erdafitinib

(Balversa®)
Other Names

Balversa®

Appearance

tablet

erdafitinib

Other Name(s):

Balversa®

Appearance:

tablet

This handout gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on medication

People Talking

This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

 

Who do I contact if I have questions or need help?

 

My cancer health care provider is: _____________________________________________

During the day I should contact: _______________________________________________

Evenings, weekends and holidays: _____________________________________________

 

This page gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on this medication

People Talking

This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

What is this treatment for?

Erdafitinib is used to treat a certain type of cancer in the bladder and urinary tract organs.

What should I do before I start this treatment?

Tell your health care team if you have or had significant medical condition(s), especially if you have / had:

  • kidney, liver problems 

  • vision or eye problems

  • any allergies.

Important Icon

Remember To:

 
  • Tell your health care team about all of the other medications you are taking.

  • Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.

You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.

How is this treatment given?
  • This medication is usually taken once a day by mouth. Talk to your health care team about how and when to take your medication.

  • You may need a mix of  tablets of different strengths to get the right dose. Make sure you look at your tablets closely so that you take the right dose.

  • Swallow the tablets whole with a full glass of water, with or without food.

  • If you forget to take a dose of your erdafitinib:

    • If you forget to take a dose, take it as soon as you remember if it is the same day. Then take your next dose at the normal scheduled time. 

    • If you miss a day's dose, do not take extra (double up) to make up for the missed dose. Take your next dose at the normal scheduled time.

  • If you vomit (throw up) after taking your medication, do NOT take another dose. Take your next dose the next day at the normal time. 
     

Warning: If you take too much of this medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.

 

Other medications you may be given with this treatment

To Prevent or Treat Dry Eyes

To prevent or treat dry eyes, at least every 2 hours while awake your health care team may ask you to use artificial tears or lubricating eye gels/ointments at least every 2 hours while awake during treatment. Talk to your health care team on the product(s) to use and how frequent you need to use them.

Other important things for you to know about this treatment

This treatment may cause Hand-Foot Syndrome

Hand-foot syndrome is a side-effect of erdafitinib treatment that affects the skin on your hands and the bottoms of your feet. It usually starts with tingling or swelling of your skin. Your skin can become painful, red and numb. In worse cases, your skin may start to peel and you can get blisters or sores. This may start days or weeks after your treatment begins.

 

You can help to prevent symptoms of hand-foot syndrome by doing these things:

  • Keep your skin moist, especially in the skin folds.

  • Gently apply moisturizer cream or lotion to the inside of your hands and bottom of your feet as needed. Choose a fragrance-free cream that contains lanolin (like Bag Balm®, Udderly Smooth®) or urea 10% (like Uremol 10®).

  • Do not let your hands and feet get too hot. Wash sweat from your skin. Bathe or shower in lukewarm water and gently pat yourself dry.

  • Do not do activities that cause rubbing or pressure on your skin, like heavy-duty washing, gripping tools, typing, playing musical instruments, and driving.

  • Wear gloves while cleaning to protect your skin from things like laundry detergent, bleach, cleaning products, and dish soap.

  • Wear loose fitting clothes and loose fitting, comfortable shoes with cushioned soles. Do not walk in bare feet.

  • Drink 6–8 glasses of liquids each day unless your health care team told you otherwise.

DO this while on treatment DO NOT do this while on treatment

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  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.  

  • DO use a lubricating eye ointment or a tear replacement therapy at least every 2 hours while awake to prevent or treat dry eyes.
     
  • Do follow to a low phosphate diet. Ask your health care team for dietary advice.

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  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
     

  • DO NOT drive, operate machinery or do any tasks that need you to be alert if you experience eye problems such as blurry vision or having difficulty seeing.
     

DO this while on treatment

Check Mark Icon

  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.  

  • DO use a lubricating eye ointment or a tear replacement therapy at least every 2 hours while awake to prevent or treat dry eyes.
     
  • Do follow to a low phosphate diet. Ask your health care team for dietary advice.

DO NOT do this while on treatment

Stop Icon

  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
     

  • DO NOT drive, operate machinery or do any tasks that need you to be alert if you experience eye problems such as blurry vision or having difficulty seeing.
     

