Page 1 ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — anastrozole (an AS troh zole) Brand name — Arimidex® (uh RIH mih dex) Approved uses Anastrozole is used in postmenopausal women as: A first step treatment for breast cancer that has spread beyond the breast itself and is either hormone dependent or has an uknown hormone status Treatment for early stage hormone dependent breast cancer after surgery with or without radiation therapy o Treatment for advanced stage breast cancer that has progressed after treatment with tamoxifen (Nolvadex®) Dose and schedule Taking anastrozole 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 anastrozole is 1 milligram (1 mg) to be taken by mouth at a scheduled time once a day. Anastrozole can be taken with or without food but at the same time each day. Anastrozole should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow anastrozole, talk to your care provider or pharmacist for possible options. If you miss a dose of anastrozole, 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 Anastrozole has many drug interactions. Inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products that you are taking. Talk with your care team or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle anastrozole 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 anastrozole at room temperature (68°F–77°F) in a dry location away from light. Keep anastrozole out of reach of children and pets. Leave anastrozole in the provided packaging until it is ready to be taken. Whenever possible, give anastrozole to yourself and follow the steps below. If a family member, friend, or caregiver needs to give anastrozole to you, they also need to follow these steps: 1. Wash hands with soap and water.ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Anastrozole Below are common side effects that have been known to happen in about one third or more of patients taking anastrozole 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 Management Hot flashes (sudden sweating and feelings of warmth) If hot flashes are bothersome: • Mild, regular exercise may help. Consult first with your care provider. • Try staying in a cool environment. • Wear layers so that if you experience a hot flash, the outer layers may be removed. • Avoid or limit caffeine, spicy food, alcohol, and stress, which may cause hot flashes to worsen. • Inform your care provider if this side effect is bothersome as there may be medications that can help with hot flashes. Muscle or joint pain or weakness • Keep a diary of your pain, including a description of when and where the pain is occurring, what it feels like, and how long it lasts. • Stay as active as possible, but know that it is okay to rest as needed, too. • Tell your care provider if pain interferes with your activity. If the pain or weakness bothers you, ask your provider what you may use to help with this discomfort. Take only pain medication that has been prescribed or recommended by your care provider. 2. Put on gloves to avoid touching the medication. (Gloves are not necessary if you give the drug to yourself.) 3. Gently transfer the anastrozole 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. If a daily pill box or pill reminder will be used, contact your care team before using: • 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 anastrozole, 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 anastrozole. If you are traveling, put your anastrozole’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed.ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Page 3 Serious side effects of anastrozole Anastrazole may decrease your bone density making you more likely to have a fracture. Your care provider may prescribe medication to help prevent fractures. o Anastrazole may cause your cholesterol levels to increase in your blood. Speak to your care provider to know when you need to have laboratory tests done to monitor your cholesterol levels. Your care provider may write you a prescription for a cholesterol lowering medication if your levels become high. Seek medical attention right away if you have any chest pain or tightness. If you have a history of ischemic heart disease, anastrozole may increase your risk of a cardiovascular event. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Anastrozole remains in your body for several days after it is taken, so some of the drug may be present in urine, stool, sweat, or vomit. Once you have started to take anastrozole, it is important to follow the instructions below every day for as long as your treatment lasts. This will keep yourself, 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 anastrozole 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. Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking anastrozole. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of three weeks after the last dose of anastrozole. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Inform your care provider if you become pregnant.ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Page 4 o Do not breastfeed while taking anastrozole and for two weeks after the last dose of anastrozole. It is safe to hug and kiss. Special precautions may be needed for sexual activity while on anastrozole, and you are encouraged to ask your care provider. Obtaining medication Talk with your care provider about how to obtain your anastrozole. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Anastrozole drug information: www.arimidex.com Product prescribing information: https://www.accessdata.fda.gov/drugsatfda docs/ label/2011/020541s026lbl.pdf Product resources: www.arimidex.com/support breast cancer.html Updated – June 7, 2021 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 © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved

Page 1 APALUTAMIDE ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — apalutamide (A puh LOO tuh mide) Brand name — Erleada™ (er LEE duh) Approved uses Apalutamide is used to treat metastatic castration sensitive and non metastatic castration resistant prostate cancer. Dose and schedule Taking apalutamide 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 apalutamide is 240 milligrams (240 mg) to be taken by mouth at a scheduled time once a day. Apalutamide can be taken with or without food but at the same time each day. Apalutamide should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow apalutamide, talk to your care provider or pharmacist for possible options. If you miss a dose of apalutamide, do not take an extra dose or two doses at one time. Simply take your dose as soon as you remember on that day and then 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 Apalutamide 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 apalutamide; avoid eating or drinking these during treatment with apalutamide. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle apalutamide 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 apalutamide at room temperature (68°F–77°F) in a dry location away from light. Keep apalutamide out of reach of children and pets. Leave apalutamide in the provided packaging until it is ready to be taken. Whenever possible, you should give apalutamide to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the apalutamide 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 apalutamide from its package to a small medicine or other disposable cup. APALUTAMIDE ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Apalutamide Below are common side effects that have been known to happen in about one third or more of patients taking apalutamide 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 Management Changes in electrolytes and other laboratory values • High cholesterol levels • High glucose levels • High tryglyceride levels • High potassium levels Changes in some lab values may occur and will be monitored by a simple blood test. • You may not feel any symptoms if the changes are mild, and they usually are not a sign of a serious problem. • More severe changes may occur, which can be a sign of a serious problem. Notify your care provider if you have any of the following: • Shortness of breath • Chest discomfort • Weakness or fatigue • New aches and pains • Headaches • Dizziness • Swelling of your legs or feet • Red or brown colored urine Continued on the next page 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. A daily pill box or pill reminder is not recommended to be used with apalutamide. If you have any unused apalutamide, 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 apalutamide. If you are traveling, put your apalutamide’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. APALUTAMIDE ORAL CHEMOTHERAPY EDUCATION Page 3 Possible Side Effect Management Decreased hemoglobin, part of the red blood cells that carry iron and oxygen Your hemoglobin should be monitored by a simple blood test. When your hemoglobin is low, you may notice that you get tired or fatigued more easily. • Try to get 7–8 hours of sleep per night. • Avoid operating heavy machinery if you feel too tired. • Find a balance between work and rest. • Stay as active as possible, but know that it is okay to rest as needed. • You might notice that you are more pale than usual. Let your care provider know right away if you experience any of the following: • Shortness of breath • Dizziness • Palpitations Decreased white blood cells (WBCs) and increased risk for infection Your WBCs should be monitored by a simple blood test. When your WBCs are low, you are at a greater risk of having an infection. Take the following precautions to protect yourself from infection. • Wash your hands often, especially before eating and after using the bathroom. • Avoid crowds and people with fevers, flu, or other infection. • Bathe regularly to keep good personal hygiene. Contact your care provider if you experience any signs or symptoms of an infection: • Fever (temperature more than 100.4°F or 38°C) • Chills • Sore throat • Burning with urination • Unusual tiredness • A sore that becomes red, is draining, or does not heal Check with your care provider before taking any medicine for a fever or chills. Fatigue 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.APALUTAMIDE ORAL CHEMOTHERAPY EDUCATION Page 4 Serious side effects of apalutamide Apalutamide can cause bones to weaken and may increase your risk for falls and fractures. Your provider may prescribe medication to help prevent fractures. o Apalutamide may make it more likely that you have a seizure. You should avoid activities where a sudden loss of consciousness could cause serious harms. Seek medical attention right away if you have symptoms of a seizure and inform your care provider. Apalutamide may cause narrowing of arteries in your heart. Contact your care team if you have shortness of breath or chest pain. Apalutamide can increase your risk of having a stroke. It is important to know the signs and symptoms of a stroke. Pay attention to when the signs and symptoms begin, and call 911 immediately at the first sign of a stroke. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Apalutamide remains in your body for several days after it is taken, and some of the drug may be present in urine, stool, sweat, or vomit. Once you have started to take apalutamide, it is important to know 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. 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 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. 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 apalutamide 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. Pregnancy, sexual activity, and contraception Men who have a pregnant partner should use a condom during intercourse, both during therapy and for a minimum of three months after the last dose of apalutamide. APALUTAMIDE ORAL CHEMOTHERAPY EDUCATION Page 5 Men should use effective contraception to avoid getting a woman pregnant and should avoid donating sperm during treatment and for three months after treatment is complete. Do not breastfeed while taking apalutamide and for one month after the last dose of apalutamide. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Please inform your care provider if you become pregnant. 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 provider. Obtaining medication Talk with your care provider about the process for obtaining your apalutamide. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: www.erleada.com Product prescribing information: www.janssenlabels.com/package insert/product monograph/prescribing information/ERLEADA pi.pdf Product resources: www.janssencarepath.com/hcp/erleada Updated – June 7, 2021 Additional instructions IBRUTINIB ORAL CHEMOTHERAPY EDUCATION Page 6 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 © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved

