ORAL CANCER TREATMENT EDUCATION CAPIVASERTIB Name of your medication Generic name — capivasertib (ka-PEE-vah-SER-tib) Brand name — Truqap® (TROO-kap) Common uses Capivasertib is used to treat hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)–negative advanced or metastatic breast cancer with one or more of the following genetic variants: PIK3CA, AKTI, or PTEN. Capivasertib may be used in combination with another medication, fulvestrant. Capivasertib may also be used for other treatments. Dose and schedule Taking capivasertib 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 capivasertib is 400 milligram (400 mg) to be taken by mouth at a scheduled time twice a day for 4 consecutive days followed by 3 days off treatment each week. The dose may be adjusted by your care provider based on your individual needs. o Capivasertib can be taken with or without food, but at the same time each day, about 12 hours apart on scheduled days. o Capivasertib should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow capivasertib, talk to your care provider or pharmacist for possible options. o If you miss a dose of capivasertib: • Only take the missed dose if it has been less than 4 hours since you were supposed to take it. • If you miss a dose of capivasertib, do not take an extra dose or two doses at one time. Simply take your 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 Capivasertib has many drug interactions; please inform your care providers of all prescription medications, over-the counter medications, vitamins, and herbal products that you are taking. o Grapefruit or grapefruit juice may interact with capivasertib. Avoid eating or drinking these during treatment with capivasertib. o Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Page 1 ORAL CANCER TREATMENT EDUCATION CAPIVASERTIB Storage and handling Handle capivasertib 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 capivasertib at room temperature (68°F to 77°F) in a dry location away from light. o Keep capivasertib out of reach of children and pets. o Leave capivasertib in the provided packaging until it is ready to be taken. o Whenever possible, you should give capivasertib to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the capivasertib 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 capivasertib 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 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 were worn. Page 2 ORAL CANCER TREATMENT EDUCATION CAPIVASERTIB Side Effects of Capivasertib Below are common side effects that have been known to happen in about one-third or more of patients taking capivasertib; 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 Diarrhea Changes in electrolytes and other laboratory values • High glucose levels Management Monitor how many bowel movements you have each day. • Drink 8–10 glasses of water or fluid each day unless your care provider has instructed you to limit your fluid intake. • Eat small, frequent meals throughout the day rather than a few large meals. • Eat bland, low-fiber foods (e.g., bananas, applesauce, potatoes, chicken, rice, toast). • Avoid high fiber foods, such as raw vegetables, raw fruits, and whole grains. • Avoid foods that cause gas, such as broccoli and beans. • Avoid lactose-containing foods, such as yogurt and milk. • Avoid spicy, fried, and greasy foods. Contact your provider if any of the following occur: • The number of bowel movements you have in a day increases by 4 or more. • You feel dizzy or lightheaded. Your care provider may recommend an over-the-counter medication called loperamide (Imodium®) to help with your diarrhea, but talk to your care provider before starting this medication. 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 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 Page 3 ORAL CANCER TREATMENT EDUCATION CAPIVASERTIB Possible Side Effect Rash or itchy skin Management • 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 UV (ultra-violet) radiation occurs between the hours of 10am and 4pm. • 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 If your rash or itching continues to worsen, contact your care provider. 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. Decreased white blood cells (WBCs) and increased risk for infection Decreased hemoglobin, part of the red blood cells that carry iron and oxygen 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. 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 Continued on the next page Page 4 ORAL CANCER TREATMENT EDUCATION CAPIVASERTIB Possible Side Effect Fatigue Nausea or vomiting Management 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. • 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. Increased triglyceride levels Mouth irritation or sores Serious side effects Your provider may prescribe medication to help with the nausea or vomiting. Changes in triglycerides may occur and will be monitored by a simple blood test. You may not feel any symptoms if changes occur. Your care team will monitor for this. 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 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. o Capivasertib may cause redness, pain, swelling, or blisters on the palms of your hands or soles of your feet. If you experience this side effect, your doctor may change your dose or stop treatment for some time. o Your blood sugar levels may be higher while taking capivasertib. Your care provider may have you check your blood sugar regularly. Contact your care team if you are urinating more than normal, are very thirsty, are more tired than normal, or are having trouble keeping your blood sugar within a desired range. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: Page 5 ORAL CANCER TREATMENT EDUCATION CAPIVASERTIB Handling body fluids and waste Because capivasertib 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 capivasertib, 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 capivasertib 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 Patients of reproductive ability should not become pregnant or get their partner pregnant while taking capivasertib. Women of childbearing age and potential should use effective contraception during therapy and for at least 1 month after the last dose of capivasertib. Men should use effective contraception during therapy and for at least 4 months after the last dose of capivasertib. o Effective contraception could include 1 or more of the following: oral contraceptive, barrier methods, etc. o Do not breastfeed while taking capivasertib. 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 cancer treatment, 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 capivasertib. Page 6 ORAL CANCER TREATMENT EDUCATION CAPIVASERTIB Additional resources Product website: https://www.truqap.com Product prescribing information: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/218197s000lbl.pdf Product resources: https://www.truqap.com/patient-support-program Additional instructions Updated – February 16, 2024 Important notice: The Association of Community Cancer Centers (ACCC), Hematology/Oncology Pharmacy Association (HOPA), National Community Oncology Dispensing Association, Inc. (NCODA), and Oncology Nursing Society (ONS) have collaborated in gathering information for and developing this patient education guide. This guide represents a brief summary of the medication derived from information provided by the drug manufacturer and other resources. This guide does not cover all existing information related to the possible uses, directions, doses, precautions, warnings, interactions, adverse effects, or risks associated with this medication and should not substitute for the advice of a qualified healthcare professional. Provision of this guide is for informational purposes only and does not constitute or imply endorsement, recommendation, or favoring of this medication by ACCC, HOPA, NCODA, or ONS, who assume no liability for and cannot ensure the accuracy of the information presented. The collaborators are not making any representations with respect to the medications whatsoever, and any and all decisions, with respect to such medications, are at the sole risk of the individual consuming the medication. All decisions related to taking this medication should be made with the guidance and under the direction of a qualified healthcare professional. Permission: Oral Cancer Treatment Education (OCE) sheets are provided as a free educational resource for patients with cancer in need of concise, easy-to-understand information about oral cancer drugs. Healthcare providers are permitted to copy and distribute the sheets to patients as well as direct patients to the OCE website for information. However, commercial reproduction or reuse, as well as rebranding or reposting of any type, are strictly prohibited without permission of the copyright holder. Please email permission requests and licensing inquiries to This email address is being protected from spambots. You need JavaScript enabled to view it.. Copyright © 2024 by Hematology/Oncology Pharmacy Association. All rights reserved. Page 7