Important Instructions for Oral Chemotherapy

Your doctor has ordered chemotherapy medicine that you will take as a pill at home.

Chemotherapy, whether given in the office or taken at home, needs to be closely monitored for side effects. This information will help you feel more prepared for taking oral chemotherapy. If you have any questions or concerns, please reach out to your doctor or care team.

My doctor has written a prescription for oral chemotherapy; what happens now?

• You will be connected to a nurse and financial counselor that will assist you throughout the process. Your nurse will be your guide and will give you drug information for you to review. The nurse or doctor will ask you to sign a consent form for the treatment of chemotherapy.
• Oral chemotherapies require special authorizations from your insurance company that the financial counselor will work on obtaining. This authorization could take a few days or a few weeks to obtain depending on your insurance.
• Once the oral medicine is authorized you will be notified, and the prescription will be sent to a specialty pharmacy determined by your insurance.

How do I get my prescription once it is approved?

• Once the specialty pharmacy receives the prescription it will begin to process it.
• The specialty pharmacy will notify you of any costs associated with your prescription. The pharmacy and/or our financial counselor will work to help you if you need assistance in paying your copay.
• Your medicine will be delivered to your home through a postal service. They will not send your medicine unless they speak with you to finalize the process and arrange a delivery date.

My chemotherapy pills came in the mail. Should I start to take them now?

• No, once you receive your medicine please call and notify your nurse.
• Please do not start taking your medicine until you have spoken with the nurse, so we can assist and monitor your progress the first few weeks.
• You will be told the following information:
  • What side effects to report immediately to your doctor or nurse.
  • What to do if you miss a dose.
  • What to do if you vomit less than 30 minutes after swallowing the drug.
  • What to do if you are unable to swallow your pills or capsule.
  • What to do with leftover pills and capsules when you are no longer taking the medicine.
  • How to store your medicine.
    • If refrigerated, do not place medicines on the shelf nearest the freezer. Place in a zip-lock bag in the crisper bin.
    • Do not store medicines in a bathroom with a shower because high humidity can cause damage.

I have been taking my chemotherapy pills and I feel really nauseated. Who or when should I call?

• At any time if you are feeling uncomfortable and have questions please feel free to reach out to your nurse.
• You can expect to receive calls during the first and second week after first starting your medicine from your nurse. You may also receive calls from your insurance and pharmacy checking in on your progress. These calls are meant to help you and keep you safe when first starting your medicine.

Are there any other safety concerns when I take oral chemotherapy medicines at home?

• Keep all medicines in a safe place away from children and pets.
• There is no danger to others from contact with you by hugging, kissing or sharing food.
• Wash your hands before and after you touch your medicines.
• Caregivers should not touch the pills with bare hands and should wear latex gloves.
• After every dose of treatment, the medicine usually remains in the body for either three or seven days, depending upon its chemical properties. It is excreted in the urine, stool, vomit, semen and vaginal secretions during this time. You will be told your time frame.
• If urine, stool or vomit comes in contact with your hand or other body parts, wash the area immediately with soap and water. If caretakers have contact with your body wastes, they should wear latex gloves.
• After using the toilet, flush it immediately. If you have young children or pets in the home that may have contact with the toilet, flush the toilet twice. You may choose to close the toilet lid when flushing to avoid splashing. If splashing occurs, wipe the seat with a disinfectant using gloves.
• The use of condoms is recommended for three or seven days after therapy to protect your partner from exposure to chemotherapy in your body fluids.

What happens if I’m unable to swallow pills?

• Ask your doctor if you can crush your pills or open your capsules. DO NOT do this without asking your doctor first!
• Find an area that is away from air flow such as from a fan, air conditioner, or window, and away from where food is prepared.
• Cover the work area with a plastic, disposable cloth or mat.
• Wash your hands.
• Mix crushed pills or the contents of an open capsule with applesauce, juice, or flavored syrup.
• After mixing, place all items used to mix the medicine into a zip-lock bag and then place the sealed bag in a sealed, hard plastic container such as a detergent bottle. This include the open capsule pieces, the stirrers, gloves, mat, and any other clean-up materials.
• Throw the container in your household trash.

I am due for a refill and have been doing great. When will I see the doctor?

• Most doctors will schedule you back within the first few months as a check-up on your progress, this usually depends on the type of medicine you are taking.
• The specialty pharmacy will reach out to you to schedule your refill. If a new prescription is needed they may notify you as well as the office for a renewal. If you have any concerns, please reach out to your nurse.
• Lab appointments must be kept to continue your medicine. Monitoring your lab values as well as your symptoms are essential to your safety.
• Your nurse will continue to follow up with monthly phone calls for approximately 6 months. They will also reach out to you on your yearly anniversary to renew consents and review your progress.

Revised February 2023