Page 1 ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — anastrozole (an AS troh zole) Brand name — Arimidex® (uh RIH mih dex) Approved uses Anastrozole is used in postmenopausal women as: A first step treatment for breast cancer that has spread beyond the breast itself and is either hormone dependent or has an uknown hormone status Treatment for early stage hormone dependent breast cancer after surgery with or without radiation therapy o Treatment for advanced stage breast cancer that has progressed after treatment with tamoxifen (Nolvadex®) Dose and schedule Taking anastrozole 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 anastrozole is 1 milligram (1 mg) to be taken by mouth at a scheduled time once a day. Anastrozole can be taken with or without food but at the same time each day. Anastrozole should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow anastrozole, talk to your care provider or pharmacist for possible options. If you miss a dose of anastrozole, 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 Anastrozole has many drug interactions. Inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products that you are taking. Talk with your care team or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle anastrozole 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 anastrozole at room temperature (68°F–77°F) in a dry location away from light. Keep anastrozole out of reach of children and pets. Leave anastrozole in the provided packaging until it is ready to be taken. Whenever possible, give anastrozole to yourself and follow the steps below. If a family member, friend, or caregiver needs to give anastrozole to you, they also need to follow these steps: 1. Wash hands with soap and water.ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Anastrozole Below are common side effects that have been known to happen in about one third or more of patients taking anastrozole 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 Management Hot flashes (sudden sweating and feelings of warmth) If hot flashes are bothersome: • Mild, regular exercise may help. Consult first with your care provider. • Try staying in a cool environment. • Wear layers so that if you experience a hot flash, the outer layers may be removed. • Avoid or limit caffeine, spicy food, alcohol, and stress, which may cause hot flashes to worsen. • Inform your care provider if this side effect is bothersome as there may be medications that can help with hot flashes. Muscle or joint pain or weakness • Keep a diary of your pain, including a description of when and where the pain is occurring, what it feels like, and how long it lasts. • Stay as active as possible, but know that it is okay to rest as needed, too. • Tell your care provider if pain interferes with your activity. If the pain or weakness bothers you, ask your provider what you may use to help with this discomfort. Take only pain medication that has been prescribed or recommended by your care provider. 2. Put on gloves to avoid touching the medication. (Gloves are not necessary if you give the drug to yourself.) 3. Gently transfer the anastrozole 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. If a daily pill box or pill reminder will be used, contact your care team before using: • 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 anastrozole, 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 anastrozole. If you are traveling, put your anastrozole’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed.ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Page 3 Serious side effects of anastrozole Anastrazole may decrease your bone density making you more likely to have a fracture. Your care provider may prescribe medication to help prevent fractures. o Anastrazole may cause your cholesterol levels to increase in your blood. Speak to your care provider to know when you need to have laboratory tests done to monitor your cholesterol levels. Your care provider may write you a prescription for a cholesterol lowering medication if your levels become high. Seek medical attention right away if you have any chest pain or tightness. If you have a history of ischemic heart disease, anastrozole may increase your risk of a cardiovascular event. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Anastrozole remains in your body for several days after it is taken, so some of the drug may be present in urine, stool, sweat, or vomit. Once you have started to take anastrozole, it is important to follow the instructions below every day for as long as your treatment lasts. This will keep yourself, 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 anastrozole 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. Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking anastrozole. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of three weeks after the last dose of anastrozole. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Inform your care provider if you become pregnant.ANASTROZOLE ORAL CHEMOTHERAPY EDUCATION Page 4 o Do not breastfeed while taking anastrozole and for two weeks after the last dose of anastrozole. It is safe to hug and kiss. Special precautions may be needed for sexual activity while on anastrozole, and you are encouraged to ask your care provider. Obtaining medication Talk with your care provider about how to obtain your anastrozole. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Anastrozole drug information: www.arimidex.com Product prescribing information: https://www.accessdata.fda.gov/drugsatfda docs/ label/2011/020541s026lbl.pdf Product resources: www.arimidex.com/support breast cancer.html Updated – June 7, 2021 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 © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved

Page 1 EXEMESTANE ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — exemestane (EK seh MEH stayn) Brand name — Aromasin® (uh ROH muh sin) Approved uses Exemestane is used in the treatment of certain types of hormone dependent breast cancer in postmenopausal women. Dose and schedule Taking exemestane 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 exemestane is 25 milligrams (25 mg) to be taken by mouth at a scheduled time once a day. Exemestane should be taken after a meal at the same time each day. Exemestane should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow exemestane, talk to your care provider or pharmacist for possible options. If you miss a dose of exemestane, 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 Exemestane has many drug interactions. Inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products. Exemestane should not be taken with estrogen containing products. Contact your healthcare team with questions. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle exemestane 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 exemestane at room temperature (68°F–77°F) in a dry location away from light. Keep exemestane out of reach of children and pets. Leave exemestane in the provided packaging until it is ready to be taken. Whenever possible, give exemestane to yourself and follow the steps below. If a family member, friend, or caregiver needs to give exemestane 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 exemestane 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. EXEMESTANE ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Exemestane Below are common side effects that have been known to happen in about one third or more of patients taking exemestane 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 Management Hot flashes (sudden sweating and feelings of warmth) If hot flashes are bothersome: • Mild, regular exercise program may help. Consult first with your care provider. • Try staying in a cool environment. • Wear layers so that you can remove outer layers when experiencing a hot flash. • Avoid or limit caffeine, spicy food, alcohol, and stress, which may worsen hot flashes. Inform your care provider if your hot flashes are bothersome as there may be medications that can help. Muscle or joint pain • Keep a diary of your pain, including a description of when and where the pain is occurring, what it feels like, and how long it lasts. • Stay as active as possible, but know that it is okay to rest as needed, too. • Tell your care provider if pain or a spasm interferes with your activity. If the pain bothers you, ask your provider what you may use to help with this discomfort. Take pain medication only that has been prescribed or recommended by your care provider. If a daily pill box or pill reminder will be used, contact your care team before using: • 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 exemestane, 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 exemestane. If you are traveling, put your exemestane’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Serious side effects of exemestane Exemestane may decrease your bone density making you more likely to have a fracture. Your care provider may prescribe medication to help prevent fractures. Be sure to ask your doctor about vitamin D and/or calcium supplementation before starting. Exemestane can cause changes in your blood work. Ask your care team how this will be monitored. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) EXEMESTANE ORAL CHEMOTHERAPY EDUCATION Page 3 Handling body fluids and waste Because exemestane 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 exemestane, it is important to follow the instructions below every day for as long as your treatment lasts. This is to keep yourself, 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 exemestane 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. Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking exemestane. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of one month after the last dose of exemestane. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Do not breastfeed while taking exemestane and for one month after the last dose of exemestane. Inform your care provider if you become pregnant. 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 provider. Obtaining medication Talk with your care provider about the process for obtaining your exemestane. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) EXEMESTANE ORAL CHEMOTHERAPY EDUCATION Page 4 Additional resources Product website: www.pfizer.com/products/product detail/aromasin Product prescribing information: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=61d86c55 9946 273f 4f22 42d3fc33d143 Product resources: www.aromasin.com/tools and resources Updated – July 15, 2021 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 © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved.