Will this treatment interact with other medications or natural health products?

Yes, this medication can interact with other medications, vitamins, foods, traditional medicines and natural health products. Interactions can make this medication not work as well or cause severe side effects.

Tell your health care team about all of your:

  • prescription and over-the-counter (non-prescription) medications
  • other drugs and substances, such as cannabis/marijuana (medical or recreational)
  • natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements, or traditional medicines

Check with your health care team before starting or stopping any of them.
 

Medication Icon
Talk to your health care team BEFORE taking or using these :
  • Anti-inflammatory medications such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®) or Aspirin®.
  • Over-the-counter products such as dimenhydrinate (Gravol®) 
  • Natural health products such as St. John’s Wort
  • Traditional medicines
  • Supplements such as vitamin C
  • Grapefruit juice
  • Alcoholic drinks 
  • Tobacco 
  • All other drugs or substances, such as marijuana or cannabis (medical or recreational)
What to do if you feel unwell, have pain, a headache or a fever
  • Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).

    • Fever can be a sign of infection that may need treatment right away.

    • If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.

How to check for fever:

Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain). 

  • You have a fever if your temperature taken in your mouth (oral temperature) is:

    • 38.3°C (100.9°F) or higher at any time

  •       OR

    • 38.0°C (100.4°F) or higher for at least one hour.

Medication Icon

If you do have a fever: 

  • Try to contact your health care team.  If you are not able to talk to them for advice, you MUST get emergency medical help right away.

  • Ask your health care team for the Fever pamphlet for more information.

 

 

 

 

 

If you do not have a fever but have mild symptoms such as headache or mild pain:

  • Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.

Important Icon

Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.

How will this treatment affect sex, pregnancy and breastfeeding?

Talk to your health care team about:

  • How this treatment may affect your sexual health
  • How this treatment may affect your ability to have a baby, if this applies to you

This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

  • If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until 3 months after your last treatment dose. Talk to your health care team about which birth control options are best for you.
  • Do not breastfeed while on this treatment and for 3 months after your last dose.

  • Do not donate sperm while using erdafitinib and for up to 3 months after your last dose.   

How to safely store and handle this medication
  • Keep erdafitinib tablets in the original packaging at room temperature in a dry place, away from heat and light.

  • Keep out of sight and reach of children and pets.

  • Do not throw out any unused erdafitinib tablets/capsules at home. Bring them to your pharmacy to be thrown away safely.

 

How to safely touch oral anti-cancer medication


If you are a patient:

  • Wash your hands before and after touching your oral anti-cancer medication.

  • Swallow each pill whole. Do not crush or chew your pills.

If you are a caregiver:

  • Wear nitrile or latex gloves when touching tablets, capsules or liquids.
     

  • Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
     

  • Throw out your gloves after each use. Do not re-use gloves. 
     

  • Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
     

What to do if anti-cancer medication gets on your skin or in your eyes 

If medication gets on your skin:

  • Wash your skin with a lot of soap and water.

  • If your skin gets red or irritated, talk to your health care team.

If medication gets in your eyes:

  • Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.

 

What are the side effects of this treatment?

The following table lists side effects that you may have when getting _______ treatment. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.

Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on _______ treatment.


Very Common Side Effects (50 or more out of 100 people)
Side effects and what to do When to contact health care team

Too much phosphate your body
(May be severe)

High phosphate levels may not cause any symptoms that you can see or feel. Your health care team may order a blood test to check your phosphate levels.

In some cases, high phosphate levels may cause:

  • Muscle spasms, cramping, bone or joint pain.
  • Small, hard lumps in your skin and soft tissue (such as fat, muscle, tendons)
  • Numbness or tingling around the mouth
  • Seizures, confusion
  • Irregular heart beat

What to do?

  • Limit foods that are high in phosphate (such as processed foods, deli meats, cheese, soft drinks, etc.). Ask your health care team or a dietitian for dietary advice.

  • Speak to your health care team before using medications that can increase phosphate in your blood, such as:

    • potassium phosphate or vitamin D supplements

    • antacids, and enemas or laxatives containing phosphate

            They can increase the amont of phosphate in your blood. 

