Nilonib

Indications

Nilotinib is a targeted cancer medicine. It is used to treat Philadelphia chromosome positive chronic myeloid leukaemia (CML), a blood cancer, in adults and children, both in newly diagnosed patients and in those whose disease did not respond to, or who could not tolerate, earlier treatment such as Imatinib.

How It Works

In CML, an abnormal gene makes a faulty enzyme called BCR-ABL tyrosine kinase that drives cancer cells to grow. Nilotinib blocks this enzyme, slowing or stopping the growth of leukaemia cells.

Dosage and Administration

Take exactly as prescribed by your cancer specialist. Capsules are usually taken twice a day, about 12 hours apart, on an empty stomach: do not eat for 2 hours before and 1 hour after each dose, because food raises the amount absorbed and the risk of heart rhythm problems. Swallow capsules whole with water. Do not change or stop the dose yourself. Regular blood tests and heart tracings (ECG) are needed.

Interactions

Avoid grapefruit and grapefruit juice. Strong CYP3A4 blockers such as Ketoconazole, Itraconazole, Clarithromycin and Ritonavir raise its level; inducers such as Rifampicin, Carbamazepine, Phenytoin and St John's Wort lower it. Avoid other medicines that prolong the QT interval, such as Amiodarone, Sotalol, Haloperidol and Methadone. Antacids and acid reducers may need spacing. Tell your doctor about every medicine you take.

Contraindications

• Allergy to nilotinib or any ingredient
• Low potassium or magnesium that has not been corrected
• Long QT syndrome

Side Effects

Common effects include rash, itching, headache, nausea, tiredness, muscle and joint pain, hair thinning, constipation or diarrhoea, low blood counts, raised blood sugar and cholesterol, and raised liver and pancreas enzymes. Long term use can increase the risk of narrowing of the arteries in the heart, brain or legs.

Get urgent medical help for fainting, a fast or irregular heartbeat, chest pain, sudden weakness or numbness, severe tummy pain, signs of bleeding, fever or signs of infection, or yellow skin or eyes.

Pregnancy and Lactation

Nilotinib may harm an unborn baby. Women should use reliable contraception during treatment and for at least 2 weeks after the last dose. Do not breastfeed during treatment and for at least 2 weeks after the last dose.

Precautions and Warnings

Your doctor will check potassium, magnesium, ECG, blood counts, liver tests, blood sugar and lipids. Tell your doctor about heart, liver or pancreas disease, or past stomach surgery. Do not stop without medical advice.

Overdose

Overdose may cause low blood counts, vomiting and drowsiness and may affect heart rhythm. Seek emergency help.

Therapeutic Class

Antineoplastic; tyrosine kinase inhibitor

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep in the original pack.