Safety Considerations
Read this section, in addition to TORISEL Side Effects, to learn about safety issues related to TORISEL.
Before starting TORISEL, you should be aware of potentially serious side effects and risks of therapy. Some of these side effects may be easy to notice. Others may be impossible to recognize without special tests that your health care provider may require.
Liver function
- You should not receive TORISEL if blood tests show that your liver function is moderately or severely impaired. TORISEL should be used with caution in patients whose liver function is mildly impaired and should be given at a reduced dose.
Increased cholesterol and/or triglycerides
- Patients are likely to have an increase in cholesterol and/or triglycerides.
- This may require treatment with, or an increase in the dose of, a medicine that lowers cholesterol and/or triglycerides.
Increased blood sugar levels (hyperglycemia)
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Patients are likely to have raised blood sugar levels. This may require treatment with, or an increase in the dose of, a medicine that lowers blood sugar levels.
- Tell your doctor or nurse if you are thirstier than normal, urinating more than normal, feeling more hungry, losing weight, or feeling tired or irritated.
Blood tests
- Your blood may be tested before you begin treatment and at other times over the course of therapy. Your doctor or nurse may have you fast (not eat or drink) before blood tests.
Some medications and foods can interfere with TORISEL treatment
-
Before you begin treatment, tell your doctor or nurse about ALL MEDICINES you are taking, including:
- Prescription medications, including but not limited to
- Antibiotics
- Antidepressants
- Anticonvulsants
- Antifungals
- Antivirals
- Blood pressure medications
- Blood thinners
- Steroids such as dexamethasone
- Vaccines
- Nonprescription (over the counter) medications
- Vitamins
- Herbal supplements, including but not limited to St. John’s Wort
- Do not take St. John’s Wort during the course of your treatment with TORISEL.1[1R -- PI, p. 6]
- Avoid eating grapefruit or drinking grapefruit juice during the course of your treatment with TORISEL, including the time between treatments.1 It may change the amount of TORISEL in your body. [1R -- PI, p. 6]
Other important saftey information about treatment with TORISEL
-
Treatment with TORISEL may make you feel weak or sick.1
[1F -- PI, p. 12]
- For this reason, you may want to schedule someone to drive you to your weekly treatment appointments.
Pregnancy concerns
-
TORISEL can harm an unborn baby1
- Both men and women should use a reliable form of birth control during treatment with TORISEL and for 3 months after the last dose of TORISEL.
- Tell your doctor before beginning treatment if you are pregnant or thinking of becoming pregnant.
Vaccine issues
-
Some vaccines may be harmful when given during the course of treatment with TORISEL.
-
You should avoid the use of live vaccines and close contact with those who have recently received live vaccines.1
[1S -- PI, p. 11]
- Ask your doctor or nurse if you can receive a flu shot.
Concerns for people 65 or older
-
If you are 65 or older, you may be more likely to experience certain issues during TORISEL therapy, including:
- Diarrhea
- Edema (swelling)
- Pneumonia
- Read about TORISEL Side Effects
Important Safety Information
- You should not receive TORISEL if certain tests show that your liver function is moderately or severely impaired. TORISEL should be used with caution in patients whose liver function is mildly impaired and should be given at a reduced dose.
- TORISEL can cause serious side effects. If you experience side effects that are too severe to tolerate, your health care professional may choose to delay your treatment, give you a lower dose of TORISEL, or discontinue treatment.
- Before you begin treatment with TORISEL, your doctor may give you an antihistamine. It is possible to have a serious (including a life-threatening or fatal) allergic reaction even after you receive an antihistamine. Tell your doctor or nurse if you are allergic to antihistamines or are unable to take antihistamines for any other medical reasons. Tell your doctor or nurse if you have any swelling around your face or trouble breathing during or after treatment with TORISEL.
- Patients are likely to experience increased blood sugar levels. This may require treatment with or an increase in the dose of a medicine that lowers blood sugar levels. Tell your doctor or nurse if you are thirstier than usual or urinate more often than usual.
- Patients are likely to experience an increase in cholesterol and/or triglycerides. This may require treatment with or an increase in the dose of a medicine that lowers cholesterol and/or triglycerides.
-
Before you begin treatment with TORISEL, tell your doctor or nurse about ALL MEDICINES you are taking, including
- Prescription medications, including but not limited to antibiotics, anticonvulsants, antidepressants, antifungals, antivirals, blood pressure medications, blood thinners, dexamethasone, vaccines
- Nonprescription (over the counter) medications
- Vitamins
- Herbal supplements, including but not limited to St. John’s Wort
- Avoid eating grapefruit or drinking grapefruit juice during the course of your treatment with TORISEL, including the time between treatments, as they may change the amount of TORISEL in your body.
- Treatment with TORISEL may affect your immune system. You may be at greater risk of getting an infection while receiving TORISEL.
- Patients may get chronic inflammation of the lungs during treatment with TORISEL. Rare fatal cases have been reported. Tell your doctor or nurse right away if you have any trouble breathing, or develop a cough or fever.
- TORISEL may cause bowel perforation. Fatal cases have been reported. Tell your doctor or nurse right away if you have any new or worsening stomach pain or blood in your stool.
- Treatment with TORISEL may be associated with a risk of kidney failure, sometimes fatal.
- During treatment with TORISEL, wounds may not heal properly. Tell your doctor or nurse if you are recovering or still have an unhealed wound from surgery. Tell your doctor or nurse if you plan to have surgery during treatment with TORISEL.
- TORISEL may increase the risk of bleeding in the brain, which has, in some cases, been fatal. You are at increased risk if
- You have a central nervous system tumor, such as a brain tumor
- You are taking medicine to keep your blood from clotting
- Some vaccines may be less effective when given during the course of treatment with TORISEL. You should avoid the use of live vaccines and close contact with people who have recently received live vaccines. Ask your doctor or nurse if you are eligible to receive a flu shot.
- Both men and women should use a reliable form of birth control during treatment and for 3 months after the last dose of TORISEL. TORISEL can harm an unborn baby. Tell your doctor or nurse before beginning treatment if you are pregnant or thinking of becoming pregnant.
- Elderly patients may be more likely to experience certain side effects including diarrhea, edema and pneumonia.
- The most common side effects are
- Rash
- Weakness/fatigue
- Mouth sores
- Nausea
- Swelling/fluid retention
- Loss of appetite
Please see the full Prescribing Information for TORISEL.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Reference:
- TORISEL® Kit (temsirolimus) Prescribing Information, June 2011.