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This information is about Nilotinib, which is also known as Tasigna®. It may be used to treat people with a type of leukaemia called chronic myeloid leukaemia (CML)|.
Nilotinib is a type of treatment called a tyrosine kinase inhibitor. It works by blocking (inhibiting) signals within the leukaemia cells that make them grow and divide. Blocking the signals causes the leukaemia cells to die.
Nilotinib may be prescribed when you're no longer being helped by imatinib| (Glivec®) or if you can't take it because of the side effects. Nilotinib may also be used to treat other types of cancer as part of a clinical trial|.
Although nilotinib is licensed and can be prescribed in the UK, it's still being assessed by the National Institute for Health and Clinical Excellence (NICE|). NICE currently gives advice on which new drugs or treatments should be available on the NHS. As a result, nilotinib may not be widely available on the NHS, although you may be given it as part of a clinical trial.
In Scotland, the SMC |(Scottish Medicines Consortium) has approved nilotinib for people who are in the chronic phase of their leukaemia.
Nilotinib is available as 200mg and 150mg capsules. It's usually taken twice daily, 12 hours apart. Take the capsule on an empty stomach with a large glass of water. It’s important you don’t eat for two hours before or for one hour after taking nilotinib as this may increase the side effects.
It’s also important you don’t drink grapefruit juice or eat grapefruit while you're taking nilotinib as this can increase the side effects.
Nilotinib is a long-term treatment and you carry on taking it for as long as your specialist doctor (haematologist) tells you. You'll have regular blood tests to see how well it’s working for you.
Each person’s reaction to cancer treatment is different. Some people may have very few side effects while others may experience more. The side effects of nilotinib are generally mild or moderate.
We have outlined the most common side effects but haven't included those that are rare and unlikely to affect you. As it’s still a new drug it’s too early to know everything about the possible side effects.
If you notice any effects that you think may be because of the drug, but are not listed here, let your nurse or doctor know. This is particularly important if the problem is putting you off taking nilotinib.
Nilotinib can reduce the number of white blood cells produced by the bone marrow, making you more prone to infection.
You'll have a blood test before having more treatment to make sure that your blood cells have recovered. Occasionally it may be necessary to delay your treatment if the number of your blood cells (blood count) is still low.
Nilotinib can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. They will advise you about this and any precautions you should take. You may need to have a platelet transfusion| if your platelet count is low.
You may become anaemic while having treatment with nilotinib. This can make you feel tired| and breathless|. Tell your doctor or nurse if these you have these symptoms. You may need to have a blood transfusion| if the number of your red cells becomes too low.
This is usually mild. Your doctor can prescribe effective anti-sickness (anti-emetic) drugs| to prevent or reduce this.
A dietitian or specialist nurse at the hospital can give you advice and tips on boosting your appetite|, coping with eating difficulties and maintaining weight.
Some people have headaches when taking nilotinib. Let your doctor know if you get any headaches as painkillers| can be given to help.
Tiredness is common but usually mild. It’s important to give yourself plenty time to rest.
Your skin may become dry and itchy or you may develop a mild skin rash. Making sure you drink enough fluids can help. Your doctor can prescribe medicine or creams to help with this.
This can usually be controlled easily with medicine but tell your doctor if it's severe or if it continues. It’s important to drink plenty of fluids if you have diarrhoea|.
Constipation| can be helped by drinking plenty of fluids, eating a high-fibre diet and doing some exercise. Sometimes you may need to take medicines to stimulate your bowel (laxatives). Your doctor can prescribe these.
You'll have regular blood tests taken to check how well your liver and kidneys are working.
Some people have pain| or discomfort in their tummy when taking nilotinib.
A small number of people may notice a change in their heart rhythm with nilotinib. Heart beats may become less regular or the heart may feel as if it's beating too fast. If you notice any changes in your heart rhythm or pain in your chest, let your doctor know straight away. Some people may have an increase in their blood pressure while taking nilotinib.
You may have muscle joint or bone pain while having treatment. Your doctor can prescribe painkillers to ease this.
This can affect different parts of the body. Most commonly it causes swelling of the ankles or swelling around the eyes. Drugs that make you pass more urine (diuretics) can help to get rid of some of the fluid. A short course of steroids may also be helpful. Usually, fluid retention settles without treatment.
Sometimes fluid may collect in the lining of the lungs (pleural effusion) or rarely in the abdominal space (ascites) or in the sac around the heart (pericardial effusion).
If you develop a cough, chest pain, are feeling more breathless than usual, or if you gain weight suddenly, let your doctor know straight away.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they're not mentioned above.
Some medicines can be harmful to take when you're taking nilotinib. Let your doctor know about any other medicines you're taking, including those bought over the counter and herbal medicines|.
More research needs to be done to find out how nilotinib affects fertility|.
We don’t know a lot about the effects of nilotinib on a developing baby so it’s not advisable to become pregnant or father a child while taking this treatment. It’s important to use effective contraception while taking this drug and for at least a few months afterwards.
Nilotinib may be passed on in breast milk. Therefore breastfeeding should be stopped before starting treatment.
This information has been compiled using information from a number of sources, including:
electronic Medicines Compendium (eMC). (accessed 27th September 2010).
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