Everolimus (Afinitor) is an oral medication used to treat different types of cancer, including certain types of breast cancer and kidney cancers. It's taken by mouth, typically just once daily. But depending on the type of cancer you're being treated for, your provider might ask you to do regular blood draws to figure out a dose that's safe for you. Keep in mind that everolimus (Afinitor) comes in 3 different formulations and they don't all treat the same conditions. Some common side effects everolimus (Afinitor) can cause include mouth sores and skin rashes.
Breast cancer (hormone receptor-positive, HER2-negative)
Neuroendocrine tumors (NET)
Kidney cancer (renal cell cancer or RCC)
Tuberous sclerosis complex (TSC)-associated kidney tumor
Tuberous sclerosis complex (TSC)-associated brain tumor (people age 1 years and older)
Tuberous sclerosis complex (TSC)-associated seizures (people age 2 years and older)
Everolimus (Afinitor) is kinase inhibitor. It blocks a specific type of protein that's involved in cell growth and spread. This protein can be more active in cancer cells, leading to tumor growth. When everolimus (Afinitor) blocks this protein, cancer cells can’t grow and spread as well.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bloating or swelling of the face, arms, hands, lower legs, or feet
bloody nose
chest pain or tightness
chills
decreased weight
difficult or labored breathing
difficulty with swallowing
general feeling of discomfort or illness
hoarseness
lower back or side pain
painful or difficult urination
rapid weight gain
sores, ulcers, or white spots on the lips, tongue, or inside the mouth
tingling of the hands or feet
Less common
Bleeding gums
bloody urine
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
coughing up blood
extreme tiredness or weakness
fast, pounding, or irregular heartbeat or pulse
increased thirst or urination
irregular breathing
loss of appetite
nervousness
nosebleeds
prolonged bleeding from cuts
red or black, tarry stools
red or dark brown urine
slow heartbeat
stomach ache
sweating
unusual tiredness or weakness
vomiting
Incidence not known
Agitation
confusion
decreased awareness or responsiveness
dizziness
hostility
irritability
muscle twitching
seizures
severe sleepiness
unusual drowsiness, dullness, or feeling of sluggishness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Change in taste
itching skin or rash
lack or loss of strength
loss of taste
pain in the arms or legs
stomach pain
trouble sleeping
Less common
Back pain
blistering, peeling, redness, or swelling of the palms, hands, or bottoms of the feet
bumps on the skin
burning, dry, or itching eyes
discoloration of the fingernails or toenails
feeling of fullness
flushing or redness of the skin
jaw pain
numbness, pain, tingling, or unusual sensations in the palms of the hands or bottoms of the feet
passing of gas
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Oral pill, taken once daily
Available as a lower-cost generic
Can be taken with or without food
Can be taken by children (only for TSC-associated brain tumors or seizures)
Can raise blood sugar levels
Can cause painful sores in the mouth
Might make it difficult for you to have children in the future
Raises the risk of infection
Higher risk of serious side effects in older adults
Take everolimus (Afinitor) at the same time each day. It can be taken either with or without food, but try to keep it consistent. Swallow Afinitor and generic everolimus tablets whole with a glass of water. Don’t break or crush the tablets.
Afinitor or Afinitor Disperz aren’t interchangeable and one can’t be substituted for the other. Make sure to take the right form of medication that’s appropriate for your condition. Don’t mix the two together. Ask your provider or pharmacist if you have questions about which form of everolimus you’re supposed to take.
If you miss a dose, take it as soon as you remember if it’s within 6 hours from the time you normally take it. If it’s been more than 6 hours, then skip your dose for that day. The next day, take your dose at the normal time.
If you’re taking angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril), to lower blood pressure, let your provider know. Taking everolimus (Afinitor) with ACE inhibitors raises your risk for serious swelling of the tongue and face (angioedema). If you do experience angioedema, your provider will likely ask you to stop taking everolimus (Afinitor).
