Bosutinib (Bosulif®)
Pronounced: [boe-SUE-ti-nib]
About Your Medication
Bosutinib is an oral medicine that your doctor prescribed for the treatment of your cancer. Please take your Bosutinib as directed by your prescriber.
How to Take Your Medication
· Take your bosutinib at approximately the same time each day.
· Take bosutinib with food.
· If a dose is missed, make it up within 12 hours before your next dose is due
· 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 bosutinib, including:
· Trouble swallowing pills
· Forgetting to take doses
· Trouble affording your medications
· Throwing up pills
· Side effects
Important Precautions
· Bosutinib 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 bosutinib passes into breast milk. Nursing mothers should discuss with their healthcare providers whether to discontinue nursing or to discontinue bosutinib.
· Bleeding events have been reported with bosutinib, caution if decreased platelets or concurrent anticoagulation.
· QT prolongation is an abnormal heart rhythm associated with bosutinib. The cancer clinic will monitor your heart rhythm intermittently.
What foods and drugs may interact with my bosutinib?
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 bosutinib. Some examples of products that interact with bosutinib 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®)
· Anticoagulants like warfarin (Coumadin®)
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 bosutinib 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 bosutinib in its original container with the lid tightly closed.
· Keep the medication out of reach from children and pets.
· Return expired, damaged, or unused bosutinib to a pharmacy or hospital for disposal. Do not discard into the garbage or toilet, or anywhere that children or pets may have access.
Bosutinib (Bosulif®) Side Effect Summary
This list does not include all possible side effects of bosutinib. 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 bosutinib 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
· 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 bosutinib 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
· Respiratory Tract Infections – infection in your lungs
What Can I Do? / When to Call the Clinic?· Maintain adequate hydration
· Wash hands regularly
· Avoid close contact with others who are sick
· Use Tylenol as needed to manage pain and fevers / · Temperature of 100.5˚F or higher- CONTACT IMMEDIATELY
· Significant sputum production
· Sudden onset or worsening of symptoms such as difficulty breathing, cough, or chest pain
· If symptoms have not improved after about 3 days
Below are some less common side effects of bosutinib.
Anorexia
(Decreased appetite) / · Stay well-hydrated
· Eat smaller, more frequent meals/snacks that are high in calories / · Unable to stay hydrated- CONTACT IMMEDIATELY
· Unable to eat
Joint Pain / · Use pain medication recommended by the clinic / · Unable to perform normal daily activities
Liver Dysfunction / · The clinic will monitor your labs to assess / · Yellowing of eyes or skin
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 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.