Page 1 Name of your medication Generic name — asciminib (as-KIM-uh-nib) Brand name — SCEMBLIX® Approved uses Asciminib is used to treat chronic myeloid leukemia (CML). Dose and schedule Taking asciminib 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 asciminib is: • 80 milligrams (80 mg) to be taken by mouth at a scheduled time once a day OR • 40 milligrams (40 mg) to be taken by mouth at a scheduled time twice a day approximately 12 hours apart • 200 milligrams (200 mg) to be taken by mouth at a scheduled time twice a day approximately 12 hours apart o Asciminib should be taken without food, at the same time each day. Do not eat for at least 2 hours before and 1 hour after taking asciminib. o Asciminib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow asciminib, talk to your care provider or pharmacist for possible options. o If you miss a dose of asciminib: • For once daily dosing: only take the missed dose if it has been less than 12 hours since you were supposed to take it. Then take the next dose at the regularly scheduled time. • For twice daily dosing: only take the missed dose if it has been less than 6 hours since you were supposed to take it. • Do not take two doses at one time. • Be sure to write down if you miss a dose and let your care provider know about any missed doses. ASCIMINIB ORAL CHEMOTHERAPY EDUCATION Page 2 Drug and food interactions o Asciminib has many drug interactions; please inform your care providers of all prescription medications, over-the-counter medications, vitamins, and herbal products. o Grapefruit or grapefruit juice may interact with asciminib; avoid eating or drinking these during treatment with asciminib. o Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle asciminib 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 asciminib at room temperature (68 to 77 F) in a dry location away from light. o Keep asciminib out of reach of children and pets. o Leave asciminib in the provided packaging until it is ready to be taken. o Whenever possible, you should give asciminib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the asciminib 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 asciminib 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. o A daily pill box or pill reminder is NOT recommended to be used with asciminib. o If you have any unused asciminib, 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 asciminib. o If you are traveling, put your asciminib in a separate sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed.

Page 1 AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name avapritinib (AY vah PRIH tih nib) Brand name Ayvakit™ (aye vah kit) Approved uses Avapritinib is used to treat adults with a certain type of stomach, bowel, or esophagus cancer called gastrointestinal stromal tumor (GIST) that cannot be treated with surgery or that has spread to other parts of the body (metastatic), and that is caused by certain abnormal platelet derived growth factor receptor alpha (PDGFRA) genes. Dose and schedule Taking avapritinib 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 avapritinib is 300 milligrams (300 mg) to be taken by mouth at a scheduled time once a day. Avapritinib should be taken on an empty stomach, at least one hour before and two hours after a meal. Avapritinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow avapritinib, talk to your care provider or pharmacist for possible options. If you miss a dose of avapritinib, follow these guidelines: Take it as soon as you remember, unless your next scheduled dose is due within eight hours. Take the next dose at your regular time. Do not take two doses at one 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 Avapritinib has many drug interactions. Please inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products. Avapritinib should not be taken with food. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle avapritinib 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 avapritinib at room temperature (68°F–77°F) in a dry location away from light. Keep avapritinib out of reach of children and pets. Leave avapritinib in the provided packaging until it is ready to be taken. AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 2 Whenever possible, you should give avapritinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the avapritinib 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 avapritinib 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. If a daily pill box or pill reminder will be used, contact your care team before using. 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 avapritinib, 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 avapritinib. If you are traveling, put your avapritinib’s packaging in a separate sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Avapritinib Below are common side effects that have been known to happen in about one third or more of patients taking avapritinib; 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 Management Decreased hemoglobin, part of the red blood cells that carry iron and oxygen Your hemoglobin should be monitored by a simple blood test. When your hemoglobin is low, you may notice that you get tired or fatigued more easily. Try to get 7–8 hours of sleep per night. Avoid operating heavy machinery if you feel too tired. Find a balance between work and rest. Stay as active as possible, but know that it is okay to rest as needed. You might notice that you are more pale than usual. Let your care provider know right away if you experience any of the following: Shortness of breath Dizziness Palpitations Fluid retention or swelling Do not stand for long periods of time. Keep your legs elevated when sitting or lying down. Try not to eat salty foods, which can increase swelling. Avoid tight fitting clothing and shoes. Weigh yourself daily. Contact your provider if you notice any of the following: Swelling in the hands, feet, or legs Shortness of breath Weight gain of five pounds or more in one week Changes in liver function Your liver function should be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: Yellowing of the skin or whites of your eyes Dark or brown urine Bleeding or bruising Continued on the next page AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management Nausea or vomiting 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. Avoid vigorous exercise immediately after eating. Don’t lie down immediately after eating. Avoid strong odors. Let your provider know if you experience nausea or vomiting. Your provider may prescribe medication that can help. Decreased white blood cells (WBCs) and increased risk for infection Your WBCs should be monitored by a simple blood test. When your WBCs are low, you are at a greater risk of having an infection. Take the following precautions to protect yourself from infection. Wash your hands often, especially before eating and after using the bathroom. Avoid crowds and people with fevers, flu, or other infection. Bathe regularly to keep good personal hygiene. Contact your care provider if you experience any signs or symptoms of an infection: Fever (temperature more than 100.4°F or 38°C) Chills Sore throat Burning with urination Unusual tiredness A sore that becomes red, is draining, or does not heal Check with your care provider before taking any medicine for a fever or chills. Fatigue 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 cars or machinery if you feel too tired. Continued on the next page AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 5 Possible Side Effect Management Changes in electrolytes and other laboratory values including Low phosphate levels Low potassium levels Low magnesium levels Low albumin levels High creatinine levels High bilirubin levels High aspartate aminotransferase (AST) levels Changes in some laboratory values may occur and will be monitored by a simple blood test. You may not feel any symptoms if the changes are mild, and they usually are not a sign of a serious problem. More severe changes may occur, which can be a sign of a serious problem. Notify your care provider if you have any of the following: Shortness of breath Chest discomfort Weakness or fatigue New aches and