Page 1 MERCAPTOPURINE ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — mercaptopurine mer KAP toh PYOOR een Brand name — Purinethol® pyoor IN eh thol ; Purixan® PYOOR ee zan Other names — 6 mercaptopurine and 6 MP Approved uses Mercaptopurine is used to treat adult and pediatric patients with acute lymphoblastic leukemia ALL . Dose and schedule Taking mercaptopurine as instructed is important to allow your treatment to be as effective as possible, so here are some key points to remember. Your dose is based on many factors, including your height and weight, overall health, and diagnosis. Mercaptopurine can be taken with or without food but at the same time each day. Mercaptopurine tablets should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow mercaptopurine, talk to your care provider or pharmacist for possible options. Mercaptopurine suspension should be shaken vigorously for at least 30 seconds prior to taking. If you miss a dose of mercaptopurine, do not take an extra dose or two doses at one time. Simply take your next dose at the regularly scheduled time. Be sure to write down if you miss a dose and let your care provider know about any missed doses. Storage and handling Handle mercaptopurine 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 mercaptopurine at room temperature 68°F–77°F in a dry location away from light. Keep mercaptopurine out of reach of children and pets. Leave mercaptopurine in the provided packaging until it is ready to be taken. Once opened, mercaptopurine suspension should be used within 8 weeks. Whenever possible, give mercaptopurine to yourself and follow the steps below. If a family member, friend, or caregiver needs to give mercaptopurine 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 mercaptopurine 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. MERCAPTOPURINE ORAL CHEMOTHERAPY EDUCATION Page 2 If a daily pill box or pill reminder is used, a separate one should be used for mercaptopurine. Do not mix other medications into the box with mercaptopurine. 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 mercaptopurine, 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 mercaptopurine. If you are traveling, put your mercaptopurine in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Handling body fluids and waste Because mercaptopurine 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 mercaptopurine, 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 mercaptopurine with soap and water. Linens or clothing that are soiled with body fluids or body waste should be washed separately from other linens and clothing. If you do not have a washer, place the soiled linens in a plastic bag until they can be washed. Wash hands with soap and water after touching linens or clothing that may be soiled with body fluids. Drug and food interactions Mercaptopurine has many drug interactions. 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. MERCAPTOPURINE ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Mercaptopurine The common side effects that have been known to happen in more than 30% of patients taking mercaptopurine are listed in the left side of this table. You MAY NOT experience these side effects. Options to help manage any side effects that do occur are included on the right side of this table. These should be discussed with your care provider. If you experience any side effect you cannot manage or that is not listed here, contact your care provider. Possible Side Effect Management 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 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. 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. Continued on the next page MERCAPTOPURINE ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management 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 healthcare provider know right away if you experience any of the following: Shortness of breath Dizziness Palpitations 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 If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: INSTITUTIONAL CONTACT INFO Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking mercaptopurine. 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 mercaptopurine. Do not breastfeed while taking mercaptopurine and for one month after the last dose of mercaptopurine. 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 mercaptopurine. PHARMACY OR SPECIALTY PHARMACY CONTACT INFO MERCAPTOPURINE ORAL CHEMOTHERAPY EDUCATION Page 5 Additional resources Product website: www.purixan us.com Product prescribing information: www.accessdata.fda.gov/drugsatfda docs/label/2011/009053s032lbl.pdf; www.purixan us.com/resources/Package Insert.pdf Product resources: www.purixan us.com/information instructions/#info Updated – February 5, 2018 Additional instructions Important notice: The Association of Community Cancer Centers ACCC , Hematology/Oncology Pharmacy Association HOPA , National Community Oncology Dispensing Association, Inc. NCODA , and Oncology Nursing Society ONS have collaborated in gathering information for and developing this patient education guide. This guide represents a brief summary of the medication derived from information provided by the drug manufacturer and other resources. This guide does not cover all existing information related to the possible uses, directions, doses, precautions, warnings, interactions, adverse effects, or risks associated with this medication and should not substitute for the advice of a qualified healthcare professional. Provision of this guide is for informational purposes only and does not constitute or imply endorsement, recommendation, or favoring of this medication by ACCC, HOPA, NCODA, or ONS, who assume no liability for and cannot ensure the accuracy of the information presented. The collaborators are not making any representations with respect to the medications whatsoever, and any and all decisions, with respect to such medications, are at the sole risk of the individual consuming the medication. All decisions related to taking this medication should be made with the guidance and under the direction of a qualified healthcare professional. Permission: Oral Chemotherapy Education OCE sheets are provided as a free educational resource for patients with cancer in need of concise, easy to understand information about oral cancer drugs. Healthcare providers are permitted to copy and distribute the sheets to patients as well as direct patients to the OCE website for information. However, commercial reproduction or reuse, as well as rebranding or reposting of any type, are strictly prohibited without permission of the copyright holder. Please email permission requests and licensing inquiries to This email address is being protected from spambots. You need JavaScript enabled to view it.. Copyright © 2018 by Hematology/Oncology Pharmacy Association. All rights reserved.

