Adjuvant Abemaciclib A1540 (Verzenios)
What is Abemaciclib?
Abemaciclib is a targeted (biological) therapy, it is not chemotherapy. This group of drugs block the growth and spread of cancer. They target and interfere with processes in the cells that cause cancer to grow. When used to treat breast cancer, Abemaciclib is taken alongside hormone (endocrine) therapy.
Why am I having Abemaciclib?
Abemaciclib has been found to reduce the risk of the breast cancer recurring, when used with hormone therapy tablets. It is important you take your hormone therapy tablets (Tamoxifen or letrozole) each day whilst on Abemaciclib and if pre or peri menopausal have your Zoladex or prostap injections regularly also .
How often will I be assessed or need bloods taken ?
You will need to have regular blood tests, two weekly for the first 2 months, 4 weekly until 6 months then 12 weekly for the rest of the 2 years. We will also telephone once we have your blood result each time, to check how you are feeling and discuss any problems you may have. You can have your bloods done locally therefore no need to come to Velindre Cancer Centre.
How should I take the Abemaciclib tablets?
Abemaciclib tablets should be taken twice a day every day. Try to take them at approximately the same time every day, morning and evening. The tablets can be taken with or without food. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed. Do not take any tablets that are broken in any way.
Do not take grapefruit or grapefruit juice at any time whilst taking Abemaciclib.
How many Abemaciclib tablets will I need to take?
The amount you need to take will be clearly marked on the box. The dose may alter depending on if you are experiencing any side effects such as diarrhoea. It is not unusual to get some minor side effects in the first few months and we alter the dose as a result of how you are feeling.
What should I do if I forget to take my tablets?
If you forget to take your tablets, miss the dose and take the dose as normal the next day.
If you vomit after taking a dose, do not repeat the dose. Take your next dose at your normal time.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet. Please ask for the chemotherapy pager.
How should I store the tablets?
Your tablets should be stored in their original packaging and in a safe place away from children. They should be kept in a cool dry place (below 25oC).
Any unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.
What are the possible side effects?
This treatment is usually well tolerated but there are some possible side effects that you need to be aware of. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Diarrhoea is a very common side effect of Abemaciclib. This is usually worst in the first month of treatment. If you have diarrhoea you should take the anti-diarrhoea treatment, loperamide. Take 2 loperamide capsules as soon as you have your first liquid stool, then take 1 capsule with each liquid stool. The maximum dose of loperamide is 8 tablets in any 24 hour period. Try to drink 2-3 litres of fluids a day. If you have 4 episodes of diarrhoea, whilst taking loperamide, telephone the treatment helpline; the telephone number is at the end of the leaflet.
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.
Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade or if your temperature is below 35.5°. The telephone number is at the end of the leaflet.
Tiredness and fatigue
The treatment can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as taking rest.
Loss of taste, appetite or sickness
You may experience a loss of taste and appetite. Try stronger flavoured foods to help with loss of taste. Eat smaller, more regular meals to help with appetite. Some people may have nausea or vomiting. Take anti-sickness medication to help with this. However, if this doesn’t help or you are sick more than once in 24 hours despite taking regular anti-sickness medicine, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Anaemia (low number of red blood cells)
While having this treatment you may become anaemic. This may make you feel tired and breathless.
Let your doctor or nurse know if these symptoms are a problem. If needed, we can arrange a blood transfusion.
Abemaciclib may reduce the production of platelets (which help the blood to clot). This will increase your risk of bruising or bleeding. If you notice any excessive bruising on your body or bleeding such as nosebleeds or bleeding from your gums you should contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
This treatment should not make you lose your hair. However, some people may experience hair thinning. We have a leaflet that tells you more about coping with hair loss, if needed. Please ask your nurse if you would like a copy.
Some patients will develop a rash. Usually this can be easily treated with some non-perfumed cream or lotion.
If this becomes itchy or widespread, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Other side effects:
Occasionally you can feel dizzy with Abemaciclib. Avoid driving if you feel dizzy.
Abemaciclib can sometimes affect your liver function, your bloods will be monitored for this in clinic.
Pregnancy and breast-feeding
It is important you do not become pregnant whilst having treatment. This is because Abemaciclib could damage the unborn baby. You need to use barrier contraception during treatment and for at least 3 weeks after completing Abemaciclib. In addition, it should not be used whilst breast feeding.
Is it alright to take other medicines?
In clinic your doctor will discuss your current medicines with you before starting Abemaciclib. If you are prescribed other medicines, whilst on a course of Abemaciclib please let your doctor, nurse or pharmacist know at Velindre, as there are many medications which should not be taken with Abemaciclib.
There are also many over the counter medicines that you may have to avoid, you need to check with your pharmacist before taking any over the counter medication.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor/ nurse immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
For urgent advice at any time of the day or night please ask for the treatment helpline
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
Macmillan freephone Helpline 0808 808 0000
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.