Everolimus is also known as Afinitor®. It is a targeted therapy drug that is used to treat some advanced types of cancers.

What is everolimus (Afinitor®)?

Everolimus (Afinitor®) is a targeted therapy drug. It is used to treat some types of cancers that have spread (advanced). These types of cancer include:

Everolimus is also used with a hormonal therapy drug called exemestane, to treat secondary (advanced) breast cancer

It is best to read this information with our general information about targeted therapies and the type of cancer you have. 

Targeted therapies target something in or around the cancer cell that is helping it to grow and survive. Everolimus is a type of targeted therapy called a cancer growth inhibitor. This works by blocking signals that tell cancer cells to grow and divide. It also blocks signals that help cancer cells develop a blood supply, so it is an angiogenesis inhibitor as well.

Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

How everolimus is given

You have everolimus as a tablet, which you can take at home. It may be given on its own, or with other cancer drugs. 

During treatment you see a cancer doctor, a specialist nurse and a specialist pharmacist. This is who we mean when we mention doctor, nurse or pharmacist in this information. 

You are given everolimus as an outpatient. The specialist nurse or pharmacist gives you the tablets to take home. You may be given tablets of different strengths. Always take them exactly as explained. This is important to make sure they work as well as possible for you. Everolimus can reduce the number of blood cells in your blood. It may also affect your blood sugar and cholesterol levels, and your kidneys and liver. You have regular blood tests before and during treatment. This is to check for any changes and make sure that your blood test results are at a safe level to continue treatment. 

Your nurse, pharmacist or doctor will talk to you about your test results and ask you how you have been feeling. Sometimes your treatment may be delayed for a short time until side effects improve. You may also have your next dose of treatment reduced.

You keep taking everolimus for as long as it is working for you and side effects can be managed. It is important that you do not stop taking it without talking to your doctor.

Taking everolimus tablets

Everolimus tablets must be swallowed whole with a glass of water. They should not be chewed, broken or crushed. You can take them with or without food, but do the same thing each day. Take them at the same time every day.

Do not eat grapefruit or drink grapefruit juice while you are having this treatment. This can change how effective the drug is.

Other things to remember about your tablets:

  • If you forget to take the tablets, do not take the missed dose. Instead, take the next dose as usual. Do not take a double dose to make up for the tablets you did not take. Let your doctor or nurse know.
  • If you are sick just after taking the tablets, contact the hospital. Do not take another dose.
  • Keep the tablets in the original package and at room temperature, away from heat and direct sunlight.
  • Keep them safe and out of sight and reach of children.
  • Other people should avoid direct contact with everolimus tablets. 
  • It is important to get a new prescription before you run out of tablets and make sure you have plenty for holidays.
  • If your treatment is stopped, return any unused tablets to the pharmacist. 

About side effects

We explain the most common side effects of this treatment here. We also include some that are less common.

You may get some of the side effects we mention, but you are unlikely to get all of them. And you may have some side effects, including rarer ones, that we have not listed here. 

Always tell your doctor, nurse or pharmacist about any side effects you have. They can give you: 

  • drugs to help control some side effects
  • advice about managing side effects. 

It is important to take any drugs exactly as explained. This means they will be more likely to work for you. 

Serious and life-threatening side effects

Some cancer treatments can cause serious side effects. Sometimes, these may be life-threatening. Your doctor, nurse or pharmacist can explain the risk of these side effects to you.

Contact the hospital

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Common side effects

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If your white blood cell count is low, you may be more likely to get an infection. A low white blood cell count is called neutropenia.

An infection can be very serious when the number of white blood cells is low. It is important to get any infection treated as soon as possible. If you have any of the following symptoms, contact the hospital straight away on the 24-hour number:

  • a temperature above 37.5°C 
  • a temperature below 36°C
  • you feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

  • feeling shivery and shaking
  • a sore throat
  • a cough
  • breathlessness
  • diarrhoea
  • needing to pass urine (pee) often, or discomfort when you pass urine.

It is important to follow any specific advice your cancer treatment team gives you.

You will have regular blood tests during treatment. If your white blood cell count is low, your doctor may stop your treatment for a short time, until your cell count increases. Sometimes they will reduce the dose of your treatment.

Bruising and bleeding

This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot.

If the number of platelets is low, you may bruise or bleed easily. You may have:

  • nosebleeds
  • bleeding gums
  • heavy periods
  • blood in your urine (pee) or stools (poo)
  • tiny red, brown or purple spots that may look like a rash – these spots can be harder to see if you have black or brown skin. 