Page 1 ABEMACICLIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — abemaciclib uh BEH muh SY klib Brand name — Verzenio™ ver ZEH nee oh Approved uses Abemaciclib (Verzenio™) is used to treat adult patients with hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)–negative breast cancer. Dose and schedule Taking abemaciclib 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 abemaciclib is 150 milligrams 150 mg to be taken by mouth twice daily when given in combination with fulvestrant or an aromatase inhibitor. When abemaciclib is given alone as monotherapy, the usual dose is 200 milligrams 200 mg taken by mouth twice daily. The dose may be adjusted by your care provider based upon your individual needs. Abemaciclib can be taken with or without food, but at the same times each day. Abemaciclib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow abemaciclib, talk to your care provider or pharmacist for possible options. If you miss a dose of abemaciclib, do not take an extra dose or two doses at one time. Simply take your next dose at the regularly scheduled time. Be sure to write down if you miss a dose and let your care provider know about any missed doses. Storage and handling Handle abemaciclib 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 abemaciclib at room temperature 68°F–77°F in a dry location away from light. Keep abemaciclib out of reach of children and pets. Leave abemaciclib in the provided packaging until it is ready to be taken. Whenever possible, give abemaciclib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the abemaciclib 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 abemaciclib 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. ABEMACICLIB ORAL CHEMOTHERAPY EDUCATION Page 2 If a daily pill box or pill reminder is used, a separate one should be used for abemaciclib. Do not mix other medications into the box with abemaciclib. 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 abemaciclib, 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 abemaciclib. If you are traveling, put your abemaciclib in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Handling body fluids and waste Abemaciclib 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 abemaciclib, 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 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 abemaciclib with soap and water. Linens or clothing that are soiled with body fluids or body waste should be washed separately from other linens and clothing. If you do not have a washer, place the soiled linens in a plastic bag until they can be washed. Wash hands with soap and water after touching linens or clothing that may be soiled with body fluids. Drug and food interactions Abemaciclib has the potential for drug interactions. Inform your care provider of all prescription medications, over thecounter medications, vitamins, and herbal products that you are taking. Grapefruit or grapefruit juice may interact with abemaciclib. Avoid eating or drinking these during your treatment with abemaciclib. Abemaciclib can be taken with or without food. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. ABEMACICLIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Abemaciclib The common side effects that have been known to happen in more than 30% of patients taking abemaciclib are listed in the left side of this table. You MAY NOT experience these side effects. Options to help manage any side effects that do occur are included on the right side of this table. These should be discussed with your care provider. If you experience any side effect you cannot manage or that is not listed here, contact your care provider. Possible Side Effect Management Changes in kidney function Your kidney renal function should 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 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 due to some other health problem. 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 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 page ABEMACICLIB 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: 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 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 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. Continued on the next page ABEMACICLIB 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 to help with the nausea or vomiting. 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 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 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. Abdominal pain Abdominal pain or discomfort may occur. Report any serious pain or symptoms to your care provider immediately. Continued on the next page ABEMACICLIB ORAL CHEMOTHERAPY EDUCATION Page 6 If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: INSTITUTIONAL CONTACT INFO Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking abemaciclib. Women of childbearing age and potential should use effective contraception during therapy and for a minimum of three weeks after the last dose of abemaciclib. Men of reproductive age and potential should use effective contraception during therapy and for a minimum of three months after the last dose of abemaciclib. Do not breastfeed while taking abemaciclib and for three weeks after the last dose of abemaciclib. 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 abemaciclib, and you are encouraged to ask your care provider. Obtaining medication Talk with your care provider about the process for obtaining your abemaciclib. PHARMACY OR SPECIALTY PHARMACY CONTACT INFO Possible Side Effect Management 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 five 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. ABEMACICLIB 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 © 2018 by Hematology/Oncology Pharmacy Association. All rights reserved. Additional resources Product website: www.verzenio.com Product prescribing information: http://uspl.lilly.com/verzenio/verzenio.html#pi Product resources: www.verzenio.com/savings support Updated – March 2, 2018 Additional instructions

