Jevtana-Cabazitaxel & Predinsone

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Description

Your chemotherapy treatment is called cabazitaxel + prednisone. It is commonly used to treat prostate cancer and has also been used to treat other diseases. This treatment is made up of two drugs:
  • Cabazitaxel (ka-BAZ-i-TAX-el) or Jevtana® (jev-TA-na)
  • Prednisone (PRED-ni-sone)
Cabazitaxel prevents cancer cells from dividing and growing, and can eventually cause the cancer cells to shrink and die. Prednisone is a corticosteroid.

What Do I Need to Know Before Starting Treatment?

Be sure to tell your healthcare provider about any prescription or over-the-counter products you are taking, including dietary supplements, vitamins, herbal medicines and homeopathic remedies. Use an effective birth control method while you are being treated. Cabazitaxel can cause harm to a fetus, so be sure to tell your healthcare provider right away if your partner becomes pregnant. Some chemotherapy drugs can cause sterility. Talk with your healthcare provider about your options if you want to have children in the future. Do not get any immunizations or vaccinations while you are being treated without the approval of your healthcare provider. Chemotherapy can sometimes cause changes in the amount of electrolytes in your body, such as sodium, potassium and magnesium. Your healthcare provider will check your blood for these changes and will treat any problems that are found.

What Do I Need to Know Before Starting?

Cabazitaxel can cause a severe allergic reaction, usually during the first or second infusion. In very rare cases, prednisone can cause an allergic reaction. Tell your healthcare provider immediately if you have a rash, itching, trouble breathing, dizziness, fainting, or swelling of the lips, throat or tongue. Tell your healthcare provider if you have a history of liver disease or decreased liver function. Your risk of side effects from cabazitaxel is greater if you have poor liver function. Your healthcare provider will check your liver during your treatment with cabazitaxel and decide if your dose needs to be changed or stopped. In rare cases, the increase in side effects because of poor liver function can be severe and life-threatening. Cabazitaxel may cause kidney damage. Your risk of kidney damage is higher if you develop a severe infection or get dehydrated during your treatment with cabazitaxel. Tell your healthcare provider if you have a history of kidney disease or decreased kidney function. Your healthcare provider will check your kidneys during treatment and decide if your dose needs to be changed or stopped. Cabazitaxel commonly causes gastrointestinal side effects, such as nausea, vomiting and diarrhea (see “What Are the Possible Side Effects?”). Call your healthcare provider if you have an additional four bowel movements in one day, if you have diarrhea in the middle of the night or if your diarrhea is severe. Cabazitaxel and prednisone can increase your risk of getting an infection (see “What Are the Possible Side Effects?”). Tell your healthcare provider immediately if you have any signs of infection, such as fever, cough, flu-like symptoms, tiredness, painful or frequent urination, or warm, red or painful skin. Tell your healthcare provider if you have an infection that does not go away or a history of infections that keep coming back. Also tell your healthcare provider if you have an illness that puts you at high risk for infections, such as HIV or diabetes that is not well controlled. If you have an infection called ocular herpes simplex, using prednisone may increase your risk of corneal perforation (a hole in your cornea). Tell your healthcare provider if you have this infection. Prednisone can reduce the stomach’s protective layer, making it more prone to irritation by stomach acid. In rare cases, this can lead to bleeding ulcers or perforation (a hole in the stomach). Tell your healthcare provider if you have indigestion or other stomach problems. You may be given medicine to help relieve these symptoms. Prednisone may cause your blood sugar level to rise, especially if you have diabetes. You may have regular blood or urine tests during treatment to check your blood sugar. Tell your healthcare provider if you are very thirsty, if you are urinating more than usual or if you are being treated for diabetes. Your healthcare provider will tell you if you need to check your blood sugar more closely during your treatment. Prednisone may increase your blood pressure. Tell your healthcare provider immediately if you have headaches, visual problems, confusion or sleepiness, or if you are being treated for high blood pressure. Tell your healthcare provider if you are being treated for a mental health condition. Using prednisone can make mental health problems worse. Prednisone can cause mood swings, personality changes, insomnia, feelings of euphoria and, in rare cases, severe depression. Tell your healthcare provider immediately if you feel depressed. In rare cases, the allergic reactions, decreased kidney function, infections, and diarrhea caused by this treatment can be severe and life-threatening. Your treatment can interact with other substances, including:
  • Phenytoin (Dilantin®), phenobarbital (Luminal®) or carbamazepine (Tegretol®)
  • Rifabutin (Mycobutin®), rifampin (Rifadin®) or isoniazid
  • St. John’s wort
  • Fluconazole (Diflucan®), itraconazole (Sporanox®), ketoconazole (Nizoral®), voriconazole (Vfend®) or posaconazole (Noxafil®)
  • Clarithromycin (Biaxin®), erythromycin (E-mycin®) or telithromycin (Ketek®)
  • Drugs used to treat HIV, such as amprenavir (Agenerase®), atazanavir (Reyataz®), indinavir (Crixivan®), nelfinavir (Viracept®), ritonavir (Norvir®), saquinavir (Invirase®) or delavirdine (Rescriptor®)
  • Verapamil (Verelan®, Calan® or Covera-HS®), diltiazem (Cardizem®) or nifedipine (Nifedical® XL, Procardia XL®, Procardia® or Adalat® CC)
  • Amiodarone (Cordarone® or Nexterone®)
  • Cyclosporine (Gengraf®, Neoral® or Sandimmune®), sirolimus (Rapamune®) or tacrolimus (Prograf®)
  • Grapefruit juice or starfruit
  • Fluvoxamine (Luvox®)
  • Aprepitant (Emend®)
  • Non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen or naproxen
  • Warfarin (Coumadin®)
  • Digoxin (Lanoxin®)
  • Furosemide (Lasix®) or other diuretics
  • Drugs used to treat a condition called myasthenia gravis, such as neostigmine
  • Cholestyramine (Questran®)
Please note this list is a summary and does not contain all possible drug interactions. Contact your healthcare provider if you are taking any medications that can interact with your treatment. You should not take this treatment if you:
  • Are allergic to cabazitaxel, drugs that contain polysorbate 80 or any other component of this drug.
  • Have a very low white blood cell count.
  • Are allergic to prednisone, other corticosteroids or any other component of this drug.
 

