Let's learn about the drug Alpelisib (Vijoice)? (PIK3CA-related overgrowth spectrum - PROS)

You, or perhaps your child, may have been told by your doctor to start taking a medicine called Alpelisib (brand name: Vijoice). When you hear the name of such a special medicine, it is normal for many questions to come to your mind, such as "What does this do?", "How should I take it?", "What are the precautions?" So don't be afraid. Today, we will talk about this medicine called Alpelisib in a very clear and simple way.

What kind of medicine is Alpelisib?

Simply put, Alpelisib is a drug that controls the abnormal, uncontrolled growth of certain cells in the body. This drug is specifically used to treat a condition in which certain parts of the body (for example, an arm, a leg, or some tissues) become excessively large due to a mutation in a gene called PIK3CA . We call this condition PIK3CA-related overgrowth spectrum (PROS) . This drug works by blocking the signaling pathway that causes that abnormal cell growth, thereby controlling the disease.

Your doctor may prescribe this for other medical conditions as well, so if you have any questions, talk to your doctor about it.

Things you need to tell your doctor before starting medication

For your safety and to get the most out of the medication, it is important to tell your doctor this information before starting Alpelisib.

• If you have diabetes: Tell us if you already have diabetes or high blood sugar levels.
• Lung diseases: If you have any lung disease, such as asthma or pneumonia.
• Allergies: Be sure to tell your doctor if you have any allergies to Alpelisib or any other medicine, food, or dye.
• Pregnancy: If you are pregnant, trying to get pregnant, or have even the slightest suspicion that you are pregnant.
• If you are a breastfeeding mother: If you are breastfeeding a child.

When the doctor is aware of these things, it will be easier for him to plan treatment that best suits you.

How exactly do I use this medicine?

It is very important to follow the exact instructions for using this medicine.

• Take the medicine exactly as prescribed by the doctor, at the same time every day .
• Do not cut or chew this tablet. Swallow the tablet whole with water.
• It is best to take the medicine with a meal .
• Continue taking the medicine until your doctor tells you to stop. Don't stop suddenly, even if you feel better.

What to do if the pill is hard to swallow?

Some people, especially children, have difficulty swallowing pills. In that case, here's how to do it:

1. Place the tablet in a glass with 2-4 ounces (about 60-120 ml) of water.

2. After about 5 minutes, crush the tablet well with a clean spoon and stir well until it dissolves in the water.

3. Drink this mixture immediately.

4. Then, add 2-3 more tablespoons of water to the same glass, wash down any remaining medicine in the glass, and drink that. Do this in a way that not a single drop of the medicine is wasted.

What if I take too much medicine (overdose)?

If you think you have taken too much of this medicine, do not delay. Immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.

What to do if you miss a dose of medicine?

If you forget to take a dose, take it as soon as you remember. However, if it is less than 9 hours until your next dose when you remember (i.e., more than 9 hours late), skip the missed dose. Just take the next dose at the scheduled time. Never take two doses at once to make up for a missed dose.

Other drugs that may interact with this medicine (Drug Interactions)

Some medications you are taking may interact with Alpelisib and affect its effectiveness or side effects. Therefore, tell your doctor if you are taking any of the following medications or any other supplements, vitamins, or herbal remedies.

• Some medications used for epilepsy: For example, `(Carbamazepine)`, `(Phenobarbital)`, `(Phenytoin)`.
• `Cyclosporine`
• `Eltrombopag`
• `Enzalutamide`
• `Mitotane`
• `Rifampin` (a medicine for tuberculosis)
• `St. John's Wort` (an herbal remedy for mental health)
• `Sulfasalazine`
• `Warfarin` (a medicine given to prevent blood clotting)

This list is not complete, so it's best to inform your doctor about all medications you're taking.

Things you should be especially careful about when taking the medicine

• Regular medical checkups: Check with your doctor regularly to see if your symptoms are improving or worsening. Don't skip necessary blood tests (blood work).
• Severe skin reactions: Some people may develop a serious skin rash even weeks after starting this medicine. Tell your doctor right away if you develop a rash with symptoms like fever or chills . These rashes may turn red or purple, then blister and peel. Or if you notice a red rash on your face, lips, neck or armpits along with swollen lymph nodes.
• Severe diarrhea and dehydration: Tell your doctor if you have severe diarrhea, vomiting, or excessive sweating . Losing too much fluid from your body (dehydration) can be dangerous while taking this medicine.
• High blood sugar (Hyperglycemia): This medicine can cause high blood sugar. This risk is higher in people who already have diabetes. Tell your doctor if you feel more thirsty than usual, urinate more often, feel unusually tired, or have blurred vision .
• Dry mouth: You may experience a dry mouth. This can be controlled by things like chewing sugar-free gum and drinking plenty of water. However, if the problem persists or is severe, tell your doctor.

Side effects that may occur due to medication

How do you keep your medicine safe?

• Keep away from children and pets.
• Store at a temperature between 20 and 25 degrees Celsius (68-77 Fahrenheit), which is normal room temperature.
• Do not use expired medicine.
• When throwing away unused or expired medications, check the label to see if they are safe to throw away. If in doubt, ask your doctor. If they are safe to throw away, remove the pills from the bottle and mix them with something like used coffee grounds, soil, or cat litter, put them in a tightly sealed bag or container, and throw them in the trash.

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