Page 1 ABIRATERONE ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — abiraterone acetate (A bih RA the rone A seh tayt) Brand names — Zytiga® (zye Tee ga), Yonsa® Please make sure to follow the instructions on the side of the table that your provider has checked. Approved uses Dose and schedule Taking abiraterone acetate as instructed is important to allow your treatment to be as effective as possible, so here are some key points to remember. Drug and food interactions Abiraterone acetate has many drug interactions. Inform your care providers of all prescription medications, over thecounter medications, vitamins, and herbal products that you are taking. Grapefruit or grapefruit juice may interact with abiraterone acetate; avoid eating or drinking these during treatment with abiraterone acetate. Talk with your care team or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle abiraterone acetate 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. Treatment of metastatic castration resistant prostate cancer (CRPC) and treatment of metastatic high risk castrationsensitive prostate cancer (CSPC) Treatment of metastatic castration resistant prostate cancer (CRPC) Abiraterone (Zytiga) Yonsa For CRPC, take 1,000 mg orally once daily with prednisone 5 mgh orally twice daily. For CSPC, take 1,000 mg orally once daily with prednisone 5 mg orally once daily. Zytiga is recommended to be taken on an empty stomach. Patients should either be prescribed a gonadotropinreleasing hormone (GnRH) analog or have had a bilateral orchiectomy. Take 500 mg administered orally once daily in combination with methylprednisolone 4 mg administered orally twice daily. Yonsa is recommended to be taken with or without food. Patients should either be prescribed a gonadotropinreleasing hormone (GnRH) analog or have had a bilateral orchiectomy. Abiraterone (Zytiga) YonsaABIRATERONE ORAL CHEMOTHERAPY EDUCATION Page 2 Store abiraterone acetate at room temperature (68°F–77°F) in a dry location away from light. Keep abiraterone acetate out of reach of children and pets. Leave abiraterone acetate in the provided packaging until it is ready to be taken. Whenever possible, give abiraterone acetate to yourself and follow the steps below. If a family member, friend, or caregiver needs to give abiraterone acetate 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 abiraterone acetate 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 abiraterone acetate, 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 abiraterone acetate. If you are traveling, put your abiraterone acetate’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed.ABIRATERONE ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Abiraterone Acetate The common side effects that have been known to happen in more than 30% of patients taking abiraterone acetate are listed in the left side of this table. You MAY NOT experience these side effects. Options to help manage any side effects that do occur are included on the right side of this table. These should be discussed with your care provider. If you experience any side effect you cannot manage or that is not listed here, contact your care provider. Possible Side Effect Management Changes in electrolytes and other laboratory values • High trigylceride levels • High glucose levels • Low sodium 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 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 • Unusual bleeding or bruising 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 pageABIRATERONE ORAL CHEMOTHERAPY EDUCATION Page 4 Serious side effects of abiraterone acetate Abiraterone can cause high blood pressure, low potassium and fluid retention. Tell your healthcare provider if you get any of the following symptoms: dizziness, fast heartbeats, feel faint or lightheaded, headache, confusion, muscle weakness, pain in your legs, swelling in your legs or feet. Abiraterone can cause damage to your adrenal glands. Speak to your care provider to know when you need to have laboratory tests done to monitor your adrenal glands. Steroid medication is often prescribed to help with this side effect. Abiraterone may be harmful to your liver. Speak to your care provider to know when you need to have laboratory tests done to monitor your liver function. If your get this side effect, your doctor may change your dose or stop treatment for some time. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Abiraterone acetate 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 abiraterone acetate, 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 abiraterone acetate 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 abiraterone acetate. 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 abiraterone acetate. o Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Inform your care provider if you become pregnant. ABIRATERONE ORAL CHEMOTHERAPY EDUCATION Page 5 It is safe to hug and kiss. Special precautions may be needed for sexual activity while on abiraterone acetate, and you are encouraged to ask your care provider. Obtaining medication Talk with your care provider about how to obtain your abiraterone acetate. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: www.zytiga.com, www.yonsarx.com Product prescribing information: www.zytiga.com/shared/product/zytiga/zytiga prescribing information.pdf, www.yonsarx.com/wp content/uploads/2019/03/YonsaFullPrescribingInformation.pdf Updated – July 21, 2021 Additional instructions ABIRATERONE 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 © 2020 by Hematology/Oncology Pharmacy Association. All rights reserved

Page 1 ACALABRUTINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — acalabrutinib (uh KA luh BROO tih nib) Brand name — Calquence® (KAL kwents) Approved uses Acalabrutinib is used to treat patients with mantle cell lymphoma, chronic lymphocytic leukemia or small lymphocytic lymphoma Dose and schedule Taking acalabrutinib 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 acalabrutinib is 100 milligrams (100 mg) to be taken by mouth every 12 hours. The dose may be adjusted by your care provider based upon your individual needs. Acalabrutinib can be taken with or without food, but at the same time each day. Acalabrutinib should be taken whole and not crushed, cut, opened, or dissolved. If you are unable to swallow acalabrutinib, talk to your care provider or pharmacist for possible options. If you miss a dose of acalabrutinib, follow these guidelines: • Only take the missed dose if it has been less than three hours since you were supposed to take it. Then, take the next dose at the regularly scheduled 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 Acalabrutinib has the potential for drug interactions. Inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products that you are taking. Grapefruit or grapefruit juice