If your doctor has told you or someone in your family that you have Chronic Myelogenous Leukemia (CML), a type of blood cancer, you may have heard about a drug called Nilotinib. This is a very important, specialized drug. So today, we'll talk simply and clearly about what you need to be aware of when using this drug, how to use it correctly, and what side effects to expect.
What is Nilotinib?
Simply put, Nilotinib is a specific drug that stops the growth of cancer cells. We call these types of drugs "targeted therapy." That is, this drug goes directly to target certain proteins in cancer cells, stops them from working, and controls the division and growth of cancer cells.
This medicine is mainly used to treat a type of leukemia called Chronic Myelogenous Leukemia (CML) . It is also marketed under the name Tasigna .
Things you need to tell your doctor before starting medication
Nilotinib is a very powerful drug. Therefore, before starting this treatment, your doctor will need to have a complete picture of your health. If you have any of the following conditions, be sure to inform your doctor.
| Situation that may apply to you |
|---|
| Diabetes |
| Conditions such as heart disease, heart rhythm irregularities, or Long QT syndrome. |
| Liver disease |
| If you have a history of pancreatitis. |
| If you have low levels of potassium or magnesium in your blood. |
| If you have problems with blood circulation in the legs. |
| If the stomach has been completely surgically removed (Total Gastrectomy). |
| If you have an allergy to nilotinib, lactose, gelatin, or any other medicine or food. |
| If you are pregnant, trying to get pregnant, or breastfeeding. |
How exactly do I use this medicine?
To get the most out of this medicine, it is very important to use it correctly.
- Take on an empty stomach: This is the most important thing. You should take the medicine at least one hour before or two hours after a meal. Taking this medicine with food can change the amount absorbed by the body and cause dangerous side effects.
- Drink with a glass of water: Swallow the capsule whole with a glass of water.
- Do not break, crush, or chew the capsule: Do not break, crush, or chew the capsule.
- If you have trouble swallowing: Some people have trouble swallowing capsules. If so, don't worry. Carefully open the capsule, mix the powder with a teaspoon of applesauce, and swallow the mixture immediately . Do not save it for later use.
- Avoid grapefruit: Do not drink grapefruit juice or eat grapefruit for any reason. It can dangerously change the way the medicine works.
- Timing of taking with other medications: If you are taking medication for gastritis, do not take medications such as antacids (e.g., Digene) within 2 hours before or after taking this capsule. Take medications such as H2-blockers (e.g., Famotidine) 10 hours before or 2 hours after taking this medication. Ask your doctor to confirm this.
- Take it on time: Try to take your medicine at the same time every day. Do not stop taking your medicine without your doctor's advice.
What to do if you miss a dose of medication?
If you miss a dose, never double up on the next dose to make up for it. That can be dangerous. Forget about the missed dose and take only the prescribed dose at the next scheduled time.
What if I take too much medicine?
If you accidentally take more than the prescribed dose, it is an emergency. Immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other medications that may interact with Nilotinib
Nilotinib is a drug that has a high potential for interaction with other medications. Therefore, it is essential to tell your doctor about all medications you are taking.
| Do not take Nilotinib with this medicine. |
|---|
| Cisapride, Dronedarone, Pimozide, Thioridazine, Ziprasidone (medicines that affect the heart rate) |
| Flibanserin, Lomitapide, Saquinavir |
| Fluconazole, Posaconazole (antifungal) |
| If you are using these things, inform your doctor. |
|---|
| Antiviral drugs for HIV/AIDS |
| Antibiotics such as Clarithromycin and Erythromycin |
| Medications for high blood pressure, heart disease, and mental illness |
| Other antifungals such as Ketoconazole, Itraconazole |
| Medications for gastritis (Antacids, Cimetidine, Omeprazole) |
| Blood thinners such as Warfarin |
| Herbal products such as St. John's Wort |
Neither of these lists is complete. Therefore, it is important for your safety to tell your doctor about all medications, vitamins, herbal products, and traditional medicines you are taking.
What are the possible side effects of taking the medicine?
Like any medication, Nilotinib can cause side effects. Some are serious, while others are common. The important thing is to be aware of these and take action quickly if necessary.
| Side effect | Features to expect |
|---|---|
| Side effects that require immediate medical attention | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Bleeding | Black or bloody stools, vomit that looks like coffee grounds, red spots on the skin, unusual bleeding from the nose or gums. |
| Changes in heart rate | Chest pain, dizziness, fast or irregular heartbeat, fainting. |
| Liver injury | Dark yellow or brown urine, yellowing of the eyes or skin, pain in the upper right part of the stomach, loss of appetite. |
| Pancreatitis | Abdominal pain (especially radiating to the back), pain that worsens after eating, fever, nausea, vomiting. |
| Fluid accumulation in the body (Edema) | Sudden weight gain, swelling of the ankles, limbs, difficulty breathing. |
| Side effects that should be reported to the doctor if they persist | |
| Common disorders | Headache, nausea, vomiting, diarrhea, constipation. |
Be especially careful during pregnancy and lactation
This is a very important point.
- Never become pregnant while taking Nilotinib.
- Avoid getting pregnant for at least 14 days after stopping the medication.
- Do not breastfeed your baby while taking this medicine and for 14 days after stopping.
This medicine can cause serious harm to the unborn baby, so talk to your doctor about this openly.
Take-Home Message
- Always take Nilotinib on an empty stomach, either one hour before or two hours after a meal.
- Never eat grapefruit or drink its juice.
- Be sure to tell your doctor about all other medications, vitamins, and herbal products you are taking.
- If you experience any serious side effects such as chest pain, difficulty breathing, or unusual bleeding, seek medical advice immediately.
- Avoid pregnancy and breastfeeding completely while taking the medicine and for 14 days after stopping.
- Don't skip your clinic appointments with the doctor. Get your blood tests done as scheduled.
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