PATIENT EDUCATION REGARDING TKIs

Imatinib (Novartis, 2011a)

• Sexually active patients should use effective birth control methods during treatment. Women should not breastfeed during therapy. Inform patients that fetal harm can occur if they become pregnant while on therapy.
• Stress the importance of weighing routinely to monitor for edema. Inform patients to report any rapid weight gain immediately.
• Instruct patients to report fever or any bleeding immediately.
• Inform patients to report any skin changes.
• Instruct patients to take the drug with food and a large glass of water to minimize gastric irritation.
• Teach self-management and use of over-the-counter (OTC) medications to control nausea, vomiting, and diarrhea.
• Teach patients to avoid any OTC medications not previously discussed with healthcare provider. Imatinib may interact with acetaminophen, St. John’s wort, hypericum perforatum, warfarin, rifampin, erythromycin, metoprolol, ketaoconazole, and phenytoin.

Dasatinib (Bristol-Myers Squibb, 2011)

• Sexually active patients should use effective birth control methods during treatment. Women should not breastfeed during therapy. Inform patients that fetal harm can occur if they become pregnant while on therapy.
• Instruct patients to report fever or any bleeding immediately.
• Teach patients to report any swelling anywhere on the body or rapid weight gain immediately.
• Instruct patients to report any shortness of breath, cough, or feeling of faintness immediately.
• Dasatinib interacts with many other drugs. Ensure a thorough assessment of all concomitant medications prior to therapy initiation. Teach patients to never take any OTC or other prescribed medications until they discuss them with the healthcare provider first.
• Do not use proton pump inhibitors while on this medication.
• Instruct patients to take the drug at the same time each day, with or without food.

Nilotinib (Novartis, 2011)

• Instruct patients to report fever or any bleeding immediately.
• Inform patients to report shortness of breath, faint feelings, or feelings of heart rhythm irregularities immediately.
• Sexually active patients should use effective birth control methods during treatment. Women should not breastfeed during therapy. Inform patients that fetal harm can occur if they become pregnant while on therapy.
• Teach patients self-management and use of OTC medications to control nausea, vomiting, and diarrhea.
• Do not use proton pump inhibitors while on this medication.
• Tell patients to avoid food for two hours before and at least one hour after taking each dose. Do not take with food.
• Nilotinib is not recommended for patients with severe lactase deficiency due to lactose in the capsule.
• Instruct patients to avoid grapefruit juice, eating grapefruit, or taking supplements with grapefruit extract.