may interact with acalabrutinib. Avoid eating or drinking these during your treatment with acalabrutinib. Medications that decrease stomach acid decrease acalabrutinib concentrations. Avoid use with proton pump inhibitors (e.g., omeprazole [Prilosec®], esomeprazole [Nexium®]), if possible. If taken with a histamine blocker (e.g., ranitidine [Zantac®], famotidine [Pepcid®]), take acalabrutinib 10 hours after the histamine blocker and at least 2 hours prior to the next histamine blocker dose. Separate use of acalabrutinib from antacids by at least 2 hours. Talk with your care team or pharmacist before taking new medications or supplements, or receiving any vaccines. ACALABRUTINIB ORAL CHEMOTHERAPY EDUCATION Page 2 Storage and handling Handle acalabrutinib 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 acalabrutinib at room temperature (68°F–77°F) in a dry location away from light. Keep acalabrutinib out of reach of children and pets. Leave acalabrutinib in the provided packaging until it is ready to be taken. Whenever possible, give acalabrutinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the acalabrutinib 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 acalabrutinib 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 acalabrutinib, 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 acalabrutinib. If you are traveling, put your acalabrutinib’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. ACALABRUTINIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Acalabrutinib Below are common side effects that have been known to happen in about one third or more of patients taking acalabrutinib 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 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 five 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. Continued on the next page ACALABRUTINIB ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management Headache Ask your provider what you may use to help with this discomfort. Contact your care provider right away if your 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 • Is made worse by coughing or lowering the head 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 page ACALABRUTINIB ORAL CHEMOTHERAPY EDUCATION Page 5 Serious side effects of acalabrutinib Secondary malignancy is the growth of a cancer months or years after treatment. This is a rare but possible side effect of treatment with acalabrutinib. Acalabrutinib may cause arrhythmias, which are problems with your heartbeat. Call your care team right away if you feel a change in the way your heart beats. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) 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 due to some other health problem. • 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 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. ACALABRUTINIB ORAL CHEMOTHERAPY EDUCATION Page 6 Handling body fluids and waste Acalabrutinib 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 acalabrutinib, 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 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 acalabrutinib 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 acalabrutinib. Women of childbearing age and potential should use effective contraception during therapy and for a minimum of four weeks after the last dose of acalabrutinib. Men of reproductive age and potential should use effective contraception during therapy and for a minimum of four weeks after the last dose of acalabrutinib. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Do not breastfeed while taking acalabrutinib and for two weeks after the last dose of acalabrutinib. 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. ACALABRUTINIB 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. Obtaining medication Talk with your care provider about the process for obtaining your acalabrutinib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: www.calquence.com Product prescribing information: www.azpicentral.com/calquence/calquence.pdf#page=1 Product resources: www.calquence.com/patient/support for patients.html Updated – September 11, 2020 Additional instructions

Page 1 Name of your medication Generic name — adagrasib (a-DAH-GRA-sib) Brand name — KRAZATI® Common uses Adagrasib is used to treat patients with non-small cell lung cancer that have a genetic variant called KRAS G12C. Adagrasib may also be used for other treatments. Dose and schedule Taking adagrasib 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 adagrasib is 600 milligram (600 mg) to be taken by mouth at a scheduled time twice daily. o Adagrasib can be taken with or without food, but at the same time each day. o Adagrasib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow adagrasib, talk to your care provider or pharmacist for possible options. o If you miss a dose of adagrasib: • Only take the missed dose if it has been less than 4 hours since you were supposed to take it. Then take the next dose at the regularly scheduled 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 o Adagrasib 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 adagrasib; avoid eating or drinking these during treatment with adagrasib. o Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. ADAGRASIB ORAL CHEMOTHERAPY EDUCATION ADAGRASIB ORAL CHEMOTHERAPY EDUCATION Page 2 Storage and handling Handle adagrasib 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 adagrasib at room temperature (68°F to 77°F) in a dry location away from light. o Keep adagrasib out of reach of children and pets. o Leave adagrasib in the provided packaging until it is ready to be taken. o Whenever possible, you should give adagrasib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the adagrasib 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 adagrasib 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 adagrasib. o If you have any unused adagrasib, 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 adagrasib. o If you are traveling, put your adagrasib’s packaging in a separate sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. ADAGRASIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Adagrasib Below are common side effects that have been known to happen in about one-third or more of patients taking adagrasib; 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 Diarrhea Monitor how many bowel movements you have each day. • Drink 8–10 glasses of water or fluid each day unless your care provider has instructed you to limit your fluid intake. • Eat small, frequent meals throughout the day rather than a few large meals. • Eat bland, low-fiber foods (e.g., bananas, applesauce, potatoes, chicken, rice, toast). • Avoid high fiber foods, such as raw vegetables, raw fruits, and whole grains. • Avoid foods that cause gas, such as broccoli and beans. • Avoid lactose-containing foods, such as yogurt and milk. • Avoid spicy, fried, and greasy foods. Contact your provider if any of the following occur: • The number of bowel movements you have in a day increases by 4 or more. • You feel dizzy or lightheaded. Your care provider may recommend an over-the-counter medication called loperamide (Imodium®) to help with your diarrhea, but talk to your care provider before starting this medication. 