This leaflet provides information on a course of treatment called regorafenib. The leaflet will explain what this is and when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers are given at the end of the leaflet.
What is regorafenib?
Regorafenib is a cancer treatment which is given as tablets.
Why am I having regorafenib?
Regorafenib has been found to help some patients with your type of cancer.
How often will I see the specialist team?
You will see the specialist team every 4 weeks. You will have regular blood tests and 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.
Can I bring relatives and friends with me?
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
How should I take the regorafenib tablets?
Regorafenib tablets should be taken once a day. Try to take them at approximately the same time every day. Take the tablets after a light meal which is low in fat, (for example: avoid butter, cheese and cream). The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed.
How many regorafenib tablets will I need to take?
It is usual to take four 40mg tablets daily but sometimes your doctor may alter the dose. The amount you need to take will be clearly marked on the box.
It is usual to take the tablets for three weeks and then have one week off. You will see the medical team every four weeks
What should I do if I forget to take my tablets?
If you forget to take your tablets, you can take them the same day, however you must not take two doses in the same day.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is on page 7. 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.
Nausea and vomiting, loss of appetite
Loss of appetite varies from person to person and some people may have a problem with nausea and vomiting. If you do have these symptoms please tell your doctor or
nurse. They can give you anti-sickness medication to take at home.
Hair loss
You may experience hair thinning or hair loss with this chemotherapy. This is temporary and your hair will grow back when you finish your chemotherapy. We can arrange a wig if you would like one, please ask your nurse for more information.
We have a leaflet on coping with hair loss. Please ask your nurse if you would like a copy.
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 on page 7.
Tiredness and fatigue
Regorafenib 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.
Soreness to your hands and feet
You may experience mild pain, redness and swelling of your hands or feet. If this occurs we recommend using a non perfumed cream or lotion regularly. Please contact Velindre Cancer Centre if your hands or feet become painful.
Sore mouth
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. 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 regorafenib tablets and contact Velindre Cancer Centre for advice. The telephone number is on page 7.
Bleeding
Regorafenib may cause bleeding problems. Tell your doctor if you take any medicines that may affect bleeding, such as aspirin, warfarin or vitamin E. If you cough or vomit blood or pass blood in your stools, inform your doctor.
High blood pressure
Regorafenib can cause an increase in blood pressure in some people. Your blood pressure will be checked regularly during your treatment. If you have headaches, nosebleeds or feel dizzy let your doctor know. High blood pressure can usually be controlled with tablets prescribed by your doctor
Infection
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. Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade. The telephone number is on page 7.
Bowel perforation
A small number of patients can develop a small hole in the wall of the bowel (perforation). This is rare, but if you develop any abdominal pain, swelling, pass blood in stool or vomit blood contact Velindre Cancer Centre for advice.
Skin changes
Regorafenib may cause a rash, itching, peeling, redness and blistering to the skin. If this happens telephone Velindre Cancer Centre.
Blood clots
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
Other side effects and information
Some people may experience problems with headaches. Try taking the painkillers you would normally take for a headache. If you find that painkillers do not help or you have any problems with your vision please tell your doctor or nurse.
Wounds may take longer to heal while you are having treatment with regorafenib.
Regorafenib may cause heart problems. If you have a heart condition or you take any heart medication please tell your doctor before you start chemotherapy.
Is it alright to take other medicines?
Please tell your doctor, nurse or pharmacist if you take other medicines. There are a small number of medicines that you may have to avoid. Please tell your doctor, nurse or pharmacist if you take warfarin tablets.
Avoid drinking grapefruit juice whilst taking regorafenib.
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.
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
cancer helpline
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.