AFAtinib
Other Name: Giotrif®
in various strengths and colours
For treating certain types of non-small cell lung cancer.
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Tell your doctor and pharmacist if you have or had significant medical condition(s), especially if you have or had:
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liver, kidney, lung, heart or skin problems,
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a history of severe dry eye or swelling of the eye,
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medical conditions with diarrhea (such as Crohn's or colitis), or
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any allergies.
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Afatinib tablets contains a small amount of lactose. If you cannot have lactose, talk to your healthcare team.
Remember to:
- Tell your health care team about all of the other medications you are taking.
- Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
Talk to your health care team about:
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How this medication may affect your sexual health.
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How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
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If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until 2 weeks after your last dose. Talk to your health care team about which birth control options are best for you.
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Do not breastfeed while on this medication and for at least 2 weeks after your last dose.
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This medication is usually taken once a day by mouth. Talk to your health care team about how and when to take your medication.
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Swallow the tablet whole with a glass of water; do not crush or chew.
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Take afatinib on an empty stomach, at least 1 hour before or 3 hours after eating.
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If you forget to take a dose of your afatinib:
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If there are more than 8 hours until your next dose, take the dose as soon as you remember. Then take your next dose at the normal scheduled time.
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If there are less than 8 hours until your next dose, do not take the dose. Take your next dose at the normal scheduled time. Do not take extra (double up) to make up for the missed dose.
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If you vomit after taking a dose, DO NOT take a replacement dose. Take the next dose at its original scheduled time.
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If you take too much of your medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017
To Treat Diarrhea
Afatinib can cause diarrhea. Diarrhea is when you have loose bowel movements (watery poo) or you need to go poo (have bowel movements) more often than usual. Diarrhea may start a few days after your treatment.
You will be given a medication called loperamide (Imodium®) to help treat your diarrhea. Take this medication only if you need it.
Keep your loperamide with you all the time. When diarrhea starts, take the loperamide right away:
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Take 2 tablets (4mg) of loperamide right away.
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Take 1 tablet (2mg) with every loose bowel movement after that, up to maximum of 20mg (10 tablets) per day.
- Keep taking loperamide until you have no diarrhea for 12 hours.
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Will this medication interact with other medications or natural health products?
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This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
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Tell your health care team about all of your:
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prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)
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natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
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Check with your health care team before starting or stopping any of them.
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What should I do if I feel unwell, have pain, a headache or a fever?
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
- 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 (100.4°F) or higher for at least one hour.
- 38.3°C (100.9°F) or higher at any time
If you do have a fever:- Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
- Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
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Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
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Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
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What to DO while on this medication:
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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
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DO protect your skin from the sun. Wear a long sleeved shirt, long pants and a hat. Apply sunscreen with UVA and UVB protection and an SPF of at least 30. Your skin may be more sensitive to the sun and you could develop a bad sunburn or rash more easily.
What NOT to DO while on this medication:
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
- Open only one pouch at a time. All the tablets in the blister card should be taken before opening the next pouch.
How to safely touch oral anti-cancer medications
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
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Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
What to do if oral anti-cancer medication gets on your skin or in your eyes
If medication gets on your skin:
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Wash your skin with a lot of soap and water.
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If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:
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Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
The following table lists side effects that you may have when getting afatinib. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on afatinib.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Diarrhea (May be severe) What to look for?
What to do? If you have diarrhea:
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Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day) |
Mouth sores (May be severe) What to look for?
To help prevent mouth sores:
Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information. |
Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow |
Rash; dry, itchy skin (May be severe) What to look for?
What to do? To prevent and treat dry skin:
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. |
Talk to your health care team if it does not improve or if it is severe |
Nail changes (May be severe) What to look for?
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Talk to your health care team if it does not improve or if it is severe |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Low appetite / weight loss What to look for?
Ask your health care team for the Loss of Appetite pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Nausea and vomiting (Generally mild) What to look for?
What to do? To help prevent nausea:
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Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Problems with your nose What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe. If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. |
Talk to your health care team if it does not improve or if it is severe. |
Trouble Sleeping Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe |
Talk to your health care team if it does not improve or if it is severe |
Headache; mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Infection (May be severe) What to look for?
You have a fever if your temperature taken in your mouth (oral temperature) is:
What to do?
If you have a fever: If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away.
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If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you MUST get emergency medical help right away |
Hair thinning or loss What to look for?
What to do?
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Talk to your health care team if this bothers you |
Constipation What to look for?
What to do? To help prevent constipation:
To help treat constipation:
Ask your health care team for the Constipation Pamphlet for more information.
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Talk to your health care team if it does not improve or if it is severe |
Liver problems (May be severe) Your health care team may check your liver function with a blood test. Liver changes do not usually cause any symptoms.
If you have any symptoms of liver problems, get emergency medical help right away.
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Get emergency medical help right away |
Too much or too little salt in your body What to look for?
What to do? Get emergency medical help right away for severe symptoms. |
Get emergency medical help right away for severe symptoms |
Eye problems (May be severe) What to look for?
What to do?
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Contact your health care team as soon as possible (office hours) |
Dizziness What to look for?
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Talk to your health care team if it does not improve or if it is severe |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
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Signs of a kidney problem such as lower back pain, swelling, peeing less than usual and weight gain that is not normal for you
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Chest pain, fainting spells or swelling in your legs, ankles and belly
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Swelling and hardening of the vein in an arm or leg
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Severe pain in your belly or stomach area that may extend to your back
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Black stools (poo) or blood in your stools or vomiting (throwing up) blood
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New or worsening cough, shortness of breath, difficulty breathing, coughing up blood
- Pain, thinning, reddening, tingling, numbness and peeling of the skin on your palms or the soles of your feet
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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June 2022 Updated Info Sheet
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.