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 lay down immediately after eating. • Avoid strong odors. Let your provider know if you experience nausea or vomiting. Your provider may prescribe medication to help with the nausea or vomiting. Continued on the next page ADAGRASIB 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 infections. • Bathe regularly to keep good personal hygiene. Contact your care provider if you experience any of the following 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. • Stay as active as possible, but know that it is okay to rest as needed, too. • Avoid operating heavy machinery if you feel too tired. Changes in electrolytes and other laboratory values • Decreased sodium • Decreased albumin • Increased lipase 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 experience 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 ADAGRASIB ORAL CHEMOTHERAPY EDUCATION Page 5 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 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 the following symptoms: • Shortness of breath • Dizziness • Palpitations 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 OK 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. 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 symptoms: • Yellowing of the skin or whites of your eyes • Dark or brown urine • Bleeding or bruising Changes in kidney function Your kidney (renal) function will be checked periodically by a simple blood test. Contact your care provider if you notice either of the following symptoms: • Decreased amount of urination • Unusual swelling in your legs and feet Cough or shortness of breath A cough that does not produce any mucous or congestion relief (i.e., 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. Continued on the next page ADAGRASIB ORAL CHEMOTHERAPY EDUCATION Page 6 Possible Side Effect Management Fluid retention or swelling • Do not stand for long periods of time. • Keep your legs elevated when sitting or lying down. • Try to not eat salty foods, which can increase swelling. • Avoid tight-fitting clothing and shoes. • Weigh yourself daily. Contact your care provider if you notice any of the following: • Swelling in the hands, feet, or legs • You are short of breath • You have gained 5 pounds or more in one week Decreased appetite or weight loss Talk to your care provider if you notice a decrease in weight when taking this medication. When you do not feel like eating, try the following: • Eat small, frequent meals throughout the day rather than a few large meals. • 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, particularly if you are not eating, unless your care provider has instructed you to limit your fluid intake. Serious side effects o Adagrasib may cause your lung tissue to scar, which is called interstitial lung disease. Call your care team if you are feeling short of breath, have a fever, or have a lasting dry cough. o Adagrasib may cause a condition called QT or QTc prolongation, which is a heart rhythm that can cause fast, irregular heartbeats. These fast heartbeats may cause you to faint or have a seizure. In rare cases, this could be life-threatening. Tell your care team right away if you feel faint, lightheaded, dizzy, or if you feel your heart beating irregularly or fast, when taking adagrasib. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: ADAGRASIB ORAL CHEMOTHERAPY EDUCATION Page 7 Handling body fluids and waste Because adagrasib 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 adagrasib, it is important to adhere to the following instructions every day for as long as your treatment lasts. This is to keep yourself, loved ones, and the environment as safe as possible. o Pregnant women should avoid touching anything that may be soiled with body fluids from the patient. o Toilet and septic systems: • You may use the same toilet, septic tank, and/or sewer that you usually use. If you have a low-flow toilet, close the lid and flush twice to ensure that all waste has been discarded. • If the toilet or toilet seat becomes soiled with urine, stool, or vomit, clean the surfaces before other people use the toilet. • Wash hands with soap and water after using the toilet. o If you need a bedpan, be sure your caregiver knows to wear gloves to assist with cleanup and to wash the bedpan with soap and water every day. o If you do not have good control of bladder or bowels, use a disposable pad with a plastic back, a diaper, or a sheet to absorb body waste. o Wash any skin that has been exposed to body waste or adagrasib 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 adagrasib. Males and females of childbearing age and potential should use effective contraception during therapy and for a minimum of 1 month after the last dose of adagrasib. o Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. o Do not breastfeed while taking adagrasib and for 1 week after the last dose of adagrasib. o Please inform your care provider if you become pregnant. o It is safe to hug and kiss. Special precautions may be needed for sexual activity while on oral chemotherapy, and you are encouraged to ask your care team for assistance. Obtaining medication o Talk with your care provider about the process for obtaining your adagrasib. ADAGRASIB ORAL CHEMOTHERAPY EDUCATION Page 8 Additional resources Product website: https://www.mirati.com Product prescribing information: https://www.mirati.com/krazati_uspi Product resources: https://www.mirati.com/responsibility/sponsorships-grants Updated – July 10, 2023 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 © 2023 by Hematology/Oncology Pharmacy Association. All rights reserved.