pains Headaches Dizziness Swelling of your legs or feet Red or brown colored urine Cognitive impairment Cognitive impairment includes: Memory impairment Confused state Disturbance in attention Amnesia Mental impairment Mental status changes Dementia Abnormal thinking Mental disorder Retrograde amnesia Let your provider know if you think you are experiencing any of these side effects. Decreased appetite or weight loss Talk to your care provider if you notice a decrease in weight while taking this medication. When you do not feel like eating, try the following: Small, frequent meals instead of 3 large meals each day Keep snacks nearby so you can eat when you feel hungry. Liquid nutritional supplements Drink 8–10 glasses of water or fluid each day, especially if you are not eating, unless your care provider has instructed you to limit your fluid intake. Continued on the next page AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 6 Serious side effects Avapritinib may cause rare but serious side effects, including the following: A buildup of fluid between your lung and chest cavity. Alert your care team immediately if you develop sudden onset chest pain or shortness of breath. Increased risk of bleeding in the brain. Contact your care team if you notice frequent nose bleeds, blood in your stool, bleeding that occurs by itself without injury, or bleeding that will not stop after five minutes of pressure. Stop taking avapritinib and tell your healthcare provider if you develop any symptoms such as severe headache, vision problems, severe sleepiness, or severe weakness on one side of your body. 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 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. Excessive tearing Your care provider may refer you for evaluation by an ophthalmologist. Be sure to let your provider know if are experiencing increased tearing or watery eyes. If you experience increased tearing when you are exposed to the sun, wear sunglasses when you go outdoors. Abdominal pain Abdominal pain/discomfort may occur. Report any serious pain or symptoms to your care provider immediately. Changes in kidney function Your kidney (renal) function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: Decreased amount of urination Unusual swelling in your legs or feet Hair color changes Changes to your hair color may occur during treatment. The hair usually returns to normal after treatment; for some, the change is permanent. AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 7 Avapritinib can cause serious birth defects. Do not take avapritinib if you are pregnant or think you might be pregnant. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Since avapritinib 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 avapritinib, 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. 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 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. 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 avapritinib 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. Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking avapritinib. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of six weeks after the last dose of avapritinib. Effective contraception could include condoms and/or oral contraceptives as prescribed. Do not breastfeed while taking avapritinib and for two weeks after the last dose of avapritinib. Please inform your care provider if you become pregnant. 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 provider. Obtaining medication Talk with your care provider about the process for obtaining your avapritinib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 8 Additional resources Product website: https://www.ayvakit.com Product prescribing information: https://www.accessdata.fda.gov/drugsatfda docs/ label/2020/212608s000lbl.pdf Product resources: https://www.yourblueprint.com Updated – January 22, 2020 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 © 2020 by Hematology/Oncology Pharmacy Association. All rights reserved.

Page 1 Name of your medication Generic name — avatrombopag (A-va-TROM-bo-pag) Brand name — Doptelet® (DOP-te-let) Approved uses Avatromobopag is used to treat patients with low platelet count either due to liver disease or immune thrombocytopenia. Dose and schedule Taking avatrombopag 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 avatrombopag is 20 milligrams (20 mg), 40 mg, or 60 mg (based on your indication and platelet count) to be taken by mouth at a scheduled time each day. o Avatromobopag should be taken with food at the same time each day. o Avatromobopag should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow avatrombopag, talk to your care provider or pharmacist for possible options. o If you miss a dose of avatrombopag, 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 Avatromobopag has many drug interactions. Inform your care providers of all prescription medications, over-the-counter medications, vitamins, and herbal products. o Grapefruit or grapefruit juice may interact with avatrombopag; avoid eating or drinking these during treatment with avatrombopag. o Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle avatrombopag 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 avatrombopag at room temperature (68°F–77°F) in a dry location away from light. o Keep avatrombopag out of reach of children and pets. o Leave avatrombopag in the provided packaging until it is ready to be taken. o Whenever possible, you should give avatrombopag to yourself and follow the steps below. If a family member, friend, or caregiver needs to give avatrombopag 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.) AVATROMBOPAG ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Avatrombopag Below are common side effects that have been known to happen in about one-third or more of patients taking avatrombopag 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 Management Headache Ask your provider what you may use to help with this discomfort. Contact your care provider right away if you headache has any of the following characteristics: • Follows a head injury • Is severe or starts suddenly • Does not go away after three days • Is associated with vomiting, visual disturbance, neck stiffness, drowsiness, confusion, rash, weakness in an arm or leg, or numbness, or is made worse by coughing or lowering the head Fatigue You may be more tired than usual or have less energy. • Stay as active as possible, but know it is OK 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. 3. Gently transfer the avatrombopag 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. o A daily pill box or pill reminder is not recommended to be used with avatrombopag. o If you have any unused avatrombopag, 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 avatrombopag. o If you are traveling, put your avatrombopag’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Page 3 Serious side effects o Avatrombopag 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. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Because avatrombopag 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 avatrombopag, it is important to follow the instructions below 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 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 or avatrombopag 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 avatrombopag. Males and females of childbearing age and potential should use effective contraception during therapy. o Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. o Do not breastfeed while taking avatrombopag and for two weeks after the last dose of avatrombopag. o 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 provider. Page 4 Obtaining medication o Talk with your care provider about the process for obtaining your avatrombopag. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: www.doptelet.com Product prescribing information: https://doptelet.com/themes/pdf/prescribing-information.pdf Product resources: https://doptelet.com/itp/doptelet-copay Updated – October 28, 2021 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 © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved.

