Everolimus is given for the treatment of certain cancers and to prevent organ transplant rejection.
There are three brands of everolimus tablet available - Afinitor®, Certican® and Votubia®. The brands are prescribed for different conditions, so each time you collect a new supply of tablets from your pharmacy, check to see if the tablets are the same as before. If they are different, discuss this with your pharmacist who will advise you.
You will need to have regular check-ups so it is important that you keep your appointments with your doctor and/or hospital.
Contact your doctor straightaway if you feel short of breath, get a cough, or develop an infection.
|Type of medicine||A protein kinase inhibitor chemotherapy medicine|
|Used for||Treatment of cancer, prevention of organ rejection|
|Also called||Afinitor®; Certican®, Votubia®|
Everolimus is a medicine which is given for the treatment of some types of cancer. It is prescribed for kidney cancers, gastrointestinal cancers, some lung cancers, advanced breast cancer, and cancer which has spread from the pancreas.
In cancer, certain cells in the body grow and multiply in a way that is 'out of control'. Chemotherapy (anti-cancer) medicines work by inhibiting the way cells grow and increase in number. Everolimus works by blocking the action of a certain protein inside cells. This protein controls the signals to the cell to make it grow, so by stopping it from working properly, this stops cancer cells from growing and increasing in number.
Everolimus can also be used alongside other medicines to help prevent your body from rejecting an organ transplant. It works by suppressing your body's immune, or defence, system.
Before taking everolimus
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking everolimus it is important that your doctor knows:
- If you have an infection or feel particularly unwell.
- If you have any problems with the way your liver works.
- If you have ever had a bleeding disorder.
- If you are pregnant or breast-feeding.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take everolimus tablets
- Before you start the treatment, read any printed information you have been given by your doctor and the printed manufacturer's leaflet from inside the pack of tablets. These will give you more information about everolimus and will provide a full list of the side-effects which you may experience from taking it.
- Everolimus will be prescribed for you by a specialist doctor who is experienced in treating your condition. There are three brands of everolimus and several strengths of tablet available - your doctor will tell you which brand and which strength of tablet are right for you.
- It is important that you take the tablets exactly as you are told to. The directions for taking the tablets will be printed on the label of the pack to remind you, but if you are still unsure about what to do, or if you have any other concerns, you should contact your doctor or hospital clinic for advice.
- Swallow the tablets with a drink of water. Do not crush or break the tablets - they should be swallowed whole. If you have been given a brand of tablet called Votubia®, these tablets can be dispersed in water if you have difficulty swallowing tablets. To do this, gently stir the tablet into a small glass of water (about 30 ml) until it is completely dissolved - this may take about seven minutes. Drink the contents of the glass as soon as the tablet has dissolved, and then add some more water to your glass and drink this too.
- Take everolimus at the same times of day each day, as this will help you to remember to take your doses regularly. You can choose whether to take the tablets before or after meals, but you should continue to take all your doses in the same way. So, either always take your doses before meals, or always afterwards.
- If you forget to take a dose at your usual time, take it as soon as you remember, unless it is nearly time for your next dose, in which case do not take the forgotten dose. Do not take two doses together to make up for a missed dose.
- Do not drink grapefruit juice while you are on everolimus. This is because a chemical in grapefruit juice can interfere with the amount of everolimus in your bloodstream.
Getting the most from your treatment
- You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular check-ups during treatment. If at any time you feel short of breath or develop a dry cough, you must let your doctor know about it straightaway so that it can be investigated.
- Everolimus lowers the number of white cells in your blood and this increases the chance that you may get an infection. You should take precautions to reduce the risk of infection whenever you can. So, if possible, avoid other people with infections and let your doctor know straightaway if you think you are getting a sore throat or if you have a high temperature.
- While you are taking everolimus, do not have any immunisations (vaccinations) without talking to your doctor first. Everolimus lowers your body's resistance so there is a chance that you may get an infection from some vaccines.
- If you buy or take any other medicines, check with a pharmacist that they are suitable to take alongside everolimus. You should not take any preparations which contain St John's wort (a herbal remedy used for low moods), as these can reduce the effectiveness of everolimus.
- If you are having an operation or dental treatment, always tell the person carrying out the treatment which medicines you are taking.
- It is important that you do not get pregnant while you are taking everolimus. If relevant, make sure you discuss with your doctor which types of contraception are suitable for you and your partner.
Can everolimus cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with everolimus. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common everolimus side-effects |
(these may affect more than 1 in 10 people)
|What can I do if I experience this?|
|Feeling short of breath, cough, infection, high temperature||Speak with your doctor as soon as possible|
|Feeling sick (nausea) or being sick (vomiting), indigestion, abdominal discomfort||Stick to simple meals - avoid rich or spicy foods|
|Diarrhoea||Drink plenty of water. If this continues or becomes severe, you should let your doctor know|
|Feeling tired||Do not drive and do not use tools or machines unless you feel well enough|
|Headache, aches and pains, sore or dry mouth||Ask your doctor or pharmacist to recommend a suitable remedy|
|Loss of appetite, feeling thirsty, problems sleeping, swollen eyes, changes in taste, nosebleeds and other bleeding, itchy rash, hair and skin changes, swollen feet and ankles, menstrual problems, weight loss||If any become troublesome, speak with your doctor|
|Changes to some blood tests, high blood pressure||Your doctor will regularly check for these|
If you experience any other symptoms which you think may be due to the tablets, ask your doctor or pharmacist for advice.
How to store everolimus
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Please return any unused or unwanted tablets to your clinic or pharmacy to destroy.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Afinitor® Tablets; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated May 2016.
Manufacturer's PIL, Votubia® Tablets 2.5 mg, 5 mg, 10 mg; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated January 2017.
Manufacturer's PIL, Certican® Tablets 0.25 mg, 0.5 mg, 0.75 mg, 1 mg; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated July 2016.
British National Formulary 73rd Edition (Mar 2017); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.