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Fostamatinib (Tavalisse®) is used to treat adult patients with chronic immune thrombocytopenia (ITP).

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Page 1 FOSTAMATINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name fostamatinib (FOS tuh MA tih nib) Brand name Tavalisse® (TA vah lees) Approved uses Fostamatinib is used to treat adult patients with chronic immune thrombocytopenia (ITP). Dose and schedule Taking fostamatinib as instructed is important to allow your treatment to be as effective as possible, so here are some key points to remember. Your dose may vary, but the usual dose of fostamatinib is 100 milligrams (100 mg) to 150 milligrams (150 mg) to be taken by mouth twice a day. Fostamatinib can be taken with or without food, but at the same time each day. Fostamatinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow fostamatinib, talk to your care provider or pharmacist for possible options. If you miss a dose of fostamatinib, do not take an extra dose or two doses at one time. Simply take your next dose at the regularly scheduled time. Be sure to write down if you miss a dose and let your care provider know about any missed doses. Storage and handling Handle fostamatinib with care. Just like when chemotherapy is given into the vein, this drug can be toxic, and exposure of the drug to others should be limited. Store fostamatinib at room temperature (68°F–77°F) in a dry location away from light. Keep fostamatinib out of reach of children and pets. Leave fostamatinib in the provided packaging until it is ready to be taken. Whenever possible, you should give fostamatinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the fostamatinib to you, they also need to follow these steps. 1. Wash hands with soap and water. 2. Put on gloves to avoid touching the medication. (Gloves are not necessary if you give the drug to yourself.) 3. Gently transfer the fostamatinib from its package to a small medicine or other disposable cup. 4. Administer the medicine immediately by mouth with water. 5. Remove gloves and do not use them for anything else. 6. Throw gloves and medicine cup in household trash. 7. Wash hands with soap and water. FOSTAMATINIB ORAL CHEMOTHERAPY EDUCATION Page 2 If a daily pill box or pill reminder is used, a separate one should be used for fostamatinib. Do not mix other medications into the box with fostamatinib. The person filling the box or reminder should wear gloves. (Gloves are not necessary if you are filling the box or reminder.) When empty, the box or reminder should be washed with soap and water before refilling. Be sure to wash hands with soap and water after the task is complete, whether or not gloves are worn. If you have any unused fostamatinib, do not throw it in the trash and do not flush it down the sink or toilet. Talk to your care provider or pharmacist about proper disposal of fostamatinib. If you are traveling, put your fostamatinib in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Handling body fluids and waste Since fostamatinib remains in your body for several days after it is taken, some of the drug may be present in urine, stool, sweat, or vomit. Once you have started to take fostamatinib, it is important to follow the instructions below every day for as long as your treatment lasts. This will keep you, your loved ones, and the environment as safe as possible. Pregnant women should avoid touching anything that may be soiled with body fluids from the patient. Toilet and septic systems You may use the same toilet, septic tank, and/or sewer that you usually use. If you have a low flow toilet, close the lid and flush twice to ensure all waste has been discarded. If the toilet or toilet seat becomes soiled with urine, stool, or vomit, clean the surfaces before other people use the toilet. Wash hands with soap and water after using the toilet. If you need a bedpan, be sure your caregiver knows to wear gloves to assist with cleanup and to wash the bedpan with soap and water every day. If you do not have good control of bladder or bowels, use a disposable pad with a plastic back, a diaper, or a sheet to absorb body waste. Wash any skin that has been exposed to body waste or fostamatinib with soap and water. Linens or clothing that are soiled with body fluids or body waste should be washed separately from other linens and clothing. If you do not have a washer, place the soiled linens in a plastic bag until they can be washed. Wash hands with soap and water after touching linens or clothing that may be soiled with body fluids. Drug and food interactions Fostamatinib has many drug interactions. Please inform your care providers of all prescription medications, over thecounter medications, vitamins, and herbal products. Grapefruit or grapefruit juice may interact with fostamatinib; avoid eating or drinking this during your treatment with fostamatinib. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. FOSTAMATINIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Fostamatinib The common side effects that have been known to happen in more than 30% of patients taking fostamatinib are listed in the left side of this table. You MAY NOT experience these side effects. Options to help manage any side effects that do occur are included on the right side of this table. These should be discussed with your care provider. If you experience any side effect you cannot manage or that is not listed here, contact your care provider. Possible Side Effect Management Diarrhea (loose and/ or urgent bowel movements) Monitor how many bowel movements you have each day. Drink 8–10 glasses of water or fluid each day unless your care provider has instructed you to limit your fluid intake. Eat small, frequent meals throughout the day rather than a few large meals. Eat bland, low fiber foods, such as bananas, applesauce, potatoes, chicken, rice, and toast. Avoid high fiber foods, such as raw vegetables, raw fruits, and whole grains. Avoid foods that cause gas, such as broccoli and beans. Avoid lactose containing foods, such as yogurt and milk. Avoid spicy, fried, and greasy foods. Contact your provider if either of the following occurs: The number of bowel movements you have in a day increases by four or more. You feel dizzy or lightheaded. Your care provider may recommend an over the counter medication called loperamide (Imodium®) to help with your diarrhea, but talk to your care provider before starting this medication. Serious side effects Decrease in your white blood cell counts (neutropenia) can occur and can be severe with fostamatinib. Speak to your care provider to know when you need to have laboratory tests done to monitor your blood cell counts. You may have a rise in blood pressure while taking fostamatinib. Take your blood pressure on a regular basis, and let your doctor know of any big increases in blood pressure. Fostamatinib may cause liver problems. Contact your care provider if you notice yellowing of the skin or whites of your eyes, dark or brown urine, or abnormal bleeding or bruising. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking fostamatinib. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of 30 days after the last dose of fostamatinib. Do not breastfeed while taking fostamatinib and for 30 days after the last dose of fostamatinib. Please inform your care provider if you become pregnant. FOSTAMATINIB ORAL CHEMOTHERAPY EDUCATION Page 4 It is safe to hug and kiss. Special precautions may be needed for sexual activity while on fostamatinib, and you are encouraged to ask your care provider. Obtaining medication Talk with your care provider about the process for obtaining your fostamatinib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: Product prescribing information: Full Prescribing Information.pdf Product resources: resources Updated – July 11, 2018 Additional instructions Important notice: The Association of Community Cancer Centers (ACCC), Hematology/Oncology Pharmacy Association (HOPA), National Community Oncology Dispensing Association, Inc. (NCODA), and Oncology Nursing Society (ONS) have collaborated in gathering information for and developing this patient education guide. This guide represents a brief summary of the medication derived from information provided by the drug manufacturer and other resources. This guide does not cover all existing information related to the possible uses, directions, doses, precautions, warnings, interactions, adverse effects, or risks associated with this medication and should not substitute for the advice of a qualified healthcare professional. Provision of this guide is for informational purposes only and does not constitute or imply endorsement, recommendation, or favoring of this medication by ACCC, HOPA, NCODA, or ONS, who assume no liability for and cannot ensure the accuracy of the information presented. The collaborators are not making any representations with respect to the medications whatsoever, and any and all decisions, with respect to such medications, are at the sole risk of the individual consuming the medication. All decisions related to taking this medication should be made with the guidance and under the direction of a qualified healthcare professional. Permission: Oral Chemotherapy Education (OCE) sheets are provided as a free educational resource for patients with cancer in need of concise, easy to understand information about oral cancer drugs. Healthcare providers are permitted to copy and distribute the sheets to patients as well as direct patients to the OCE website for information. However, commercial reproduction or reuse, as well as rebranding or reposting of any type, are strictly prohibited without permission of the copyright holder. Please email permission requests and licensing inquiries to This email address is being protected from spambots. You need JavaScript enabled to view it.. Copyright © 2019 by Hematology/Oncology Pharmacy Association. All rights reserved.