ORAL CANCER TREATMENT EDUCATION MOMELOTINIB Name of your medication Generic name — momelotinib (MOH-meh-LOH-tih-nib) Brand name — OJJAARA® (oh-JAR-uh) Common uses Momelotinib is used to treat myelofibrosis (MF) including primary or secondary MF, with anemia. Momelotinib may also be used for other treatments. Dose and schedule Taking momelotinib as instructed is important to allow your treatment to be as effective as possible, so here are some key points to remember. o Your dose may vary, but the usual dose of momelotinib is 200 milligrams (200 mg) to be taken by mouth at a scheduled time once a day. o Momelotinib can be taken with or without food, but at the same time each day. o Momelotinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow momelotinib, talk to your care provider or pharmacist for possible options. o If you miss a dose of momelotinib: • 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. Drug and food interactions o Momelotinib has many drug interactions, please inform your care providers of all prescription medications, over-the counter medications, vitamins, and herbal products. o Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle momelotinib 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. o Store momelotinib at room temperature (68°F–77°F) in a dry location away from light. o Keep momelotinib out of reach of children and pets. o Leave momelotinib in the provided packaging until it is ready to be taken. o Whenever possible, you should give momelotinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the momelotinib to you, they also need to follow these steps. Page 1 ORAL CANCER TREATMENT EDUCATION MOMELOTINIB 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 momelotinib from its package to a small medicine cup 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. o A daily pill box or pill reminder is NOT recommended to be used with momelotinib. o If you have any unused momelotinib, 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 momelotinib. o If you are traveling, put your momelotinib’s packaging in a separate sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Side Effects of Momelotinib Below are common side effects that have been known to happen in about one-third or more of patients taking momelotinib; these are listed on 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 Decreased platelet count and increased risk of bleeding Management Your platelets should be monitored by a simple blood test. When they are low, you may bruise or bleed more easily than usual. • Use caution to avoid bruises, cuts, or burns. • Blow your nose gently and do not pick your nose. • Brush your teeth gently with a soft toothbrush and maintain good oral hygiene. • When shaving use an electronic razor instead of razor blades. • Use a nail file instead of a nail clippers Call your care provider if you have bleeding that won’t stop. Examples include: • A bloody nose that bleeds for more than 5 minutes despite pressure. • A cut that continues to ooze despite pressure. • Gums that bleed excessively when you floss or brush. Seek medical help immediately if you experience any severe headaches, blood in your urine or stool, coughing up blood, or prolonged and uncontrollable bleeding. You may need to take a break or “hold” your medication for medical or dental procedures. Talk to your care provider or dentist before any scheduled procedures. Continued on the next page Page 2 ORAL CANCER TREATMENT EDUCATION MOMELOTINIB Possible Side Effect Diarrhea (loose and/ or urgent bowel movements) Fatigue Management 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 (e.g., bananas, applesauce, potatoes, chicken, rice, 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 any of the following occur: • The number of bowel movements you have in a day increases by 4 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. You may be more tired than usual or have less energy. • Stay as active as possible, but know it is okay to rest as needed. • Try to do some activity every day. • Plan your activities, and do them at a time of day when you feel a bit more energetic. • Avoid operating heavy machinery if you feel too tired. • Eat and drink slowly. • 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 foods; avoid spicy, fried, and greasy foods. Nausea or vomiting • Avoid vigorous exercise immediately after eating. • Don’t lay down immediately after eating. • Avoid strong odors. Let your provider know if you experience nausea or vomiting. Your provider may prescribe medication to help with the nausea or vomiting. Continued on the next page Page 3 ORAL CANCER TREATMENT EDUCATION MOMELOTINIB Serious side effects o Momelotinib may be harmful to your liver. Seek medical attention if you notice yellowing of the skin or whites of your eyes, dark or brown urine, bleeding, or bruising. o Momelotinib can increase your risk of having a blood clot. Seek immediate medical attention if you have sudden swelling in an arm or leg, have chest pain, or trouble breathing. o There is a small risk of developing a second cancer months or years after taking momelotinib. Talk to your provider about this risk. o Momelotinib may cause narrowing of arteries in your heart. Contact your care team if you have shortness of breath or chest pain. o Momelotinib may cause neutropenia. Neutropenia occurs when you have too few neutrophils, a type of white blood cell. Neutrophils are important for fighting illnesses caused by germs. Speak to your care team to know when you need to have blood tests done to monitor your neutrophils. Seek medical attention if you have a fever above 100.4°F. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: Handling body fluids and waste Because momelotinib 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 momelotinib, it is important to adhere to the following instructions every day for as long as your treatment lasts. This is to keep yourself, loved ones, and the environment as safe as possible. o Pregnant women should avoid touching anything that may be soiled with body fluids from the patient. o 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 that 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. o 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. o 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. o Wash any skin that has been exposed to body waste with soap and water. o 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. o Wash hands with soap and water after touching linens or clothing that may be soiled with body fluids. Pregnancy, sexual activity, and contraception o Women should not become pregnant and men should not get a partner pregnant while taking momelotinib. Males and females of childbearing age and potential should use effective contraception during therapy and for a minimum of 1 week after the last dose of momelotinib. Page 4 ORAL CANCER TREATMENT EDUCATION MOMELOTINIB o Effective contraception could include 1 or more of the following: oral contraceptive, barrier methods, etc. o Do not breastfeed while taking momelotinib and for 1 week after the last dose of momelotinib. o Please inform your care provider if you become pregnant. o It is safe to hug and kiss. Special precautions may be needed for sexual activity while on oral chemotherapy, and you are encouraged to ask your care team for assistance. Obtaining medication o Talk with your care provider about the process for obtaining your momelotinib. Additional resources Product website: https://ojjaarahcp.com Product prescribing information: https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_ Information/Ojjaara/pdf/OJJAARA-PI-PIL.PDF Additional instructions Updated – November 30, 2023 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 Cancer Treatment 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 © 2023 by Hematology/Oncology Pharmacy Association. All rights reserved. Page 5