Everolimus (Afinitor) can make it harder for your body to heal itself. This can be a problem when your body is recovering from surgery. Make sure to tell your provider if you have a planned surgery coming up. Your provider might ask you to stop taking everolimus (Afinitor) for a week or two before and after the surgery. They’ll also monitor your healing progress to let you know when it’s safe to start taking everolimus (Afinitor) again.
If you’re taking everolimus (Afinitor) for TSC-associated brain tumors or seizures, you’ll need to have your blood work checked to monitor the levels of the medication in your body. Your provider might adjust your dose based on your lab results. Make sure to follow the lab work schedule you’re given.
Tips for Afinitor Disperz:
If you’re taking Afinitor Disperz, you need to dissolve the tablet in water to prepare a suspension. Make sure to wear gloves while preparing the suspension.
You can prepare the Afinitor Disperz in a small drinking glass. Place your dose (up to 10 mg of Afinitor Disperz) in a glass that contains about 25 mL of water. It’ll take about 3 minutes for the tablet to dissolve. Stir the suspension gently, then drink. After drinking the suspension, add another 25 mL of water to the cup. Then stir and drink again.
If you or your child aren’t able to drink the Afinitor Disperz suspension from a cup, you can also prepare the medication for an oral syringe.
If you’re taking a dose that’s higher than 10 mg of Afinitor Disperz, then you’ll need to prepare additional drinking glasses or oral syringes.
Once the suspension is made, make sure to drink the suspension immediately. Don’t take the suspension if it has been sitting out for 60 minutes or longer.
Everolimus (Afinitor) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Let your provider know right away if you experience coughing or trouble breathing while taking everolimus (Afinitor) because this medication can cause your lungs to become inflamed. If you develop these symptoms, your provider will need to examine you to figure out they’re caused by everolimus (Afinitor) or an infection, and treat you accordingly. If your symptoms aren’t too severe, your provider will likely ask you to continue taking everolimus (Afinitor), while giving you a corticosteroid to ease the inflammation in your lungs. But if they’re severe, your provider might ask you to stop this medication.
Risk factors: Taking other medications that weakens your immune system
Everolimus (Afinitor) can cause your white blood cell (WBCs), red blood cell (RBCs), and platelet counts to drop. Your provider will closely monitor your blood cell counts through lab work before you start everolimus (Afinitor) and every 6 months while you’re receiving treatment. If your blood counts are low, your dose might need to be lowered or you might stop taking the medication altogether.
Risk factors: Taking angiotensin-converting enzyme (ACE) inhibitors
Everolimus (Afinitor) can cause allergic reactions, including anaphylaxis. In addition, people who take ACE inhibitors such as lisinopril (Prinivil, Zestril) are at higher risk for swelling in the face and tongue (angioedema). Contact your provider or get medical help right away if you experience any throat tightness, trouble breathing, flushing, chest pain, or swelling of the face, airways, or tongue (angioedema).
Everolimus (Afinitor) can cause painful mouth ulcers or sores. People typically experience this within the first 2 months after starting treatment. If you have mouth sores, let your provider know. They might be able to recommend mouthwashes and other options, such as sucking on ice chips, to help with these symptoms.
Some people developed kidney problems, including kidney failure, after starting everolimus (Afinitor) can harm your kidneys. Your provider will order labs to check your kidney health before you start this medication, then at least yearly during treatment. Reach out to your provider right away if you experience blood in the urine, pain or problems urinating, or changes in the color or cloudiness of the urine. These can be signs of a serious kidney problem.
Risk factors: Diabetes
Everolimus (Afinitor) can raise your blood sugar, cholesterol, and triglyceride (a type of fat) levels. Because of this, your provider will work with you to make sure your blood sugar and lipid levels are within a healthy range before you start everolimus (Afinitor). They’ll also order lab work to check your sugar and lipid levels yearly while you’re receiving treatment. If you have diabetes, your provider will check your blood sugar levels more often. If your blood sugar or lipid levels aren’t within a healthy range and are difficult to control with medications, diet, and exercise, then your provider might recommend that you stop taking this medication.
