Nilotinib is used to treat Philadelphia chromosome-positive Chronic Myelogenous Leukaemia (CML). CML is a type of cancer where the bone marrow produces too many white blood cells called granulocytes.
This medicine is used for the newly-diagnosed, or for those who are no longer benefiting from previous treatment, or those had experienced serious side effects from previous treatment.
Take Nilotinib exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take it on an empty stomach, at least 2 hours before or 1 hour after a meal. Try to take it at the same time each day.
Swallow the capsules whole with a glass of water. If you are unable to swallow capsules, you may open each capsule and dissolve its contents in one teaspoon of applesauce, then take it immediately. Do not use any food other than applesauce.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the dosage and treatment timeframe depending on your condition and response to the medication.
Nilotinib must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
If you miss a dose, do not take the missed dose. Take only at your next scheduled dose.
DO NOT double a dose to make up for a missed dose.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- hypokalaemia (low potassium level in the blood)
- hypomagnesaemia (low magnesium level in the blood)
- heart rhythm disorder
as Nilotinib may not be suitable for you.
Do not take Nilotinib with certain antibiotics, medicines used to treat fungal infections or medicines for heart disease. Please see the section “Can I take this with other medicines?” below for more information.
Inform your doctor if you have the following conditions:
- heart disease
- history of pancreatitis (inflamed pancreas)
- liver disease
- had a surgical procedure known as gastrectomy (removal of a part or all of the entire stomach)
Let your doctor know if you are pregnant or breastfeeding. It is important that you do not get pregnant while you are being treated with Nilotinib. You must use proven birth control methods during the treatment and for at least 2 weeks after stopping the treatment. You may wish to discuss birth control methods with your doctor or pharmacist.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly. Routine tests (e.g. ECG, liver function, blood count monitoring, bone marrow assessment) may be done while you are being treated with this medicine. Your doctor will advise you about how often you will need to have these tests.
Nilotinib may cause any of the following side effects: headache, nausea, vomiting, constipation, diarrhoea, stomach pain, dry mouth, dizziness, tiredness, hair loss, muscle pain, joint pain, bone pain, cough, difficulty sleeping, rash, itch and dry skin.
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- chest pain or discomfort, irregular heartbeat, palpitations, shortness of breath
- signs of liver problems e.g. yellowing of the skin or eyes, abdominal pain, loss of appetite, dark coloured urine
- signs of pancreas problems e.g. severe abdominal pain, nausea and vomiting
- rapid weight gain, swelling of hands, ankles, feet or face
- mood changes, confusion, muscle pain or weakness
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Individual's genetic traits are unique from each other. Researchers say that certain genetic traits such as (TA)
7/(TA)
7 genotype may enhance Nilotinib's side effects. Though not routinely done, but in some exceptional cases, your doctor may advise you to take genetic testing to check if this drug is best suited for you. If you know you have this gene type, inform your doctor.
Do not take Nilotinib with the following medicines:
- certain antibiotics e.g. clarithromycin, telithromycin
- medicines to treat fungal infections e.g. ketoconazole, itraconazole, voriconazole
- medicines for HIV infection e.g. ritonavir
- medicines to treat irregular heartbeat e.g. amiodarone, disopyramide, procainamide, quinidine, sotalol
Inform your doctor and pharmacist if you are taking any of these medicines:
- haloperidol (medicine used for mood disorders)
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, phenobarbital
- medicines to treat TB (infection known as tuberculosis) e.g. rifampicin
- medicines used in organ transplant or certain immune disorders e.g. ciclosporin, tacrolimus, sirolimus
- St. John’s Wort (herbal medicines)
This list does not include all medicines that may interact with Nilotinib.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
As Nilotinib is a cancer medicine, always return any unused or expired capsule to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.
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