Adverse Event Management

Advice for Healthcare Professionals

• Proactively monitor full blood count, especially in the first two cycles, as neutropenia can be effectively managed by dose modification (i.e. temporary dose interruptions, cycle delays, and/or reductions)¹
• For full monitoring information, please refer to the IBRANCE Summary of Product Characteristics¹

Advice to Give Your Patients

• Promptly report any signs/symptoms of infection, such as fever (temperature ≥38°C) or chills⁷
• Check for fever at least once a day or as often as their Healthcare Professional recommends⁸
• Avoid crowded places and do not visit people with infections, coughs or fevers, especially when white blood counts are low⁷
• Maintain good hygiene; for example, patients should:⁸
  • Wash their hands often with soap and water, and carry hand sanitiser for times when they are unable to wash their hands
  • Wash cuts and scrapes with warm water, soap and an antiseptic until they have healed
  • Brush their teeth after meals and before they go to bed with a soft toothbrush, and use a mouth rinse that does not contain alcohol
• Use sanitising wipes to clean surfaces and items that they touch⁸
• Avoid anything that can cause cuts, scrapes or other breaks in the skin⁷
• Wash raw fruit and vegetables well before eating them⁸
• Do not eat raw or undercooked fish, seafood, meat, chicken or eggs, as these may contain bacteria that can cause infection⁷
  
  

Advice for Healthcare Professionals

• Treat underlying anaemia as appropriate
• IBRANCE®-induced anaemia is managed with dose delays and adjustments (i.e. temporary dose interruptions, cycle delays, and/or reductions)¹

Advice to Give Your Patients

• Immediately report any dizziness, shortness of breath or tiredness⁸
• Eat a well-balanced diet⁸
• Balance rest and activities⁷
• Stand up slowly, to avoid feeling dizzy; if getting up from lying down, sit for a minute before standing up⁸
• Plan important activities for when they have the most energy⁷
• Tell their doctor if unable to get around as they once were used to⁷
• Get plenty of rest; patients should try to sleep at least 8 hours each night and might also want to take 1–2 short naps (1 hour or less) during the day⁸

Advice for Healthcare Professionals

• Treat underlying leukopenia as appropriate
• IBRANCE®-induced leukopenia is managed with dose delays and adjustments (i.e. temporary dose interruptions, cycle delays, and/or reductions)¹
• Treat infections and symptoms of infection with standard-of-care treatment, including an anti-infective for bacterial infections as appropriate¹

Advice to Give Your Patients

• ​​​​​​​Promptly report any signs or symptoms of infection such as fever or chills¹
• Maintain good hygiene⁸
  • e.g. patients should wash their hands often
• Wash vegetables, salads and fruit well⁸
• Avoid crowded places and do not visit people with infections, coughs or fevers, especially when white blood counts are low⁷

Advice for Healthcare Professionals

• Thrombocytopenia is manageable with dose delays and adjustments (i.e. temporary dose interruptions, cycle delays, and/or reductions)¹

Advice to Give Your Patients

• Immediately report bleeding or bruising more easily⁸
• Avoid activities that might lead to injury⁸
• Protect skin from cuts, scrapes, and sharp objects⁸ — e.g. use an electric razor, not a blade, for shaving⁸
• Avoid medications that interfere with platelets being able to form clots e.g. NSAIDs⁸

Advice for Healthcare Professionals

• Treat infections and symptoms of infection with standard-of-care treatment
• Including an anti-infective for bacterial infections as appropriate.¹

Advice to Give Your Patients

• Promptly report any signs or symptoms of infection¹
  • Such as fever or chills
• Maintain good hygiene⁸
  • e.g. patients should wash their hands often
• Wash vegetables, salads and fruit well⁸
• Avoid crowded places, and do not visit people with infections, coughs, or fevers⁷

Advice to Give Your Patients^7-9

• Use gentle hair products, such as baby shampoos
• Be gentle when brushing and washing hair, and use a wide-toothed comb
• Avoid too much hair brushing or pulling (braids or ponytails)
• Avoid using hairdryers, curling tongs and curlers and, ideally, pat your hair dry
• Wear a hat or scarf outside to keep warm
• Wear cotton items on the scalp because they tend to stay on better than nylon or polyester
• Use sunscreen, sunblock or a hat to protect the scalp from the sun
• Wear a hairnet while sleeping, or sleep on a satin pillowcase
• Avoid perms and dyes for the first few months of new hair growth, to prevent breakage

Advice for Healthcare Professionals

• Treat IBRANCE®-related diarrhoea with an anti-diarrhoeal as appropriate

Advice to Give Your Patients⁷

• Drink plenty of clear liquid to replace lost fluids
  • e.g. water, weak tea, apple juice, peach or apricot nectar, clear broth
• Eat small, frequent meals instead of three large ones
• Avoid greasy foods, bran, raw fruits and vegetables, caffeine, very hot or spicy foods and milk or milk products
• Eat foods high in potassium
  • e.g. bananas, potatoes, apricots
• Don’t drink alcohol or use tobacco
• When the diarrhoea starts to improve, try eating small amounts of foods that are easy to digest
  • e.g. rice, bananas, applesauce, yoghurt, mashed potatoes, low fat cottage cheese and dry toast

Advice for Healthcare Professionals

If necessary, nausea and vomiting can be treated with an anti-emetic as appropriate.⁷

Advice to Give Your Patients⁷

• Drink plenty of clear liquid to replace lost fluids
  • e.g. water, weak tea, apple juice, peach or apricot nectar, clear broth
• Eat small, frequent meals instead of three large ones
• Avoid greasy foods, bran, raw fruits and vegetables, caffeine, very hot or spicy foods and milk or milk products
• Eat foods high in potassium
  • e.g. bananas, potatoes, apricots
• Don’t drink alcohol or use tobacco
• When the diarrhoea starts to improve, try eating small amounts of foods that are easy to digest
  • e.g. rice, bananas, applesauce, yoghurt, mashed potatoes, low fat cottage cheese and dry toast

Advice to give your Patients^7-9

• Plan your daily routine to make sure you are getting enough rest and activity
• Try doing light exercise each day, as this can give you more energy
• Take short rests or breaks
• Don’t push yourself too hard; rest when you begin to feel tired
• Eat a well-balanced diet and drink plenty of fluids
  • Sometimes tiredness and weakness can be caused by dehydration
• Plan important activities for when you have the most energy
• Ask others to help with more strenuous activities, such as chores
• Do things that are relaxing, such as listening to music or reading
• Support groups may be able to help you manage stress and work through things that are making you tired

Advice to Give Your Patients¹⁰

• Use a soft toothbrush and mild toothpaste
• Rinse with mild bicarbonate of soda/salt rinses; swish it around and gently gargle before spitting out
• Eat soft or pureed foods, avoid spicy, hot, crisp/crunchy, very salty or acidic foods or beverages
• Use a straw for drinking
• Avoid fizzy drinks, alcohol and tobacco
• Keep mouth moist by swishing and spitting water throughout the day, sucking on ice chips or sugar-free hard sweets
• Check mouth and tongue every day and inform HCP of any mouth sores, white spots or infections, as soon as they arise