cancer

Capecitabine - MoA

Oral prodrug of 5-FU that inhibits thymidylate synthase and DNA synthesis.

Capecitabine - Indication

Breast, colorectal and GI cancers; given in chemotherapy cycles.

Capecitabine - Adverse

Hand-foot syndrome, diarrhoea, mucositis, fatigue, myelosuppression, liver enzyme rise.

Capecitabine - Counselling

Take within 30 min after food; swallow whole; moisturise hands/feet; avoid sun; report fever, diarrhoea, mouth ulcers.

Capecitabine - Precautions

DPD deficiency ↑ toxicity; interacts with warfarin (↑ INR); dose reduce in renal impairment; infection risk.

Ibrutinib - MoA

Bruton's tyrosine kinase (BTK) inhibitor blocking B-cell receptor signalling.

Ibrutinib - Indication

CLL, mantle cell lymphoma, Waldenström's macroglobulinaemia and other B-cell malignancies.

Ibrutinib - Adverse

Diarrhoea, bleeding, atrial fibrillation, hypertension, infection risk, fatigue, rash.

Ibrutinib - Counselling

Take same time each day; swallow whole; avoid grapefruit/Seville oranges; report bleeding or palpitations; use contraception.

Ibrutinib - Precautions

Risk of serious bleeding ↑ with anticoagulants/antiplatelets; CYP3A4 interactions; cardiac monitoring recommended.

Filgrastim - MoA

Granulocyte colony-stimulating factor (G-CSF) that increases neutrophil production.

Filgrastim - Indication

Prevention/treatment of chemotherapy-induced neutropenia; stem cell mobilisation.

Filgrastim - Adverse

Bone pain, fever, headache, injection-site reactions; splenomegaly (rare).

Filgrastim - Counselling

Inject SC; rotate sites; keep refrigerated; allow to reach room temperature before use; paracetamol for bone pain; report LUQ/shoulder pain.

Filgrastim - Precautions

Monitor neutrophils; risk of splenic rupture; avoid NSAIDs if platelets low.