Page 1 AXITINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — axitinib (AK sih TIH nib) Brand name — Inlyta® (in LY tuh) Approved uses Axitinib is used to treat patients with advanced kidney cancer (renal cell carcinoma). Dose and schedule Taking axitinib 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 axitinib is 5 milligrams (5 mg) to be taken by mouth at a scheduled time twice daily (about 12 hours apart). Axitinib can be taken with or without food with a full glass of water, but at the same time each day. Axitinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow axitinib, talk to your care provider or pharmacist for possible options. If you miss a dose of axitinib, 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. If you need to have surgery, tell your care provider you are taking axitinib. Axitinib may need to be stopped until your wound heals after some surgeries. Drug and food interactions Axitinib has many drug interactions. Inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products. Grapefruit or grapefruit juice may interact with axitinib. Avoid eating or drinking these during treatment with axitinib. Talk with your care team or pharmacist before taking new medications or supplements or receiving any vaccines. Storage and handling Handle axitinib 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 axitinib at room temperature (68°F–77°F) in a dry location away from light. Keep axitinib out of reach of children and pets. Leave axitinib in the provided packaging until it is ready to be taken. Whenever possible, give axitinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give axitinib 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.)AXITINIB ORAL CHEMOTHERAPY EDUCATION Page 2 3. Gently transfer the axitinib 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. If a daily pill box or pill reminder will be used, contact your care team before using: • 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 axitinib, 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 axitinib. If you are traveling, put your axitinib’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Side Effects of Axitinib Below are common side effects that have been known to happen in about one third or more of patients taking axitinib 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 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 (e.g., bananas, applesauce, potatoes, chicken, rice, toast). • Avoid high fiber foods (e.g., raw vegetables, raw fruits, whole grains). • Avoid foods that cause gas (e.g., broccoli, beans). • Avoid lactose containing foods (e.g., yogurt, 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 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. Continued on the next pageAXITINIB ORAL CHEMOTHERAPY EDUCATION Page 3 Possible Side Effect Management Changes in kidney function Your kidney (renal) function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: • Decreased amount of urination • Unusual swelling in your legs and feet Changes in electrolytes and other laboratory values • Low bicarbonate levels • Low calcium levels • High blood glucose • Low alkaline phosphatase Changes in some laboratory values may occur and should be monitored by a simple blood test. • You may not feel any symptoms if the changes are mild, and they usually are not a sign of a serious problem. • More severe changes may occur, which can be a sign of a serious problem. Notify your care provider if you have any of the following: • Shortness of breath • Chest discomfort • Weakness or fatigue • New aches and pains • Headaches • Dizziness • Swelling of your legs or feet • Red or brown colored urine Increased blood pressure Routinely take your blood pressure. Record your blood pressure in a journal/diary and report these to your physician. Contact your care provider for high blood pressure or if the following symptoms occur: • Headache • Dizziness • Chest pain • Shortness of breath • Fluid retention, weight gain, or swelling Fatigue 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, too. • 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. Continued on the next pageAXITINIB ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management Decreased appetite or weight loss Talk to your care provider if you notice a decrease in weight while taking this medication. When you do not feel like eating, try the following: • Eat small, frequent meals instead of three large meals each day. • Keep snacks nearby so you can eat when you feel hungry. • Take liquid nutritional supplements. • Drink 8–10 glasses of water or fluid each day, especially if you are not eating, unless your care provider has instructed you to limit your fluid intake. Decreased hemoglobin, part of the red blood cells that carry iron and oxygen Your hemoglobin should be monitored using a blood test. When your hemoglobin is low, you may notice that you get tired or fatigued more easily. • Try to get 7–8 hours of sleep per night. • Avoid operating heavy machinery if you feel too tired. • Find a balance between work and rest. • Stay as active as possible, but know that it is okay to rest as needed. • You might notice that you are more pale than usual. Let your care provider know right away if you experience any of the following: • Shortness of breath • Dizziness • Palpitations Decreased white blood cells (WBCs) and increased risk for infection Your WBCs should be monitored by a simple blood test. When your WBCs are low, you are at a greater risk of having an infection. Take the following precautions to protect yourself from infection. • Wash your hands often, especially before eating and after using the bathroom. • Avoid crowds and people with fevers, flu, or other infection. • Bathe regularly to keep good personal hygiene. Contact your care provider if you experience any signs or symptoms of an infection: • Fever (temperature more than 100.4°F or 38°C) • Chills • Sore throat • Burning with urination • Unusual tiredness • A sore that becomes red, is draining, or does not heal Check with your care provider before taking any medicine for a fever or chills. Continued on the next pageAXITINIB ORAL CHEMOTHERAPY EDUCATION Page 5 Possible Side Effect Management Nausea or vomiting • 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. • Avoid vigorous exercise immediately after eating. • Don’t lie down immediately after eating. • Avoid strong odors. Let your provider know if you experience nausea or vomiting. Your provider may prescribe medication that can help. Voice changes or hoarseness These changes are not permanent and should go away during the time you are not taking the medication. Changes in liver function Your liver function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: • Yellowing of the skin or whites of your eyes • Dark or brown urine • Bleeding or bruising Serious side effects of axitinib Axitinib can increase your risk of having a stroke. Be aware of the signs of a stroke and seek medical attention immediately at the first sign of a stroke. Axitinib can increase your risk of having a heart attack. Be aware of the signs of a heart attack and seek medical attention immediately at the first sign of a heart attack. If you need to have a surgical or dental procedure, tell your doctor that you are taking axitinib. You may need to stop axitinib until your wound heals after some types of surgery. Axitinib may be harmful to your thyroid. Speak to your care provider to know when you need to have laboratory tests done to monitor your thyroid function. Your doctor may prescribe medication to keep your thyroid functioning properly. Axitinib can cause severe diarrhea or perforation (hole) of the intestine. Tell your doctor right away if you develop fever, severe abdominal pain or diarrhea that lasts longer than a day. A condition called reversible posterior leukoencephalopathy syndrome can occur while taking axitinib. Call your healthcare provider immediately if you have headaches, seizures, confusion or changes in vision. You may be at a higher risk of bleeding while taking axitinib. Contact your care team if you notice frequent nose bleeds, blood in your stool, bleeding that occurs by itself without injury, or bleeding that will not stop after five minutes of pressure. Axitinib can increase your risk of having a blood clot. Seek immediate medical attention if you have sudden swelling in an arm or leg, chest pain, or trouble breathing.AXITINIB ORAL CHEMOTHERAPY EDUCATION Page 6 If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Because axitinib 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 axitinib, it is important to follow the instructions below every day for as long as your treatment lasts. This is to keep yourself, 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 axitinib 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. Pregnancy, sexual activity, and contraception Women should not become pregnant, and men should not get a partner pregnant, while taking axitinib. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of one month after the last dose of axitinib. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Do not breastfeed while taking axitinib and for one month after the last dose of axitinib. Inform your care provider if you become pregnant. 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 provider. Obtaining medication Talk with your care provider about the process for obtaining your axitinib.AXITINIB ORAL CHEMOTHERAPY EDUCATION Page 7 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 © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: www.inlyta.com Product prescribing information: http://labeling.pfizer.com/ShowLabeling.aspx?id=759 Product resources: www.inlyta.com/cancer resources Updated – June 7, 2021 Additional instructions