If you have any unexplained bruising or bleeding, contact the hospital straight away on the 24-hour number. You may need a drip to give you extra platelets. This is called a platelet transfusion.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may feel:

  • very low in energy
  • breathless 
  • dizzy and light-headed. 

If you have these symptoms, contact the hospital straight away on the 24-hour number. You may need treatment for anaemia. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Sore mouth and throat

This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get an infection in your mouth or throat. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth or throat is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco and foods that irritate your mouth and throat.

Skin and nail changes

This treatment may affect your skin. It may cause a rash, which might be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.

This treatment can also affect your nails. Always tell your doctor or nurse about any changes to your skin or nails. They can give you advice and may prescribe creams or medicines to help.

Tell your doctor straight away if you have a severe rash.

Hair loss

Your hair may get thinner. But you are unlikely to lose all the hair from your head. Your nurse can talk to you about ways to cope with hair loss.

Tiredness and sleeping problems

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Everolimus can also cause problems with sleeping (insomnia). If you are having difficulty sleeping, tell your doctor.


This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is normal for you, or having watery or loose stools. You may also have stomach cramps. If you have a stoma, it may be more active than usual. 

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

  • taking anti-diarrhoea medicines 
  • drinking enough fluids to keep you hydrated and to replace lost salts and minerals
  • any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

Feeling sick

Your doctor, nurse or pharmacist will prescribe anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as they tell you to, even if you do not feel sick. It is easier to prevent sickness than to treat it after it has started.

If you feel sick, take small sips of fluid often and eat small amounts regularly. It is important to drink enough fluids. If you continue to feel sick, or if you are sick (vomit) 1 to 2 times in 24 hours, contact the hospital on the 24-hour number as soon as possible. They will give you advice. They may change your anti-sickness treatment. Let them know if you still feel sick.

Changes to your taste

You may get a bitter or metal taste in your mouth. Sucking sugar-free sweets may help with this. Some foods may taste different or have no taste. Try different foods to find out what tastes best to you. Your nurse can give you more advice.

Loss of appetite or weight loss

Some people lose their appetite while they are taking everolimus. If you have a poor appetite, try to eat small amounts as often as possible. Keep snacks, such as nuts or dried fruit, handy to eat whenever you can. If you are finding it difficult to eat or you are losing weight, ask to see the dietitian at your hospital. They can give you advice on how to boost your appetite and maintain your weight. Our information on the building-up diet has useful tips.

Lung changes

This treatment can cause an inflammation in the lungs, called pneumonitis. This can cause:

  • breathlessness
  • wheezing
  • a high temperature
  • a dry cough
  • pain in your chest when you breathe in.

If you have any of these symptoms, contact your hospital straight away using the 24-hour contact number you have been given.

Pneumonitis can be mild and may not always need treatment. But if it is more severe your doctor may treat it with drugs that reduce inflammation (steroids).

Raised blood sugar levels

This treatment may raise your blood sugar levels. You will have regular blood tests to check this. Symptoms of raised blood sugar include:

  • feeling thirsty
  • needing to pass urine (pee) more often 
  • feeling tired. 

If you have these symptoms while having this treatment, tell your doctor or nurse. 

If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this.

High cholesterol

Everolimus can increase the amounts of cholesterol (fats or lipids) in your blood. Your doctor will take blood tests during your treatment to check for this.

Build-up of fluid

Some people get swelling around their eyes, or in their hands, ankles or feet, because of fluid build-up. This often improves by itself but tell your doctor if you have swelling anywhere on your body. They may give you drugs to help.


This treatment may cause headaches. If you have headaches, tell your doctor, nurse or pharmacist. They can give you advice about painkillers that may help. Tell them if the headache does not get better, or gets worse.

High blood pressure

Everolimus can cause high blood pressure in some people. You will have your blood pressure checked regularly. Some people may need to take tablets to control their blood pressure.

If you already have high blood pressure and are on treatment to control it, you will have regular blood pressure checks. Talk to your doctor if you have any concerns.

Joint pain

Some people have joint pain while having treatment. Your doctor can prescribe painkillers to help.

Indigestion and abdominal pain

Some people have indigestion or acid reflux (acid coming up from the stomach into the gullet) and pain in the tummy area (abdominal pain) when taking everolimus. Tell your doctor if this affects you. They can give you medicines to help.

Less common side effects

Allergic reaction

Rarely, some people have an allergic reaction to everolimus. Contact the hospital straight away if you develop:

  • red, warm and itchy bumps on the skin (like nettle rash)
  • swelling of the lips, tongue or throat
  • breathlessness, wheezing, a cough or sudden difficulty breathing
  • a tight chest or chest pain.