Page 1 AFATINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — afatinib (ay FA tih nib) Brand name — Gilotrif® (JEE loh trif) Approved uses Afatinib is used to treat people with non small cell lung cancer (NSCLC) with an epidermal growth factor receptor (EGFR) genetic mutation or a squamous cell type of NSCLC. Dose and schedule Taking afatinib 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 afatinib is 40 milligrams (40 mg) to be taken by mouth once daily. The dose may be adjusted by your care provider based on your individual needs. Afatinib must be taken without food (at least one hour before or two hours after a meal or snack) at the same time each day. Afatinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow afatinib, talk to your care provider or pharmacist for possible options. If you miss a dose of afatinib: • 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. • Do not take two doses at one time. • Be sure to write down if you miss a dose and let your care team know about any missed doses. Drug and food interactions Afatinib 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 provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle afatinib 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 afatinib at room temperature (68°F–77°F) in a dry location away from light. Keep afatinib out of reach of children and pets. Leave afatinib in the provided packaging until it is ready to be taken. Whenever possible, give afatinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give afatinib 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.) AFATINIB ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Afatinib Below are common side effects that have been known to happen in about one third or more of patients taking afatinib 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 • Low 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 3. Gently transfer the afatinib 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 afatinib, 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 afatinib. If you are traveling, put your afatinib’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. AFATINIB 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 related to 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, 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 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. Nail changes Usually changes start at the cuticle and may affect the skin around the nail. • Biting, chewing, or picking at your nails can increase the risk for infection. • Talk to your care provider if you notice any changes in your nails. 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. Continued on the next page AFATINIB ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management Mouth irritation or sores Practice good mouth care. • Rinse your mouth frequently. • Brush your teeth with a soft toothbrush or cotton swab after meals. • Use a mild nonalcohol mouth rinse at least four times a day (after eating and at bedtime). For example, you can use 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. Rash or itchy 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 as 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. Sunlight can make symptoms worse. • Avoid sun exposure as much as possible to decrease the risk of sunburn. The highest exposure to ultraviolet (UV) radiation occurs from 10 am–4 pm. • Wear long sleeved clothing, with UV protection if possible. • Wear broad brimmed hats. • Apply broad spectrum sunscreen (UVA/UVB) with at least SPF 30 as often as directed on the bottle. If your rash or itching continues to worsen, contact your care provider. 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 • Unusual bleeding or bruising Changes in kidney function Your kidney (renal) function will be checked periodically by a simple blood test. Contact your care provider if you notice either of the following: • Decreased amount of urination • Unusual swelling in your legs and feet Continued on the next page AFATINIB ORAL CHEMOTHERAPY EDUCATION Page 5 Possible Side Effect Management Acne like rash A rash that looks like acne may appear on your face, chest, and upper back while taking this medication. • Your doctor may prescribe medication to help prevent or manage the rash. • If you get a rash, keep the area around it clean and dry. • Check with your care provider before using anything to treat it. • Do not use over the counter acne treatments, such as benzoyl peroxide or salicylic acid, and soaps containing alcohol. • Oatmeal baths and unscented moisturizers may help with itching. Sunlight can make symptoms worse. • Avoid sun exposure as much as possible to decrease the risk of sunburn. The highest exposure to ultraviolet (UV) radiation occurs from 10 am–4 pm. • Wear long sleeved clothing, with UV protection if possible. • Wear broad brimmed hats. • Apply broad spectrum sunscreen (UVA/UVB) with at least SPF 30 as often as directed on the bottle. • Use lip balm with at least SPF 30. Serious side effects of afatinib Afatinib may be harmful to your lungs. Inform your care provider of any new difficulty breathing, cough, or fever. Your provider may stop treatment with afatinib if your lungs are affected. Afatinib may be harmful to your eyes. Be sure to inform your care provider of any issue you have with your vision, or pain in your eyes. Your provider may stop treatment with afatinib if your eyes are affected. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Afatinib 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 afatinib, 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. AFATINIB ORAL CHEMOTHERAPY EDUCATION Page 6 Pregnancy, sexual activity, and contraception Women should not become pregnant and men should not get a partner pregnant while taking afatinib. Men and women of childbearing age and potential should use effective contraception during therapy and for a minimum of two weeks after the last dose of afatinib. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Do not breastfeed while taking afatinib and for two weeks after the last dose of afatinib. 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 afatinib, and you are encouraged to ask your care provider. Obtaining medication Talk with your care provider about how to obtain your afatinib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) 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 afatinib 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. ABIRATERONE ORAL CHEMOTHERAPY EDUCATION Page 7 AFATINIB 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. Additional instructions Additional resources Product website: http://www.gilotrif.com Product prescribing information: https://docs.boehringer ingelheim.com/Prescribing%20Information/PIs/ Gilotrif/Gilotrif.pdf Product resources: http://www.gilotrif.com/patient resources/patient resources.html Updated – September 11, 2020

