterol levels regularly.

Abnormal liver lab tests (may be severe)

• You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. Talk to your health care team if this happens.
• Your doctor may monitor your liver regularly with a blood test.

Abnormal kidney lab tests (may be severe)

• Signs of a kidney problem include swelling, passing very little or no pee, or new unusual weight gain. If you have these signs, call your health team or go to your closest emergency department.
• To prevent bladder or kidney problems, drink lots of water or other liquids. Your doctor may ask you to drink at least 6 to 8 cups (2 L) per day on treatment days, unless you have been told otherwise.
• Your doctor may check your kidney function regularly.

Fatigue (tiredness)

• Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
• Pace yourself, do not rush. Put off less important activities. Rest when you need to.
• Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
• Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

Rash; dry, itchy skin (may be severe)

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

• Use skin moisturizer.
• Protect your skin from the sun and the cold.
• Use sunscreen with UVA and UVB protection and a SPF of at least 30.

Mild swelling in arms and legs; puffiness (may be severe)

To help prevent swelling :

• Eat a low-salt diet.
• Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

Mouth sores

You may have round, painful, white or gray sores inside your mouth. They can occur on the tongue, lips, gums, or inside your cheeks. In more severe cases they may make it hard swallow, eat or to brush your teeth. They usually last 1 to 2 weeks.

To help prevent mouth sores: 

• Take care of your mouth by gently brushing and flossing regularly.
• Rinse your mouth often. Do not use mouthwashes with alcohol.
• Instead, try a homemade mouthwash:
• Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.

If you have mouth sores:

• Check with your health care team as soon as you notice mouth or lip sores or if it hurts to swallow.
• Avoid hot, spicy, acidic, hard or crunchy foods.. Your doctor may prescribe a mouthwash to relieve mouth sores and prevent infection.

See the Mouth Care pamphlet for more information.

Nausea and vomiting (generally mild)

May occur in hours to days after your treatment.

If you have nausea or vomiting:

• Take anti-nausea medication(s) as prescribed to you by your doctor. 
• Drink clear liquids and have small meals. Get fresh air and rest.
• Do not eat spicy, fried foods or foods with a strong smell.
• Limit caffeine (e.g. coffee, tea) and alcohol.
  Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Low appetite

• You may not feel like eating or you may lose weight.
• Try to eat foods that you like and eat small meals throughout the day. 
• You may need to take meal supplements to help keep your weight up.
• Talk to your health care team if you have a low appetite.
• See our Loss of appetite pamphlet for more information.

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

• 38.3°C (100.9°F) or higher at any time OR
• 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

• Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
• Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
• Do not eat or drink anything hot or cold right before taking your temperature.
• Wash your hands often.
• Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Cough; feeling short of breath

You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose.

Diarrhea

May happen days to weeks after you get your treatment.

If you have diarrhea :

• Take anti-diarrhea medication if your health care team prescribed it.
• Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
• Eat many small meals and snacks instead of 2 or 3 large meals.
• Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Unusual bleeding or bruising (may be severe)

• You may have black stools (poo), cough up blood, blood in your pee, purple or red dots on your skin, or bleeding that will not stop.
• It may happen in days to weeks after you receive your treatment.
• It may be due to low platelets (a type of blood cell).
• Take care of your mouth and use a soft toothbrush.
• Be careful not to cut or hurt yourself.
• Check with your doctor before you have any surgeries and before going to see the dentist.
• See the low platelets pamphlet for more information.

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.

Pains or cramps in the belly

• If you have constipation or diarrhea it may be causing the pain in your belly.
• If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.

Constipation

To help prevent constipation :

• Drink more liquids and eat well. Drink at least 6 to 8 cups of liquids each day unless you have been told otherwise.
• Be Active. Exercise can help to keep you regular.
• Try to eat more fiber (e.g. fruits with skin, leafy greens and whole grains). If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation :

• If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

Headache; mild joint, muscle pain or cramps 

• Take your pain medication as prescribed by your doctor.
• You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
• Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
• Rest often and try light exercise as it may help.]

• Eat food that needs less chewing.
• Taste foods at different temperatures, since the flavor may change.
• Try different forms of foods, like fresh, frozen or canned.
• Experiment with non-spicy foods, spices and seasonings.

Nail changes

• You may have changes in nail colour, pain or tenderness in the nailbed, swelling of cuticles, or loosening of nails.
• Will slowly return to normal after treatment ends.
• Use a moisturizer for nails and cuticles.
• Avoid nail polish and artificial fingernails until your nails have returned to normal.
• Wear gloves when doing house chores or gardening.

Trouble falling asleep

• This may be caused by one of your medications and may improve once your body gets used to the medication or when your treatment ends.
• Talk to your doctor if this bothers you.