Ponatinib

What is Ponatinib for?

Ponatinib is used to treat certain types of leukemia. The medication works by blocking the signals that trigger the production of abnormal white blood cells.

How should I take or use Ponatinib?

You may take this medication with or without food. Swallow the tablet whole, do not crush or chew it.

Do not stop taking your medication without checking with your healthcare professional.

If possible, handle the medication yourself. If a family member or caregiver needs to give the medication, do wash their hands before and after handling the medication.

What should I do if I forget to take or use Ponatinib?

If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What precautions should I take when taking or using Ponatinib?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding
• You are taking any other medications, including supplements, traditional medications and herbal remedies
• You have heart or liver problems
• You are planning to undergo any surgery

What food or medication should I avoid when I take or use Ponatinib?

Avoid taking grapefruit containing supplements or grapefruit juice when you are taking this medicine as it may interact with your medicine and increase the risk of side effects.

Avoid receiving live vaccines during therapy as the risk of vaccine associated infections may be increased.

What are some common side effects of Ponatinib?

• Skin problems (rashes and dry skin)
  • Do apply a moisturizer to relieve your dry and itchy skin
  • Use mild soap and unscented detergent
  • Avoid hot showers. Use cool or lukewarm water
• Muscle and joint pain or stiffness
  • Avoid strenuous physical exertion to prevent it from getting worse
  • Painkillers may be prescribed by your doctor to help with the pain
• Nausea and/or vomiting
  • Sucking hard, sugar-free candy may help
  • Take small and frequent meals, rather than 3 large meals
  • Consume food that are cold or at room temperature to avoid becoming nauseated from the smell
• Increased blood pressure
  • Monitor your blood pressure regularly
  • Inform your doctor if your blood pressure is higher than normal, or if you have symptoms such as headache, dizziness, chest pain or shortness of breath
  • Take your high blood pressure medicine if prescribed by your doctor
  • Do choose fresh vegetables, meats and fruits instead of canned or packaged ones.
  • You may use fresh herbs or spices to flavor your food
• Swelling, fluid retention
  • Avoid high salt content foods such as smoked or cured meats, salted canned fish, vegetables or nuts
  • For mild symptoms of leg swelling: Raise your legs on a stool, cushion, pillow
  • For severe symptoms (ie. difficulty breathing accompanied with cough, puffy eyes, rapid weight gain): Do seek immediate medical attention
• Hard stools (constipation)
  • Increase your fibre intake by taking at least 2 servings of fruits and vegetables daily
  • Ensure you are drinking sufficient fluid
  • Increasing your daily activity may also help relieve constipation
• Decreased appetite
  • Have smaller, more frequent meals
• Temporary decrease in blood cell counts
  • This may put you at higher risk of infections, bleeding or bruising and feeling tired
  • Reduce your risk of getting an infection by:
    • Maintaining good hand hygiene. Wash your hands often during the day especially before you eat or after using the toilet
    • Avoid crowded spaces and wear a mask to protect yourself
    • Eating freshly cooked food. Avoid raw meats, vegetables, eggs, half-cooked or uncooked food
  • Brush teeth gently with a soft bristle toothbrush to prevent gum bleeding
  • Be careful when handling sharp objects such as scissors or knives

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Other serious side effects may include:

• Infections
  • Signs of an infection include:
    • Fever (temperature over 38°C)
    • Chills
    • Severe sore throat
    • Cough with thick or green phlegm
    • Cloudy or foul smelling urine
    • Painful, tender, or swollen red skin wounds or sores
• Liver problems
  • Signs of liver problems include:
    • Dark or tea-coloured urine
    • Pale or light-coloured stools
    • Yellowing of your skin or eyes
    • Severe loss of appetite
    • Abdominal pain
    • Nausea or vomiting that does not go away
• Blood clots or blockage in your blood vessels
  • Signs of blood clots:
    • Calf swelling and tenderness
    • Sudden onset of cough
    • Chest pains
    • Shortness of breath
• Fast or irregular heartbeat, dizziness or feeling faint
• Changes in your vision, including a blurred vision, sensitivity to light, or pain in the eye
• Headache that does not get better

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store Ponatinib?

Keep in the original container and store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How do I throw away Ponatinib safely?

Pack the medication into a bag and bring it back to the pharmacy where you received the medication from.