Ponatinib (Iclusig )

Ponatinib (Iclusig®)

Pronounced: [poe NA ti nib]

About Your Medication

· Ponatinib is an oral medicine that your doctor prescribed for the treatment of your cancer. Please take your ponatinib as directed by your prescriber.

How to Take Your Medication

· Take your ponatinib at approximately the same time each day

· Take ponatinib with a large glass of water.

· Ponatinib can be taken with or without food. Take the tablets whole—do not crush or break them.

· 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 ponatinib, including:

· Trouble swallowing pills

· Forgetting to take doses

· Trouble affording your medications

· Throwing up pills

· Side effects

Important Precautions

· Ponatinib 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 ponatinib passes into breast milk. Nursing mothers should discuss with their healthcare providers whether to discontinue nursing or to discontinue ponatinib.

· Ponatinib has been associated with serious, sometimes fatal, cardiovascular events including myocardial infarction (MI), stroke, and peripheral vascular disease

· Heart failure, sometimes fatal, has occurred with pontainib

· Hepatotoxicity, which may be severe and/or result in fatal liver failure, has been observed with ponatinib

What foods and drugs may interact with my ponatinib?

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 ponatinib. Some examples of products that interact with ponatinib include:

· Grapefruit or grapefruit juice

· Certain anti-infectives such as rifampin (Rifadin®)

· Anti-seizure medicines, including carbamazepine (Tegretol®), phenobarbital (Luminal®), and phenytoin (Dilantin®)

· Antivirals like ritonavir (Norvir®), nelfinavir (Viracept®), and saquinavir (Invirase®)

· 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 ciprofloxacin (Cipro®) and levofloxacin (Levaquin®)

· Heart rhythm medications like quinidine, verapamil (Calan®) and amiodarone (Cordarone®)

· Immunosuppressants like cyclosporine (Gengraf® and Neoral®) and tacrolimus (Prograf®)

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 ponatinib 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 ponatinib in its original container.

· Keep the medication out of reach from children and pets.

· Return expired, damaged, or unused ponatinib to a pharmacy or hospital for disposal. Do not discard into the garbage or toilet, or anywhere that children or pets may have access.

Ponatinib (Iclusig®) Side Effect Summary

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

· Nausea/Vomiting

What are your symptoms? / What can you do…
Mild vomiting – you are having 1-2 episodes (separated by at least 5 minutes) in 24 hours / · If vomiting is not improving after 48 hours of treatment with your anti-nausea medicine, or you are having trouble staying hydrated, call the clinic
Moderate vomiting – you are having 3-5 episodes (separated by at least 5 minutes) in 24 hours / · Try to manage using the measures listed above.
· If vomiting is not improving within 24 hours, or you are having trouble staying hydrated, call the clinic
Severe vomiting – you are having 6 episodes (separated by at least 5 minutes) in 24 hours, or you are having trouble staying hydrated or performing normal daily activities / · Stop taking the olaparib and call the clinic

· Fatigue/Weakness

What Can I Do? / When to Call the Clinic?
· Don’t over-exert yourself
· Rest when you’re tired
· Ask for help
· Eat and drink well / · Unable to perform normal daily activities

· Headache – head pain

What Can I Do? / When to Call the Clinic?
· Use an over-the-counter pain medicine as directed by your cancer clinic / · Headache that continues after 24 hours with over-the-counter medicine

· Peripheral Neuropathy – Numbness, tingling, burning or weakness in the hands/fingers, feet/toes, legs.

What Can I Do? / When to Call the Clinic?
· Notify the clinic at your next visit, as this can worsen with additional treatments. / · Discomfort that affects your ability to work or perform normal activities (i.e. unable to grasp a pen/pencil, unable to button your shirt, or unable to feel the bottoms of your feet making walking difficult)

· High Blood Pressure – onset within ~3 weeks

What Can I Do? / When to Call the Clinic?
· Depending on your specific
treatment plan, you may be instructed by your clinic to monitor your blood pressure daily at home, especially during the first 6 weeks of therapy / · Blood pressure over 150/90 or as instructed by your clinic provider

· Abdominal Pain – belly/stomach pain

What Can I Do? / When to Call the Clinic?
· Use pain medications as directed by clinic
· Manage constipation or diarrhea if needed / · Unable to stay hydrated – contact the clinic IMMEDIATELY
· Pain that is severe, not treated by your pain medication, and/or is associated with an acute change in bowel habits or with nausea/vomiting

· Constipation

What Can I Do? / When to Call the Clinic?
· Stay well-hydrated
· Eat at regular times each day
· Include high fiber and “bulky” foods
· Be as active a possible
· Review constipation handouts / · No bowel movement in 2-3 or more days
· Abdominal pain, nausea, vomiting

· Rash

What Can I Do? / When to Call the Clinic?
· Avoid direct sunlight (cover exposed areas of skin and use sunscreen)
· Use antihistamines (anti-itch) medications as prescribed
· Apply non-scented lotion to affected areas to avoid dryness / · If rash becomes bothersome, if there are any open areas, or if you are unable to perform normal daily activities due to the rash
· If rash is itchy despite use of antihistamine medications
· If the skin is bleeding or looks red and/or infected
· If multiple areas of the body are affected by the rash

· Liver Dysfunction

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

· Decrease in Blood Cell Counts – lack of enough white blood cells, red blood cells, and platelets

What Can I Do? / When to Call the Clinic?
· Wash hands or use alcohol-based sanitizers regularly
· Avoid close contact with others who are sick
· Avoid activities with high risk for injury and bleeding such as contact sports
· Rest when tired; stand up slowly
· The clinic will monitor your labs / · 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
· Dizziness/lightheadedness

Below are some less common side effects of ponatinib.

Less Common Side Effects / What Can I Do? / When to Call the Clinic?
Blood Clots
(Deep Vein Thrombosis/Pulmonary Embolism; Formation of a blood clot that plugs the blood vessel) / · Your doctor may prescribe a medication to help decrease your risk of blood clots / · Shortness of breath
· Chest pain
· Swelling/tenderness/redness in the leg or arm
· Severe headache that starts suddenly
Pancreatitis / · The clinic will monitor your labs to assess / · Yellowing of eyes or skin
Heart Failure (Inability of the heart muscle to adequately pump blood to supply oxygen to the body) / • You may have tests to assess your heart function during treatment / • Shortness of breath or difficulty breathing, especially when lying down
• Rapid swelling of your legs
• Chest pain
• Feeling like you have an irregular heartbeat

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

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.