Page 1 AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name avapritinib (AY vah PRIH tih nib) Brand name Ayvakit™ (aye vah kit) Approved uses Avapritinib is used to treat adults with a certain type of stomach, bowel, or esophagus cancer called gastrointestinal stromal tumor (GIST) that cannot be treated with surgery or that has spread to other parts of the body (metastatic), and that is caused by certain abnormal platelet derived growth factor receptor alpha (PDGFRA) genes. Dose and schedule Taking avapritinib 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 avapritinib is 300 milligrams (300 mg) to be taken by mouth at a scheduled time once a day. Avapritinib should be taken on an empty stomach, at least one hour before and two hours after a meal. Avapritinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow avapritinib, talk to your care provider or pharmacist for possible options. If you miss a dose of avapritinib, follow these guidelines: Take it as soon as you remember, unless your next scheduled dose is due within eight hours. Take the next dose at your regular time. Do not take two doses at one 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 Avapritinib has many drug interactions. Please inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products. Avapritinib should not be taken with food. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle avapritinib 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 avapritinib at room temperature (68°F–77°F) in a dry location away from light. Keep avapritinib out of reach of children and pets. Leave avapritinib in the provided packaging until it is ready to be taken. AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 2 Whenever possible, you should give avapritinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the avapritinib 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 avapritinib 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. If a daily pill box or pill reminder will be used, contact your care team before using. 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 avapritinib, 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 avapritinib. If you are traveling, put your avapritinib’s packaging in a separate sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Avapritinib Below are common side effects that have been known to happen in about one third or more of patients taking avapritinib; 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 Management Decreased hemoglobin, part of the red blood cells that carry iron and oxygen Your hemoglobin should be monitored by a simple blood test. When your hemoglobin is low, you may notice that you get tired or fatigued more easily. Try to get 7–8 hours of sleep per night. Avoid operating heavy machinery if you feel too tired. Find a balance between work and rest. Stay as active as possible, but know that it is okay to rest as needed. You might notice that you are more pale than usual. Let your care provider know right away if you experience any of the following: Shortness of breath Dizziness Palpitations Fluid retention or swelling Do not stand for long periods of time. Keep your legs elevated when sitting or lying down. Try not to eat salty foods, which can increase swelling. Avoid tight fitting clothing and shoes. Weigh yourself daily. Contact your provider if you notice any of the following: Swelling in the hands, feet, or legs Shortness of breath Weight gain of five pounds or more in one week Changes in liver function Your liver function should be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: Yellowing of the skin or whites of your eyes Dark or brown urine Bleeding or bruising Continued on the next page AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management Nausea or vomiting 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. Avoid vigorous exercise immediately after eating. Don’t lie down immediately after eating. Avoid strong odors. Let your provider know if you experience nausea or vomiting. Your provider may prescribe medication that can help. Decreased white blood cells (WBCs) and increased risk for infection Your WBCs should be monitored by a simple blood test. When your WBCs are low, you are at a greater risk of having an infection. Take the following precautions to protect yourself from infection. Wash your hands often, especially before eating and after using the bathroom. Avoid crowds and people with fevers, flu, or other infection. Bathe regularly to keep good personal hygiene. Contact your care provider if you experience any signs or symptoms of an infection: Fever (temperature more than 100.4°F or 38°C) Chills Sore throat Burning with urination Unusual tiredness A sore that becomes red, is draining, or does not heal Check with your care provider before taking any medicine for a fever or chills. Fatigue 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 cars or machinery if you feel too tired. Continued on the next page AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 5 Possible Side Effect Management Changes in electrolytes and other laboratory values including Low phosphate levels Low potassium levels Low magnesium levels Low albumin levels High creatinine levels High bilirubin levels High aspartate aminotransferase (AST) levels Changes in some laboratory values may occur and will be monitored by a simple blood test. You may not feel any symptoms if the changes are mild, and they usually are not a sign of a serious problem. More severe changes may occur, which can be a sign of a serious problem. Notify your care provider if you have any of the following: Shortness of breath Chest discomfort Weakness or fatigue New aches and pains Headaches Dizziness Swelling of your legs or feet Red or brown colored urine Cognitive impairment Cognitive impairment includes: Memory impairment Confused state Disturbance in attention Amnesia Mental impairment Mental status changes Dementia Abnormal thinking Mental disorder Retrograde amnesia Let your provider know if you think you are experiencing any of these side effects. Decreased appetite or weight loss Talk to your care provider if you notice a decrease in weight while taking this medication. When you do not feel like eating, try the following: Small, frequent meals instead of 3 large meals each day Keep snacks nearby so you can eat when you feel hungry. Liquid nutritional supplements Drink 8–10 glasses of water or fluid each day, especially if you are not eating, unless your care provider has instructed you to limit your fluid intake. Continued on the next page AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 6 Serious side effects Avapritinib may cause rare but serious side effects, including the following: A buildup of fluid between your lung and chest cavity. Alert your care team immediately if you develop sudden onset chest pain or shortness of breath. Increased risk of bleeding in the brain. Contact your care team if you notice frequent nose bleeds, blood in your stool, bleeding that occurs by itself without injury, or bleeding that will not stop after five minutes of pressure. Stop taking avapritinib and tell your healthcare provider if you develop any symptoms such as severe headache, vision problems, severe sleepiness, or severe weakness on one side of your body. 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 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. Excessive tearing Your care provider may refer you for evaluation by an ophthalmologist. Be sure to let your provider know if are experiencing increased tearing or watery eyes. If you experience increased tearing when you are exposed to the sun, wear sunglasses when you go outdoors. Abdominal pain Abdominal pain/discomfort may occur. Report any serious pain or symptoms to your care provider immediately. Changes in kidney function Your kidney (renal) function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: Decreased amount of urination Unusual swelling in your legs or feet Hair color changes Changes to your hair color may occur during treatment. The hair usually returns to normal after treatment; for some, the change is permanent. AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 7 Avapritinib can cause serious birth defects. Do not take avapritinib if you are pregnant or think you might be pregnant. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Since avapritinib 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 avapritinib, 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. 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 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. 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 avapritinib 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. Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking avapritinib. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of six weeks after the last dose of avapritinib. Effective contraception could include condoms and/or oral contraceptives as prescribed. Do not breastfeed while taking avapritinib and for two weeks after the last dose of avapritinib. Please inform your care provider if you become pregnant. 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 provider. Obtaining medication Talk with your care provider about the process for obtaining your avapritinib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) AVAPRITINIB ORAL CHEMOTHERAPY EDUCATION Page 8 Additional resources Product website: https://www.ayvakit.com Product prescribing information: https://www.accessdata.fda.gov/drugsatfda docs/ label/2020/212608s000lbl.pdf Product resources: https://www.yourblueprint.com Updated – January 22, 2020 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 © 2020 by Hematology/Oncology Pharmacy Association. All rights reserved.

Page 1 AZACITIDINE ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — azacitidine (ay zuh SY tih deen) Brand name — ONUREG® (on u reg) Approved uses Azacitidine is used in the treatment of adults with acute myeloid leukemia. Dose and schedule Taking azacitidine 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 azacitidine is 300 mg orally once daily on days 1 through 14 of each 28 day cycle. Your dose is based on many factors, including your overall health and diagnosis. Administer an antiemetic 30 minutes before each dose, for at least the first 2 cycles. Azacitidine can be taken with or without food, but should be taken at the same time each day. Azacitidine should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow azacitidine, talk to your care provider or pharmacist for possible options. Do not substitute oral azacitidine for intravenous or subcutaneous azacitadine. If you miss a dose of azacitidine: • If a dose is missed or not taken at the usual time, take the dose as soon as possible on the same day, and resume the normal schedule the following day. • Do not take 2 doses on the same day. • Be sure to write down if you miss a dose, and let your care provider know about any missed doses. Do not to take an additional dose if vomiting occurs after taking azacitidine. Instead, continue with your next scheduled dose the following day. Drug and food interactions Azacitidine has potential drug interactions. Please inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle azacitidine 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 azacitidine at room temperature (68°F–77°F) in a dry location away from light. Leave pralsetinib in the provided packaging until it is ready to be taken. AZACITIDINE ORAL CHEMOTHERAPY EDUCATION Page 2 Keep bottle tightly closed. Store and dispense in the original bottle (with 2 desiccant canisters). Do not swallow the desiccants. Keep azacitidine out of reach of children and pets. Whenever possible, you should give azacitidine to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the azacitidine 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 azacitidine 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. A