Page 1 ALECTINIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — alectinib (uh LEK tih nib) Brand name — Alecensa® (A leh SEN suh) Approved uses Alectinib is used to treat metastatic non small cell lung cancer (NSCLC) that has a genetic mutation called anaplastic lymphoma kinase (ALK). Dose and schedule Taking alectinib 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 alectinib is 600 milligrams (600 mg) to be taken by mouth at a scheduled time, two times a day. Alectinib should be taken with food and at the same times each day. Alectinib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow alectinib, talk to your care provider or pharmacist for possible options. If you miss a dose of alectinib, 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 Alectinib has many drug interactions. Please inform your care provider 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. ALECTINIB ORAL CHEMOTHERAPY EDUCATION Page 2 Storage and handling Handle alectinib 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 alectinib at room temperature (68°F–77°F) in a dry location away from light. Keep alectinib out of reach of children and pets. Leave alectinib in the provided packaging until it is ready to be taken. Whenever possible, you should give alectinib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the alectinib 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 alectinib 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 alectinib. Keep alectinib in the original container until use. If you have any unused alectinib, 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 alectinib. If you are traveling, put your alectinib’s packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. ALECTINIB ORAL CHEMOTHERAPY EDUCATION Page 3 Side Effects of Alectinib Below are common side effects that have been known to happen in about one third or more of patients taking alectinib 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 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 electrolytes and other laboratory values • High creatine phosphokinase levels • High glucose levels • Low calcium 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 ALECTINIB ORAL CHEMOTHERAPY EDUCATION Page 4 Possible Side Effect Management 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. 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 three 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. Fluid retention or swelling • Do not stand for long periods of time. • Keep your legs elevated when sitting or lying down. • Avoid eating salty foods, which can increase swelling. • Avoid wearing tight fitting clothing and shoes. • Weigh yourself daily. Contact your care provider if you notice: • Swelling in the hands, feet, or legs Serious side effects of alectinib Alectinib may be harmful to your liver. Speak to your care provider to know when you need to have laboratory tests done to monitor your liver function. If your get this side effect, your doctor may change your dose or stop treatment for some time. Alectinib may be harmful to your lungs. Inform your care provider of any new difficulty breathing, cough, or fever. Your provider may stop treatment with alectinib if your lungs are affected. Alectinib may be harmful to your kidneys. Speak to your care provider to know when you need to have laboratory tests done to monitor your kidneys. If you get this side effect, your doctor may change your dose or stop treatment for some time. Alectinib can cause severe muscle pain. Let your care provider know if you experience unexplained muscle pain, tenderness, or weakness. Alectinib may cause your lung tissue to scar, which is called interstitial lung disease. Call your care team if you are feeling short of breath, have a fever, or have a lasting dry cough. ALECTINIB ORAL CHEMOTHERAPY EDUCATION Page 5 If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Since alectinib 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 alectinib, 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 alectinib 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 alectinib. Females of childbearing age and potential should use effective contraception during therapy and for a minimum of one week after the last dose of alectinib. Males with female partners of childbearing age and potential should use effective contraception during therapy and for a minimum of three months after the last dose of alectinib. Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. Do not breastfeed while taking alectinib and for one week after the last dose of alectinib. 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. ALECTINIB 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 © 2020 by Hematology/Oncology Pharmacy Association. All rights reserved. Obtaining medication Talk with your care provider about the process for obtaining your alectinib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: www.alecensa.com Product prescribing information: www.gene.com/download/pdf/alecensa prescribing.pdf Product resources: www.alecensa.com/patient/patient support/financial and other resources.html Updated – September 11, 2020 Additional instructions