  • Talk to your health care team if you have any symptoms. Get emergency medical help right away for severe symptoms.
Talk to your health care team. Get emergency medical help right away for severe symptoms

Nail changes 
(May be severe)

What to look for?

  • You may have changes in nail colour, pain or tenderness, swelling of cuticles, or loosening of nails.
  • Nails will slowly return to normal after treatment ends.


What to do?

  • Moisturize your nails and cuticles.
  • Do not use nail polish and fake fingernails until your nails have gone back to normal.
  • Wear gloves when doing house chores or gardening.
Talk to your health care team if it does not improve or if it is severe

Diarrhea

What to look for?

  • Loose, watery, unformed stool (poo) that may happen days to weeks after you get your treatment.
     

What to do?

If you have diarrhea:

  • Take anti-diarrhea medication if your health care team prescribed it or told you to take it.
  • Do not eat foods or drinks with artificial sweetener (like chewing gum or ‘diet’ drinks), coffee and alcohol, until your diarrhea has stopped.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day, unless your health care team has told you to drink more or less.
  • Talk to your health care team if you can’t drink 6 to 8 cups of liquids each day when you have diarrhea. You may need to drink special liquids with salt and sugar, called Oral Rehydration Therapy.
  • Talk to your health care team if your diarrhea does not improve after 24 hours of taking diarrhea medication or if you have diarrhea more than 7 times in one day.

Ask your health care team for the Diarrhea pamphlet for more information.

Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day)

 

 
Common Side Effects (25 to 49 out of 100 people)
Side effects and what to do When to contact health care team

Mouth sores
(May be severe)

What to look for?

  • Round, painful, white or gray sores inside your mouth that can occur on the tongue, lips, gums, or inside your cheeks.
  • In more severe cases they may make it hard to swallow, eat or brush your teeth.
  • They may last for 3 days or longer.

What to do?

To help prevent mouth sores: 

  • Take care of your mouth by gently brushing and flossing regularly.
  • Rinse your mouth often with a homemade mouthwash.
  • To make a homemade mouthwash, mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.
  • Do not use store-bought mouthwashes, especially those with alcohol, because they may irritate your mouth.


If you have mouth sores:

  • Avoid hot, spicy, acidic, hard or crunchy foods.
  • Your doctor may prescribe a special mouthwash to relieve mouth sores and prevent infection.
  • Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow.

Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information.

Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow

Dry mouth
(May be severe)

What to look for?

  • You may have a dry or sticky feeling in your mouth or throat,
  • Your saliva may be thick and stringy.
  • You may have cracks in your lips or at the corners of your mouth
  • You may have difficulty chewing, tasting, swallowing or talking

What to do?

  • Use sugar-free gum or lozenges (e.g. those that contain xylitol) to help keep your mouth moist.
  • Suck on ice chips or sugarless popsicles to help relieve dry mouth.
  • Rinse your mouth often (every 1 to 2 hours) with a homemade mouthwash.
  • To make a homemade mouthwash, mix 1 teaspoon of baking soda and 1 teaspoon of salt in 4 cups (1L) of water
  • Do not use store-bought mouthwashes, especially those with alcohol because they may irritate dry your mouth
  • Spray your mouth with water or artificial saliva products (e.g., Moi-Stir Spray®, Biotene® products) as needed to keep it moist.
  • Apply mouth lubricant (like Biotene Oral balance gel®) after you brush your teeth, at bedtime, and as needed.
  • Use a steam vaporizer at night to relieve nighttime dry mouth
  • Speak to your health care team about the right product for you.

See our Mouth Care pamphlet for more information.

Talk to your health care team if your dry mouth does not improve or if it is severe. 

Talk to your health care team if it does not improve or if it is severe

Taste changes

What to look for?

  • Food and drinks may taste different than usual.

What to do?

  • Eat foods that are easy to chew, such as scrambled eggs, pasta, soups, cooked vegetables.
  • Taste foods at different temperatures, since the flavour may change.
  • Try different forms of foods, like fresh, frozen or canned.
  • Experiment with non-spicy foods, spices and seasonings.
Talk to your health care team if it does not improve or if it is severe

Rash on your hands and feet (hand-foot syndrome)
(May be severe)

What to look for?

