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Oral Chemotherapy

  • What is oral chemotherapy?

    Oral chemotherapy is a cancer-fighting drug given by mouth in tablet, capsule, or liquid form. It is prescribed by your doctor, nurse practitioner, or physician's assistant, and has the same benefits and risks as chemotherapy given by infusion.

    Today, many cancer patients receive oral chemotherapy as a treatment. This method is sometimes easier than getting chemotherapy by infusion at the hospital or clinic, because the medicine can be taken at home. It's important to understand that these pills can be just as strong as the intravenous form of chemotherapy.

    Oral chemotherapy is not just any pill.

    Dana-Farber — a leader in patient safety and an innovator in the safe administration of chemotherapy by infusion — is committed to educating patients and their families about the benefits and risks of oral chemotherapy. We apply the same safeguards to oral chemotherapy that we do for infusions. Patient education is central to this mission.

    Oral chemotherapy is a serious treatment. When taking oral chemotherapy at home, patients must understand special instructions, precautions, and side effects. Following these instructions will help you receive the most benefit from the drug.


  • What is Oral Chemotherapy?
    Oral chemotherapy is a cancer-fighting drug given by mouth in tablet, capsule, or liquid form, and taken at home. Learn what oral chemotherapy is, and how it has the same benefits and risks as chemotherapy given by infusion.

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    What information should you gather before you begin oral chemotherapy?

    • Your doctor, nurse, or pharmacist will give you instructions for how and when to take your oral chemotherapy. Please follow instructions carefully, and keep them close by for future reference.
    • Be familiar with both the trade name and generic name of the drug.
    • Understand the dose and frequency of the drug. Always double- and triple-check the dose before taking. You may need to take several pills of different strengths to make the total dose.
    • Know the best time of day to take the drug.
    • Understand whether you should be taking the drug before or after a meal or snack.
    • Review all other medicines or supplements you take with a member of your oncology team. Some medications can interfere with how well the oral chemotherapy works.
    • Know what to do if you miss a dose, vomit, or take an extra dose by mistake.
    • If you are in a clinical trial, you might have special instructions.

    Communicate with your other health care providers. Be sure your primary care physician, dentist, and other caregivers are informed about the oral chemotherapy you are taking.

    Prepare for your start date:
    • Find out if your oral chemotherapy can be filled at your local pharmacy or ordered by mail.
    • Allow enough time for your prescription to be filled, and have it on hand before your intended start date.
    • Talk with your oncology team in advance if you have concerns.
    Oral chemotherapy can be costly, so:
    • Check with your insurance company regarding your coverage and co-payments for oral chemotherapy.
    • Learn more about treatment-related medication co-payments by calling Dana-Farber Patient Assistance and Community Resources at 617-632-3301. You may also visit NeedyMeds for help with the cost of medicine.

    How do I handle oral chemotherapy safely at home?

    Most oral chemotherapy medicine is stored at room temperature, away from heat or moisture. Your doctor or nurse will tell you if your medication needs special storage or handling.

    Storage
    • Keep your medicine in its original container.
    • Keep it away from other medications and beyond the reach of children or pets.
    • Do not store oral chemotherapy pills in a bathroom with a shower, or on your windowsill.
    Handling
    • Wash your hands thoroughly before and after you take the pills.
    • Do not crush, break, or chew your pills.
    • Caregivers should be extra cautious when administering the drug.
      • Avoid handling with bare hands.
      • Empty pill(s) into cap lid or small plastic cup for dispensing.
      • You may wear latex gloves, if contact is unavoidable.
      • The only person exposed to the drug should be the patient.
       
    Disposal
    • If you have oral chemotherapy pills left over, please return them to the pharmacy where the prescription was filled.
    • Do not flush them down the toilet, pour them in the sink, or throw them away in the trash.

    For more information about oral chemotherapy handling, storage and disposal, see Dana-Farber's oral chemotherapy fact sheet.


  • Oral chemotherapy: Handling Safely at Home
    Oral chemotherapy is a cancer-fighting drug given by mouth in tablet, capsule, or liquid form. Learn how to handle oral chemotherapy safely at home.

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    How can I be sure to take my oral chemotherapy pills at the right time?

    Remembering to take your medication at the right time of day is not as easy as it may sound, especially if you have an active life.

    Tips to keep in mind:
    • Try to take your pill at the same time and under the same circumstances every day.
    • Use the reminder features on your smart phone or home computer to prompt you to take the drug as prescribed.
    • If you travel, make sure you have enough pills on hand for unexpected delays.
    • Keep a diary (either on paper or an e-calendar) that records the time, date, and how you are feeling. A diary is a good tool to verify that you are taking the drug correctly; it will also help you recall exactly how you where feeling during the weeks or months between appointments.
    • Bring the diary to your next appointment at Dana-Farber.
    • Ask a family member or friend to call or visit you periodically to review your drug diary.
    • Leave your drug diary in a prominent place so you will see it and complete it every day.
  • Oral Chemotherapy: Remembering to Take It
    Remembering to take your pill is not as easy as it sounds. Find tips to help you remember to take your oral chemotherapy at the right time.

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    How do I manage symptoms and side effects of oral chemotherapy?

    • Be sure you understand what the drug is intended to do and how it acts in your body.
    • General side effects from oral chemotherapy include:
      • Fatigue
      • Skin changes (especially to palms of hands or soles of feet)
      • Nausea or vomiting
      • Flu-like symptoms
      • Mouth, hair, and nail changes
       
    • Become familiar with the most common side effects of your drug. Find the fact sheet for your specific drug on the  Medications A-Z page of Dana-Farber's Health Library.
    • Keep information about side effects where you can refer to it often.
    • Record in your diary 3-4 times per week the side effects you are feeling. Use a few words, or check off side effects from a list provided by a member of your clinical team.
    • Be sure to share this information with your clinical team during your next Dana-Farber appointment.
  • Oral Chemotherapy: Managing Symptoms and Side Effects
    Learn how to manage symptoms and side effects such as fatigue and nausea.

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    Don't wait to call your oncology team.

    woman on phoneDepending on the type of oral chemotherapy you are taking, you might experience some unique side effects. It's important to keep in close contact with your oncology team. Plan ahead: Keep contact numbers for your doctor or nurse, along with your drug information, in a prominent place.

    Oral chemotherapy is becoming more common to treat many types of cancers. Partnering with your oncology team and communicating any concerns is an important part of your treatment plan:

    • Contact a member of your clinical team immediately if side effects prevent you from taking your drug doses as prescribed.
    • Skin changes can be difficult to treat without direct observation. If you develop an unusual skin rash after taking the drug, call your nurse or doctor.

    Other resources

    Better Coverage for Oral Chemo: Why It Matters
    Chemotherapy Related Neuropathy: Managing This Nerve Wracking Problem
    Oral chemotherapy fact sheet
    Tips for Managing Neuropathy