If you do have a reaction, it can be treated quickly.

Effects on the kidneys and liver

Everolimus can affect how your kidneys and liver work. This is usually mild and goes back to normal after treatment. You will have blood tests before starting everolimus to check how well your kidneys and liver are working.

If you pass less urine or stop passing urine, contact your doctor straight away.

Effects on the heart

This treatment can affect how the heart works.

If you have any of these symptoms during or after treatment, contact your doctor straight away on the 24-hour number the hospital has given you:

  • swelling in your feet or legs 
  • breathlessness 
  • a persistent cough
  • dizziness
  • a fast heart rate.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor. If you cannot get through to your doctor, call the NHS urgent advice number on 111.

Hand-foot (palmar-plantar) syndrome

This treatment can affect the palms of your hands and the soles of your feet. This is called palmar-plantar or hand-foot syndrome. 

If you have white skin these areas may become red. If you have black or brown skin, these areas might get darker. 

The skin on the palms of your hands and the soles of your feet may:

  • be sore
  • be painful, tingle, or swell
  • peel, crack or blister. 

If you have any of these symptoms, contact the hospital straight away on the 24-hour number. They can give you advice. This is especially important if you have any broken skin or if walking is difficult. They can prescribe creams and painkillers to help.

You can care for your hands and feet by: 

  • keeping your hands and feet cool by washing in cool water
  • gently moisturising your hands and feet regularly
  • wearing gloves to protect your hands and nails when working in the house or garden
  • wearing loose cotton socks and avoiding tight-fitting shoes and gloves.

Slow-healing wounds

Wounds may take longer to heal while you are having treatment with everolimus. If you have any surgery planned, you may need to stop treatment for a few weeks before and after the operation. Your doctor will give you more advice.

Numb or tingling hands or feet (peripheral neuropathy)

This treatment may affect the nerves in your fingers and toes. This can cause numbness, tingling or pain in your hands or feet. This is called peripheral neuropathy. You might find it hard to do fiddly tasks such as fastening buttons or tying shoelaces.

If you have these symptoms, always tell your doctor, nurse or pharmacist. They sometimes need to change the drug or the dose of the drug. The symptoms usually improve slowly after treatment ends. But for some people they continue and are a long-term side effect of treatment.

Other information

Hepatitis B reactivation

If you have had a liver infection called hepatitis B, everolimus can make it active again. Let your doctor or nurse know if you have had hepatitis in the past or are worried about this.

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

  • throbbing pain or swelling in a leg or arm
  • reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
  • suddenly feeling breathless or coughing.

Always call 999 if you have:

  • chest pain
  • difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Other medicines

Do not take the herbal remedy St John’s Wort while you are having everolimus. This is because it can make everolimus less effective. 

Some other medicines can affect how this treatment works and may be harmful to take when you are having everolimus. Always tell your cancer doctor about any drugs you are taking or planning to take, such as: 

  • medicines you have been prescribed
  • medicines you buy in a shop or chemist
  • vitamins, herbal drugs and complementary therapies.

Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment. 

You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.

Lactose intolerance

Everolimus tablets contain lactose. If you are intolerant to lactose, let your doctor know.


Doctors usually recommend that people with cancer have vaccinations for flu and for coronavirus (covid). These help reduce your risk of serious illness from these infections. Most people can have these vaccines, including people with weak immune systems.

If your immune system is weak, you should not have live vaccinations. Live vaccines can make you unwell because they contain a very weak version of the illness they will protect you against. Live vaccines include Zostavax®, which is a shingles vaccine, and the yellow fever vaccine.

It is important to ask your doctor, nurse or pharmacist for advice about having vaccinations. They can explain what vaccines are right for you and when it is best to have them.


Your doctor, nurse or pharmacist will advise you not to get pregnant or make someone pregnant while having this treatment and for some time afterwards. The drugs may harm a developing baby. It is important to use contraception to prevent pregnancy. Follow their advice about:

  • what types of contraception to use 
  • how long after treatment you should continue to use contraception. 


If you have sex during this course of treatment, you need to use a condom. This is to protect your partner in case there is any trace of the drug in semen or vaginal fluids.


You are advised not to breastfeed while having this treatment, or for some time after treatment ends. This is because the drugs could be passed to the baby through breast milk. 

Your doctor, nurse or pharmacist can give you more information.


Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Changes to periods

If you have a period, these may become irregular or stop while you are having this treatment. This may be temporary, but it can sometimes be permanent. Your menopause may start sooner than it would have done. Your doctor or nurse can give you more information.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 January 2022
Next review: 01 July 2024
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.