  • Tingling or swelling of the skin on the palms of your hands and the bottoms of your feet. This can become painful, red and numb.
  • In worse cases your skin may start to peel and you can get blisters or sores.
  • This may happen days or weeks after you start treatment.
     

What to do?

To help prevent Hand-foot syndrome:

  • Do not do activities that cause rubbing or pressure on your skin, like heavy-duty washing, gripping tools, typing, playing musical instruments, and driving.
  • Moisturize your hands and feet often, especially in the skin folds.
  • Wear loose, comfortable footwear and clothes.
  • Rest and try to keep off your feet.
  • Do not let your hands and feet get too hot.

Ask your health care team for the Hand-foot syndrome pamphlet for more information.

Talk to your health care team if it does not improve or if it is severe

Fatigue 

What to look for?

  • Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.
     

What to do?

  • Be active. Aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.
  • Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Ask family or friends to help you with things like housework, shopping, and child or pet care.
  • Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your health care team has told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired.

Ask your health care team for the Fatigue pamphlet for more information. 

Talk to your health care team if it does not improve or if it is severe

Liver problems

Your health care team may check your liver function with a blood test. Liver changes do not usually cause any symptoms.


What to look for?

  • Rarely, you may develop yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. This may be severe.

What to do?

If you have any symptoms of liver problems, get emergency medical help right away.

Get emergency medical help right away

Low appetite

What to look for?

  • Loss of interest in food or not feeling hungry.
  • Weight loss.


What to do?

  • Try to eat your favourite foods.
  • Eat small meals throughout the day.
  • You may need to take meal supplements to help keep your weight up.
  • Talk to your health care team if you have no appetite.

Ask your health care team for the Loss of Appetite pamphlet for more information.

Talk to your health care team if it does not improve or if it is severe

Constipation

What to look for?

  • Having bowel movements (going poo) less often than normal.
  • Small hard stools (poo) that look like pellets.
  • The need to push hard and strain to have any stool (poo) come out.
  • Stomach ache or cramps.
  • A bloated belly, feeling of fullness, or discomfort.
  • Leaking of watery stools (poo).
  • Lots of gas or burping.
  • Nausea or vomiting.
     

 

What to do?

To help prevent constipation:

  • Try to eat more fiber rich foods like fruits with skin, leafy greens and whole grains.
  • Drink at least 6 to 8 cups of liquids each day unless your health care team has told you to drink more or less.
  • Be Active. Exercise can help to keep you regular.
  • If you take opioid pain medication, ask your health care team if eating more fibre is right for you.
     

To help treat constipation:

  • If you have not had a bowel movement in 2 to 3 days you may need to take a laxative (medication to help you poo) to help you have regular bowel movements. Ask your health care team what to do.

Ask your health care team for the Constipation Pamphlet for more information.

Talk to your health care team if it does not improve or if it is severe

Anemia (low red blood cells)

What to look for?

  • You may feel more tired or weaker than normal.
  • Pale skin and cold hands and feet.
  • You may feel short of breath, dizzy or lightheaded.
  • This may occur in days to weeks after your treatment starts.
     

What to do?

If your health care team has told you that you have anemia (low red blood cells):

  • Rest often and eat well.
  • Light exercise, such as walking may help.
  • You may need medication or a blood transfusion.
  • If it is very bad, your doctor may need to make changes to your treatment regimen.
Talk to your health care team if it does not improve or if it is severe
 

Hair thinning or loss 

What to look for?

  • Your hair may become thin or fall out during or after treatment.
  • In most cases, your hair will grow back after treatment. The texture or colour may change.
  • In very rare cases, hair loss may be permanent.
     

What to do?

  • Use a gentle soft brush.
  • Do not use hair sprays, bleaches, dyes and perms.

 

 
Talk to your health care team if this bothers you

Rash; dry, itchy skin
(May be severe)

What to look for?

  • You may have cracked, rough, flaking or peeling areas of the skin.
  • Your skin may look red and feel warm, like a sunburn.
  • Your skin may itch, burn, sting or feel very tender when touched.

What to do?

To prevent and treat dry skin:

  • Use fragrance-free skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
  • Avoid perfumed products and lotions that contain alcohol.
  • Drink 6 to 8 cups of non-alcoholic, non-caffeinated liquids each day, unless your health care team has told you to drink more or less.