daily pill box or pill reminder is not recommended to be used with azacitidine. If you have any unused azacitidine, 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 azacitidine. If you are traveling, put your azacitidine in a separate sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Side Effects of Azacitidine Below are common side effects that have been known to happen in about one third or more of patients taking azacitidine; 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 Management Nausea or vomiting • 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. • Avoid vigorous exercise immediately after eating. • Don’t lie 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 AZACITIDINE ORAL CHEMOTHERAPY EDUCATION Page 3 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 because of some other health problem. • 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 (e.g., raw vegetables, raw fruits, whole grains). • Avoid foods that cause gas (e.g., broccoli, beans). • Avoid lactose containing foods (e.g., yogurt, 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 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. Constipation 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. • Stay active and exercise, if possible. • Eat foods high in fiber, like raw fruits and vegetables. Contact your care provider if you have not had a bowel movement in 3 or more days. Your care provider may recommend over the counter medications to help with your constipation. A daily stool softener, such as docusate (Colace®), and/or a laxative, such as senna (Senokot®), may be helpful. If these do not help within 48 hours, tell your provider. Fatigue You may be more tired than usual or have less energy. • Stay as active as possible, but know it is OK 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. Continued on the next page AZACITIDINE ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management Decreased white blood cells (WBCs) and increased risk for infection Your WBCs should be monitored by a simple blood test. When your WBCs are low, you are at a greater risk of having an infection. Take the following precautions to protect yourself from infection. • Wash your hands often, especially before eating and after using the bathroom. • Avoid crowds and people with fevers, flu, or other infection. • Bathe regularly to keep good personal hygiene. Contact your care provider if you experience any signs or symptoms of an infection such as: • Fever (temperature more than 100.4°F or 38°C) • Chills • Sore throat • Burning with urination • Unusual tiredness • A sore that becomes red, is draining, or does not heal Check with your care provider before taking any medicine for a fever or chills. Decreased platelet count and increased risk of bleeding 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 nail clippers. Call your care provider if you have bleeding that won’t stop. Examples include the following: • 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, observe blood in your urine or stool, cough up blood, or experience 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. AZACITIDINE ORAL CHEMOTHERAPY EDUCATION Page 5 Serious side effects Azacitidine may cause rare but serious side effects, including the following: • New or worsening low white blood cell counts (neutropenia): New or worsening low white blood cell counts are common but can also be severe during treatment with azacitidine. If your white blood cell counts become very low, you are at increased risk for infections. • New or worsening low platelet counts (thrombocytopenia): Low platelet counts are common but can also be severe during treatment with azacitidine. Tell your healthcare provider right away if you have any unusual bruising or bleeding. • Fertility problems in men and women. • Birth defects: Do not take azacitidine if you are pregnant or think you might be pregnant. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Since azacitidine 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 azacitidine, 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. 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 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. 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 azacitidine 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. Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking azacitidine. Advise men of reproductive potential to use effective contraception during treatment with azacitidine and for at least 3 months after the last dose. Advise women of reproductive potential to use effective contraception during treatment with azacitidine and for at least 6 months after the last dose. AZACITIDINE ORAL CHEMOTHERAPY EDUCATION Page 6 Effective contraception could include 1 or more of the following: oral contraceptive, barrier methods. There are no data regarding the presence of azacitidine in human milk or its effects on the breastfed child or milk production. Because of the potential for serious adverse reactions in the breastfed child, advise women not to breastfeed during treatment with azacitidine and for 1 week after the last dose. Please inform your care provider if you become pregnant. 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 Talk with your care provider about the process for obtaining your azacitidine. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: https://www.onuregpro.com/?gclid=EAIaIQobChMI2sL1iaHa6wIVUvDACh3hvw51EAAYASAAEgIyDPD BwE, https://packageinserts.bms.com/ppi/ppi onureg.pdf Product prescribing information: https://www.accessdata.fda.gov/drugsatfda docs/label/2020/214120s000lbl.pdf Product resources: https://www.bmsaccesssupport.bmscustomerconnect.com/patient Updated – September 21, 2020 Additional instructions AZACITIDINE ORAL CHEMOTHERAPY EDUCATION Page 7 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 © 2020 by Hematology/Oncology Pharmacy Association. All rights reserved.

Page 1 ERDAFITINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — erdafitinib (ER duh FIH tih nib) Brand name — Balversa® (bal VER sah) Approved uses Erdafitinib is used to treat bladder cancer that has a genetic mutation called fibroblast growth factor receptor (FGFR). Dose and schedule Taking erdafitinib 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 erdafitinib is 8 milligrams (8 mg) to be taken by mouth at a scheduled time once a day. Your doctor may increase your dose to 9 milligrams (9 mg) daily after the first few weeks of treatment. Erdafitinib can be taken with or without food, but at the same time each day. Erdafitinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow erdafitinib, talk to your care provider or pharmacist for possible options. If you miss a dose of erdafitinib, follow these guidelines: • Take the missed dose as soon as possible on the same day. • Do not take two doses at one 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 Erdafitinib has many drug interactions. Please inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products. Grapefruit or grapefruit juice may interact with erdafitinib; avoid eating or drinking this during treatment with erdafitinib. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. For the first three weeks while taking erdafitinib, limit phosphate intake to 600 to 800 mg per day and avoid medications that can raise phosphate levels. Examples include potassium phosphate supplements, vitamin D supplements, antacids, and phosphate containing enemas or laxatives. Talk to your healthcare provider about other medications that may also contain phosphate. ERDAFITINIB ORAL CHEMOTHERAPY EDUCATION Page 2 Storage and handling Handle erdafitinib 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 erdafitinib at room temperature (68°F–77°F) in a dry location away from light. Keep erdafitinib out of reach of children and pets. Leave erdafitinib in the provided packaging until it is ready to be taken. Whenever possible, you should give erdafitinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the erdafitinib 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 erdafitinib 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. A daily pill box or pill reminder is not recommended to be used with erdafitinib. If you have any unused erdafitinib, 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 erdafitinib. If you are traveling, put your erdafitinib’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. ERDAFITINIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Erdafitinib Below are common side effects that have been known to happen in about one third or more of patients taking erdafitinib 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 Management Mouth irritation, mouth sores, or dry mouth Practice good mouth care. • Rinse your mouth frequently. • Brush your teeth with a soft toothbrush or cotton swab after meals. • Use a mild non alcohol mouth rinse at least four times a day (after eating and at bedtime). One example is a mixture of 1/8 teaspoon of salt and 1/4 teaspoon of baking soda in 8 ounces of warm (not hot) water. • If you have sores in your mouth, avoid using tobacco products, alcohol, and mouthwashes that contain alcohol. Call your care provider if you experience pain or sores in your mouth or throat. Changes in electrolytes and other laboratory values • High phosphate levels • Low sodium levels • Low magnesium levels Changes in some lab values may occur and will be monitored by a simple blood test. • You may not feel any symptoms if the changes are mild, and they usually are not a sign of a serious problem. • More severe changes may occur, which can be a sign of a serious problem. Notify your care provider if you have any of the following: • Shortness of breath • Chest discomfort • Weakness or fatigue • New aches and pains • Headaches • Dizziness • Swelling of your legs or feet • Red or brown colored urine Continued on the next page ERDAFITINIB ORAL CHEMOTHERAPY EDUCATION Page 4 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. Fatigue 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. Changes in kidney function Your kidney (renal) function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following. • Decreased amount of urination • Unusual swelling in your legs and feet Nail changes Usually this change starts at the cuticle and may affect the skin around the nail. • Biting, chewing, and picking at your nails can increase the risk of getting an infection. • Talk to your care provider if you notice any changes in your nails. Changes in liver function Your liver function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following. • Yellowing of the skin or whites of your eyes • Dark or brown urine • Bleeding or bruising Continued on the next page ERDAFITINIB ORAL CHEMOTHERAPY EDUCATION Page 5 Possible Side Effect Management Decreased appetite or weight loss • Talk to your care