What is axitinib?
Axitinib is a cancer treatment, known as a targeted treatment, it is not chemotherapy. It is given as tablets.
Why am I having axitinib?
Your doctor has prescribed this therapy because Axitinib has been found to help some patients with your type of cancer, when other treatments have stopped working.
How often will I see the specialist team?
You will see the specialist team every 2 weeks for the first 2 months of treatment. You will have regular blood tests (and blood pressure measurements, we will check how you are feeling and discuss any problems you may have. This is so we can check how the treatment is affecting you.
How should I take the axitinib tablets?
Axitinib tablets are usually taken twice a day, approximately 12 hours apart. Try to take them at approximately the same time every day. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed. They can be taken with or without food.
They contain lactose so inform your cancer doctor if you have lactose intolerance.
How many axitinib tablets will I need to take?
Axitinib comes in different doses. The amount you need to take will be clearly marked on the boxes. Remember to check each box to see how many tablets you need to take. It is usual for the doctor to change the dose of tablets depending on how you cope with the dose.
What should I do if I forget to take my tablets?
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.
What if I vomit?
If you vomit after taking your axitinib do not try to take another dose, wait until your next tablet is due.
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.
Can I bring relatives and friends with me?
Currently due to the need to ensure 2m space between patients during COVID-19 we do not usually allow anyone to stay with you during your treatment. If you have any concerns about this please speak to your team before your treatment starts. We may be able to make some exceptions but we will need to be aware of this before the day of treatment.
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.
Sickness
You may have nausea or vomiting with axitinib. We will give you anti sickness tablets to take if you need them. If 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.
Diarrhoea
You may have diarrhoea with this treatment. If this occurs it is important that you drink plenty of fluids. We will give you loperamide tablets to control diarrhoea. If you have four or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
Constipation
You may also have constipation with Axitinib. Drink 2-3 litres of fluids/day and eat lots of fruit, vegetables and fibre. If you have constipation, your GP will be able to give you medication to help.
Raised blood pressure
There is a risk that axitinib may cause an increase in your blood pressure. We will check your blood pressure before you start treatment and monitor it regularly whilst you are receiving treatment. Please tell your doctor if you are receiving any treatment for blood pressure. If there is a rise in your blood pressure during treatment, you may need to be started on blood pressure medication. If you are already taking blood pressure medication these may need to be changed. Sometimes patients develop protein in their urine, this may be monitored in clinic.
Tiredness and fatigue
Axitinib 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 rest. One of the reasons axitinib may make you feel tired is that it can cause a low thyroxin level. We will monitor this regularly with blood tests at your clinic visits.
Sore mouth
Your mouth may become sore or you may notice small ulcers. Your doctor may prescribe mouthwashes or medication to prevent or clear any infection.
If your mouth becomes very painful or you are finding it difficult to eat and drink, you should stop taking your axitinib tablets and contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Skin reactions
You may experience dry skin, rash or skin reaction with axitinib.
To help prevent this we suggest you should:
You may also experience painful or red hands and feet. Moisturise your hands and feet twice daily. If the hands or feet becomes cracked or blistered or you develop a severe skin reaction which is causing you pain or stopping you carrying out your normal activities, please contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
This skin reaction is temporary and will resolve completely after you have finished treatment
Bleeding
Axitinib may sometimes cause your platelets to drop. This may cause bleeding problems. If you bruise excessively or have excessive nose bleeds ring the treatment helpline. The telephone number is at the end of the leaflet.
Anaemia
Sometimes, Axitinib can cause you to become anaemic. Your team will monitor your bloods to check for anaemia. However, if you feel very tired or short of breath on slight exertion, ring the treatment helpline, and we can check for anaemia.
Voice changes
Some people may find that they develop changes in their voice which may include hoarseness or losing their voice.
Other side effects
Rarely axitinib can cause neurological problems which result in severe headaches, visual disturbances, confusion and severe sleepiness or possibly fitting. If any of these symptoms occur you should stop taking your axitinib and contact Velindre cancer centre for advice.
Very rarely some people having axitinib may experience breathing problems caused by the tablets. If you notice new breathing problems, please contact your doctor or specialist nurse. You will be monitored at regular clinic visits.
Axitinib may make your thyroid work less effectively which may make you feel very tired. We will check how well your thyroid is working during your treatment.
If you feel dizzy with the Axitinib avoid driving.
You may develop joint pains with Axitinib, if you do, discuss this with your cancer doctor.
Wounds may take longer to heal while you are having treatment with Axitinib and rarely patients can be at risk of fistulas. If you are admitted to hospital, especially for any surgery, it is important that you tell them you are taking Axitinib capsules.You should take your Axitinib capsules with you to the hospital.
Some patients experience abdominal pain/indigestion whilst taking Axitinib. Inform your cancer doctor when next in clinic.
Very rarely,a small number of patients can develop a small hole in the wall of the bowel (perforation). If you develop any severe abdominal pain or swelling contact the treatment helpline for advice.
Pregnancy
It is important you do not become pregnant or father a child whilst having treatment or for at least 1 month afterwards. You need to use contraception if you are of childbearing age. This is because axitinib could damage the unborn baby. You must not breastfeed whilst on this treatment
Is it alright to take other medicines?
If you are taking other medicines please let your doctor, nurse or pharmacist know. There are a small number of medicines that you may have to avoid. These include St. John’s Wort and you should also avoid grapefruit or pomegranate fruit/juice as this interferes with the way that axitinib works. Do not take over the counter medication, without consulting your cancer doctor.
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 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
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.
Prepared November 2012,
Updated 2014, Sept 2018