Everolimus (Afinitor®)

Printable PDF Version

About This Drug

Everolimus is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding
  • Headache
  • Tiredness and weakness
  • Fever
  • Cough
  • Upper respiratory infection and other infections
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Nausea
  • Decreased appetite (decreased hunger)
  • Pain in your abdomen
  • Loose bowel movements (diarrhea)
  • Rash
  • Swelling of your legs, ankles and/or feet
  • Blood sugar levels may change. If you have diabetes, changes may need to be made to your diabetes medication.
  • Changes in your liver function
  • Increase in your cholesterol and triglyceride level
  • Electrolyte changes

Note: Each of the side effects above was reported in 30% or greater of patients treated with everolimus. Not all possible side effects are included above.

Warnings and Precautions

  • Inflammation (swelling) of the lungs. You may have a dry cough or trouble breathing.
  • Severe infections, including viral, bacterial and fungal, which may be life-threatening
  • Risk of angioedema if you are also taking a type medication called ace inhibitor. Symptoms may be swelling of the face, feeling like your tongue or throat are swelling, and trouble breathing.
  • Severe soreness of the mouth and throat
  • Changes in your kidney function which may cause kidney failure
  • Slow wound healing

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team

Important Information

  • Everolimus may cause slow wound healing. It should not be given before surgery or if you have an open wound. If you must have emergency surgery or have an accident that results in a wound, tell the doctor that you are on everolimus.
  • Talk to your doctor before receiving any vaccinations during your treatment. Some vaccinations are not recommended while receiving everolimus. You should also avoid contact with people whom have received live vaccines.
  • Do not substitute the tablet for the oral suspension

How to Take Your Medication

  • Take the medicine consistently with or without food at the same time each day.
  • Tablet: Swallow whole with water. Do not break or crush it.
  • Oral Suspension: Prepare suspension with water only. Talk to your doctor, nurse and/or pharmacist for proper preparation, dosing and administration.
  • Missed dose: If you miss a dose, and it is within 6 hours of the missed dose, take the missed dose, otherwise, skip the missed dose and go back to your normal schedule.Do not take 2 doses at the same time or extra doses.
  • If you vomit a dose, take your next dose at the regular time and contact your physician. Do not take 2 doses at the same time and do not double up on the next dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • To help with decreased appetite, eat small, frequent meals.
  • Eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you have diabetes, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.

Food and Drug Interactions

  • Do not eat grapefruit or drink grapefruit juice while taking this medicine.Grapefruit and grapefruit juice may raise the levels of everolimus in your body. This could make side effects worse
  • Avoid the use of St. John’s Wort while taking everolimus as this may lower the levels of the drug in your body, which can make it less effective.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with everolimus. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Feeling dizzy or lightheaded
  • Headache that does not go away
  • Wheezing or trouble breathing
  • Coughing up yellow, green, or bloody mucus
  • Pain in your chest
  • Dry cough
  • Trouble breathing
  • Symptoms of angioedema: swelling of the face, feeling like your tongue or throat are swelling, and trouble breathing
  • Severe soreness of the mouth and throat
  • Fatigue that interferes with your daily activities
  • Easy bleeding or bruising
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Decreased urine
  • Abnormal blood sugar
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines
  • Weight gain of 5 pounds in one week (fluid retention)
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 8 weeks after treatment. Men with female partners of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 4 weeks after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breast feed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children.Ask for information on sperm or egg banking.

Revised February 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.