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

Talk to your health care team if it does not improve or if it is severe

 

Less Common Side Effects (10 to 24 out of 100 people)
Side effects and what to do When to contact health care team

Eye problems
(May be severe)

What to look for?

  • Your eyes may feel dry, irritated, or painful.
  • They may look red and have a lot of tears.
  • They may feel sensitive to light and your vision may be blurry.

What to do?

  • Use a lubricating eye ointment or artificial tear dropsat least every 2 hours while awake to prevent and treat dry eyes.
  • Avoid wearing contact lenses.
  • Wear sunglasses with UV protection.
  • Use protective eyewear (goggles or helmet with face mask) when playing sports, mowing the lawn or doing anything that may get particles or fumes in your eyes.
Tell your healthcare professional right away if you develop any eye problem or if your vision changes.
Contact your health care team as soon as possible (office hours)

Nausea and vomiting
(Generally mild)

What to look for?

  • Nausea is feeling like you need to throw up. You may also feel light-headed.
  • You may feel nausea within hours to days after your treatment.

 

What to do?

To help prevent nausea:

  • It is easier to prevent nausea than to treat it once it happens.
  • If you were given anti-nausea medication(s), take them as prescribed, even if you do not feel like throwing up.
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (like coffee, tea) and avoid alcohol.


 

If you have nausea or vomiting:

  • Take your rescue (as-needed) anti-nausea medication(s) as prescribed.
  • Ask your health care team for the Nausea & Vomiting pamphlet for more information.
  • Talk to your health care team if:
    • nausea lasts more than 48 hours
    • vomiting lasts more than 24 hours or if it is severe
Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours

Kidney Problems
(may be severe)

Your health care team may check for proteins in your urine (pee) and your kidney function regularly with a blood test.You may have blood in your urine.
 

What to look for?

  • New swelling in your hands, ankles, feet or other areas of your body.
  • Weight gain that is not normal for you.
  • Pain in your lower back.
  • Muscle twitches and cramps or itchiness that won't go away.
  • Nausea (feeling like you need to throw up) and vomiting.
  • Changes in urination (peeing) such as less urine than usual.

What to do?

  • If you have any of these signs, talk to your health care team or go to your closest emergency department.
     

To prevent kidney infections:

  • Drink at least 6 to 8 cups (2 litres) of water or other liquids per day unless your health care team has told you to drink more or less.
  • When you feel the need to pee, go as soon as possible. Do not wait or hold in the pee.
Get emergency medical help right away 

Bladder problems 

What to look for?

  • Feeling like you need to pee badly all of a sudden.
  • Pain in your belly or lower belly area or pain when peeing.
  • If severe, you may have blood in your pee.


What to do?

  • Drink at least 6 to 8 cups (2 Litres) of liquids per day on treatment days, unless your health care team has told you to drink more or less.
  • Tell your health care team if your pee is red or if you have other symptoms of bladder problems. Get emergency help right away for severe symptoms.
Talk to your health care team. Get emergency medical help right away for severe symptoms

Mild joint, muscle pain or cramps 

What to look for?

  • New pain in your muscles or joints, muscle cramps, or feeling achy.
     

What to do?

  • Take pain medication (acetaminophen or opioids such as codeine, morphine, hydromorphone, oxycodone) as prescribed.
  • Read the above section: "What to do if I feel unwell, have pain, a headache or a fever?" before taking acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or Aspirin. These medications may hide an infection that needs treatment or they may increase your risk of bleeding.
  • Rest often and try light exercise (such as walking) as it may help.

Ask your health care team for the Pain pamphlet for more information.

Talk to your health care team if it does not improve or if it is severe

Other rare, but serious side effects are possible with this treatment.

If you have any of the following, talk to your cancer health care team or get emergency medical help right away:

  • Unusual or heavy nosebleeds, red or pink coloured urine (pee), other unusual bleeding or bleeding that is severe or does not stop
  • Severe belly pain, bloating or feeling of fullness and severe constipation
  • new skin ulcers, serious skin infections
  • pain, swelling and hardening of a vein 

For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.

Notes

September 2026 New drug information sheet

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Last Updated: September 24, 2026