provider if you notice a decrease in weight while taking this medication. • When you do not feel like eating, try the following: – Eat small frequent meals instead of three large meals each day. – Keep snacks nearby so you can eat when you feel hungry. – Use liquid nutritional supplements. – Drink 8–10 glasses of water or fluid each day, especially if you are not eating, unless your care provider has instructed you to limit your fluid intake. Taste changes Some people experience a metallic or bitter taste in their mouth. To help with taste changes, try the following: • Choose and prepare foods that look and smell good to you. • Use plastic utensils if food tastes like metal. • Flavor foods with spices to change taste. • Suck on mints or chew gum to mask taste. • Brush teeth before and after eating with a soft bristle toothbrush. • Avoid smoking. Notify your doctor if you are having trouble eating or are losing weight. Decreased hemoglobin, part of the red blood cells that carry iron and oxygen Your hemoglobin should be monitored by a simple blood test. When your hemoglobin is low, you may notice that you get tired or fatigued more easily. • Try to get 7–8 hours of sleep per night. • Avoid operating heavy machinery if you feel too tired. • Find a balance between work and rest. • Stay as active as possible, but know that it is okay to rest as needed. • You might notice that you are more pale than usual. Let your health care provider know right away if you experience any of the following: • Shortness of breath • Dizziness • Palpitations Rash or dry skin • Keep your skin moisturized with creams and moisturizing lotions to decrease the risk of rash or itchiness, and wear loose fitting clothing. • Avoid using perfumes and cologne because these products may increase rash symptoms. • Avoid being in the heat for long periods of time. • Your provider may recommend an over the counter antihistamine or a topical cream. If your rash or itching continues to worsen, contact your care provider. ERDAFITINIB ORAL CHEMOTHERAPY EDUCATION Page 6 Serious side effects of erdafitinib Erdafitinib can cause serious birth defects. Do not take erdafitinib if you are pregnant or think you might be pregnant. Erdafitinib may cause eye problems. Eye problems include dry or inflamed eyes, inflamed cornea (front part of the eye), and problems of the retina (an internal part of the eye). Tell your care team right away if you develop blurred vision, loss of vision, or visual changes. You should use artificial tears (hydrating or lubricating eye gels or ointments) at least every two hours during waking hours to help prevent dry eyes. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Since erdafitinib 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 erdafitinib, it is important to know 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. 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 erdafitinib 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. Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking erdafitinib. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of one month after the last dose of erdafitinib. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Do not breastfeed while taking erdafitinib and for one month after the last dose of erdafitinib. Please inform your care provider if you become pregnant. 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 provider. ERDAFITINIB ORAL CHEMOTHERAPY EDUCATION Page 7 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 © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved. Obtaining medication Talk with your care provider about the process for obtaining your erdafitinib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: https://www.balversa.com Product prescribing information: https://www.accessdata.fda.gov/drugsatfda docs/ label/2019/212018s000lbl.pdf Updated – July 15, 2021 Additional instructions

Page 1 Name of your medication Generic name — belumosudil (BEL ue MOE soo dil) Brand name — Rezurock™ (RE zu rok) Approved uses Belumosudil can also be used to treat adults who have received a bone marrow or stem cell transplant and now have chronic graft-versus-host disease (cGVHD). Dose and schedule Taking belumosudil 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 belumosudil is 200 milligrams (200 mg) to be taken by mouth at a scheduled time once a day. o Belumosudil should be taken with food, at the same time each day. o Belumosudil should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow belumosudil, talk to your care provider or pharmacist for possible options. o If you miss a dose of belumosudil, 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 Belumosudil has many drug interactions, please inform your care providers of all prescription medications, over-the counter medications, vitamins, and herbal products. o Grapefruit or grapefruit juice may interact with belumosudil; avoid eating or drinking these during treatment with belumosudil. o Medications that decrease stomach acid decrease belumosudil concentrations. Speak with your care team before using proton pump inhibitors (e.g., omeprazole [Prilosec®], esomeprazole [Nexium®]). o Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle belumosudil 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 belumosudil at room temperature (68 to 77 F) in a dry location away from light. o Keep belumosudil out of reach of children and pets. o Leave belumosudil in the provided packaging until it is ready to be taken. BELUMOSUDIL ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Belumosudil Below are common side effects that have been known to happen in about one third or more of patients taking exemestane; 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 Management Changes in liver function Your liver function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: • Yellowing of the skin or whites of your eyes • Dark or brown urine • Bleeding or bruising Changes in kidney Your kidney (renal) function will be checked periodically by a simple blood test. Contact your care provider if you notice any of the following: • Decreased amount of urination • Unusual swelling in your legs and feet Continued on the next page o Whenever possible, you should give belumosudil to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the belumosudil 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 belumosudil 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. o A daily pill box or pill reminder is not recommended to be used with belumosudil. o If you have any unused belumosudil, 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 belumosudil. o If you are traveling, put your belumosudil’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Page 3 Decreased white blood cells (WBCs) and increased risk for infection Your WBCs should be monitored by a simple blood test. When your WBCs are low, you are at a greater risk of having an infection. Take the following precautions to protect yourself from infection: • Wash your hands often, especially before eating and after using the bathroom. • Avoid crowds and people with fevers, flu, or other infection. • Bathe regularly to keep good personal hygiene. Contact your care provider if you experience any signs or symptoms of an infection, such as: • Fever (temperature more than 100.4°F or 38°C) • Chills • Sore throat • Burning with urination • Unusual tiredness • A sore that becomes red, is draining, or does not heal Check with your care provider before taking any medicine for a fever or chills. Decreased platelet count and increased risk of bleeding 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 Page 4 Changes in electrolytes and other laboratory values • Low phosphate levels • High gamma glutamyl transpeptidase (GGT) levels • Low calcium levels • High alkaline phosphatase levels • High potassium Changes in some lab values may occur and will be monitored by a simple blood test. • You may not feel any symptoms if the changes are mild and they usually are not a sign of a serious problem. • More severe changes may occur which can be a sign of a serious problem. Notify your care provider if you have any of the following: • Shortness of breath • Chest discomfort • Weakness or fatigue • New aches and pains • Headaches • Dizziness • Swelling of your legs or feet • Red or brown colored urine Decreased hemoglobin, part of the red blood cells that carry iron and oxygen Your hemoglobin should be monitored by a simple blood test. When your hemoglobin is low, you may notice that you get tired or fatigued more easily. • Try to get 7 to 8 hours of sleep per night. • Avoid operating heavy machinery if you feel too tired. • Find a balance between “work” and “rest.” • Stay as active as possible, but know that it is okay to rest as needed, too. • You might notice that you are more pale than usual. Let your care provider know right away if you experience: • Palpitations Fatigue 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. Page 5 Nausea or vomiting • Eat and drink slowly. • Drink 8–10 glasses of water/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. • 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. Diarrhea (loose and/ or urgent bowel movements) Monitor how many bowel movements you have each day. • 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 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. Cough or shortness of breath A cough that does not produce any mucous or congestion relief (dry cough) may occur while taking this medication. If you experience any breathing problems or shortness of breath, notify your care provider immediately. This may be a serious side effect of the medication. Page 6 Serious side effects If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Because belumosudil 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 belumosudil, it is important to follow the instructions below 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 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 or exemestane 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 belumosudil. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of one week after the last dose of belumosudil. o Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. o Do not breastfeed while taking belumosudil and for one week after the last dose of belumosudil. o 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 provider. Page 7 Obtaining medication o Talk with your care provider about the process for obtaining your belumosudil. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: https://www.rezurock.com Product prescribing information: https://www.rezurock.com/full-prescribing-information.pdf Product resources: https://www.rezurock.com/kadmon-assist Updated – April 13, 2022 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 © 2022 by Hematology/Oncology Pharmacy Association. All rights reserved.