Risk factors: Previous, current, or subsequent radiation therapy
Everolimus (Afinitor) can cause inflammation around the areas of radiation you receive, both on your skin or inside your body. This medication can also make you more sensitive to the effects of radiation and cause more side effects. This can happen if you receive radiation therapy before, during, or after treatment with everolimus (Afinitor).
Based on animal studies, everolimus (Afinitor) can harm an unborn baby. Because of this risk, regardless of your sex, you should use birth control during treatment with everolimus (Afinitor) to prevent pregnancy. After treatment, continue to use birth control for another 8 weeks (for females) or 4 weeks (for males). Let your provider know right away if you or your partner becomes pregnant during this time.
Everolimus (Afinitor) can also affect your ability to have a baby. If you or your partner are thinking about having a child in the future, talk to your provider about your different options before starting everolimus (Afinitor), such as sperm banking or egg freezing.
Breast cancer, neuroendocrine tumors, kidney cancer, or TSC-associated kidney tumor
Afinitor and generic everolimus tablet only: The typical dose is 10 mg by mouth once daily.
TSC-associated brain tumor
Afinitor, Afinitor Disperz, and generic everolimus tablet: Your provider will determine your dose base on your body surface area (BSA, in units of m2), which takes into account your body weight and height. The typical starting dose is 4.5 mg/m2 by mouth once daily.
TSC-associated seizures
Afinitor Disperz only: Your provider will determine your dose base on your body surface area (BSA, in units of m2), which takes into account your body weight and height. The typical starting dose is 5 mg/m2 by mouth once daily.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Allergy to everolimus (Afinitor) or other rapamycins, including sirolimus (Rapamune) and temsirolimus (Torisel)
Breast cancer (hormone receptor-positive, HER2-negative)
Neuroendocrine tumors (NET)
Kidney cancer (renal cell cancer or RCC)
Tuberous sclerosis complex (TSC)-associated kidney tumor
Tuberous sclerosis complex (TSC)-associated brain tumor (people age 1 years and older)
Tuberous sclerosis complex (TSC)-associated seizures (people age 2 years and older)
Acromegaly in people who either can't get surgery or radiation, or for whom surgery or radiation didn't work well
Certain type of tumor in the gut (gastroenteropancreatic neuroendocrine tumors (GEP-NETs))
Symptoms from certain types of tumor (carcinoid syndrome) - Somatuline Depot only
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American Cancer Society. (2020). Radiation therapy side effects.
American Cancer Society. (2020). What is kidney cancer?Â
American Red Cross. (n.d.). Platelets and thrombocytopenia.
Burris III, H. A., et al. (2010). Radiation recall with anticancer agents. The Oncologist. Â Â Â
Centers for Disease Control and Prevention. (2023). Child & adolescent immunization schedule.
DÃez, M., et al. (2013). Gastroenteropancreatic neuroendocrine tumors: Diagnosis and treatment. Annals of Gastroenterology.Â
Krueger, D. A., et al. (2010). Everolimus for subependymal giant-cell astrocytomas in tuberous sclerosis. The New England Journal of Medicine.Â
Lin, C., et al. (2017). Tuberous sclerosis-associated renal angiomyolipoma: A report of two cases and review of the literature. Molecular and Clinical Oncology.Â
National Cancer Institute Dictionary of Cancer Terms. (n.d.). Neuroendocrine tumor.
National Center for Chronic Disease Prevention and Health Promotion. (n.d.). Neutropenia and risk for infection.
National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Acromegaly.
Novartis Pharmaceuticals Corporation. (2023). AFINITOR- everolimus tablet; AFINITOR DISPERZ- everolimus tablet, for suspension. DailyMed.Â
Pandit, S., et al. (2023). Carcinoid syndrome. StatPearls.Â
Teva Pharmaceuticals USA, Inc. (2022). EVEROLIMUS tablet. DailyMed.
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