Page 1 ALPELISIB ORAL CHEMOTHERAPY EDUCATION Name of your medication Generic name — alpelisib (AL peh LIH sib) Brand name — Piqray® (pik raye) Approved uses Alpelisib is used to treat breast cancer that has a genetic mutation called phosphatidylinositol 3 kinase catalytic subunit alpha (PIK3CA) and is used in combination with another medication, fulvestrant. Dose and schedule Taking alpelisib 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 alpelisib is 300 milligrams (300 mg) to be taken by mouth at a scheduled time once a day. Alpelisib should be taken with food at the same time each day. Alpelisib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow alpelisib, talk to your care provider or pharmacist for possible options. If you miss a dose of alpelisib, follow these guidelines: • Only take the missed dose if it has been less than 9 hours since you were supposed to take it. Then take the next dose at the regularly scheduled time. • Do not take the missed dose if it has been more than 9 hours since you should have taken it. Simply take the next dose at the regularly scheduled 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 Alpelisib has many drug interactions. Please inform your care providers of all prescription medications, over the counter medications, vitamins, and herbal products. Alpelisib should be taken with food. Grapefruit or grapefruit juice may interact with alpelisib; avoid eating or drinking this during treatment with alpelisib. Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle alpelisib 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 alpelisib at room temperature (68°F–77°F) in a dry location away from light. Keep alpelisib out of reach of children and pets. ALPELISIB ORAL CHEMOTHERAPY EDUCATION Page 2 Leave alpelisib in the provided packaging until it is ready to be taken. Whenever possible, you should give alpelisib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the alpelisib 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 alpelisib 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 is used, a separate one should be used for alpelisib. Do not mix other medications into the box with alpelisib. 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 alpelisib, 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 alpelisib. If you are traveling, put your alpelisib in a separate sealed plastic bag. Ask your pharmacist if any additional travel precautions are needed. Side Effects of Alpelisib Below are common side effects that have been known to happen in about one third or more of patients taking alpelisib; 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 electrolytes and other laboratory values • High glucose levels • High lipase 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: • Increased hunger or thirst • Increased urination • Weakness or fatigue • Headaches • Dizziness Continued on the next page ALPELISIB 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 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. 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 • Unusual bleeding or bruising Rash or itchy 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 as 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. Sunlight can make symptoms worse. • Avoid sun exposure as much as possible to decrease the risk of sunburn. The highest exposure to ultraviolet (UV) radiation occurs from 10 am to 4 pm. • Wear long sleeved clothing, with UV protection if possible. • Wear broad brimmed hats. • Apply broad spectrum sunscreen (UVA/UVB) with at least SPF 30 as often as directed on the bottle. • Use lip balm with at least SPF 30. Seek emergency care if you have a severe rash, or if it occurs with a fever, flu like symptoms, mucosal lesions, or becomes progressively worse. Continued on the next page ALPELISIB 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: • 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. 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. 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 ALPELISIB ORAL CHEMOTHERAPY EDUCATION Page 5 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 appetite 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. Mouth irritation or sores 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 4 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. Serious side effects Alpelisib may cause rare but serious side effects, including the following: • Severe allergic reactions. Get medical help right away if you experience trouble breathing, flushing, rash, fever, or a fast heart rate during treatment with alpelisib. • Lung problems (pneumonitis). Tell your care team right away if you develop new or worsening symptoms of lung problems, including shortness of breath or trouble breathing, cough, or chest pain. • Wash hands with soap and water after using the toilet. ALPELISIB 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 Since alpelisib 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 alpelisib, 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 alpelisib 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 alpelisib. Males and females of childbearing age and potential should use effective contraception during therapy and for a minimum of 1 week after the last dose of alpelisib. Do not breastfeed while taking alpelisib and for 1 week after the last dose of alpelisib. 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 alpelisib. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) ALPELISIB ORAL CHEMOTHERAPY EDUCATION Page 7 Additional resources Product website: https://www.us.piqray.com/metastatic breast cancer Product prescribing information: https://www.novartis.us/sites/www.novartis.us/files/piqray.pdf Product resources: https://www.us.piqray.com/metastatic breast cancer/patient resources/financial resources and access Updated – September 11, 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 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 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.