How Is the Treatment Given?

Your healthcare provider will give you cabazitaxel by injection into a vein. The dose you receive will be based on your weight and height. Your healthcare provider will determine the number of treatments you receive. Your healthcare provider may give you medicines before your treatment with cabazitaxel to help prevent an allergic reaction. These medicines include dexamethasone (dex-a-METH-a-sone), an antihistamine such as diphenhydramine (dye-fen-HYE-dra-meen) or Benadryl® and ranitidine (ra-NYE-te-deen) or Zantac®. These medicines will be given by injection into a vein about 30 minutes before your treatment with cabazitaxel. You will take prednisone by mouth. Your healthcare provider will tell you how often to take it. It is important to take the prednisone exactly as prescribed. To lessen the chance of stomach irritation, take it with food and don’t drink alcohol. Take the prednisone on a regular schedule, and at the same time each day. If you miss a dose, take it as soon as you remember, then contact your healthcare provider for advice on when to take the next dose. Store prednisone at room temperature away from children and pets. If you take too much, call your healthcare provider, local poison control center or emergency room right away. You may be given medicines for nausea and vomiting before you receive your treatment. These medicines may be given either by mouth or by injection into a vein. Do not share any medicine with others. Sharing medicines with anyone else could be harmful.

When Should I Call My Healthcare Provider?

Call your healthcare provider right away if you have any of the following symptoms:
  • Shaking chills or fever of 100.5 degrees F or higher
  • Unusual bleeding, easy bruising or pinpoint red spots on your skin
  • Vomiting that is severe or that lasts several hours
  • Painful or frequent urination or blood in your urine
  • Decreased urination or not being able to urinate
  • Diarrhea that causes an additional four bowel movements a day, diarrhea that lasts more than one day, diarrhea at night, or diarrhea with fever, cramps or bloody stools
  • Constipation that lasts more than two to three days or constipation with abdominal pain
  • Irregular or rapid heart beat, chest pain, chest tightness or shortness of breath
  • Severe fluid retention that causes sudden weight gain or swelling in the abdomen, hands or feet
  • Dizziness or feeling lightheaded
  • Inability to eat or weight loss
  • Severe depression or thoughts of suicide
  • Sudden swelling, hives or rash
 

What Are the Possible Side Effects?

All drugs can cause side effects, but every person reacts differently to each drug. The following chart lists the possible side effects that can occur with your treatment, how to recognize and minimize symptoms, and possible treatments. The side effects are grouped by how often the side effect occurs: Common (occurs in more than 25 percent of patients), Less Common (occurs in 5 to 25 percent of patients) or Rare (occurs in less than 5 percent of patients).
Side Effect How to Minimize Side Effect Possible Treatments
Risk of Infection (Common)
  • Fever and chills
  • Painful urination
  • Sore throat and cough
  • Nasal congestion
  • Swelling or redness of the skin at the site of a wound
  • Wash your hands often.
  • Brush and floss your teeth daily.
  • Clean cuts right away with warm water, soap and antiseptic.
  • When your white blood cell count is low, stay away from crowds and people with colds or other illnesses.
  • You may be given an antibiotic to treat or prevent infection or a medicine to increase your white blood cell count.
  • Your healthcare provider may decrease your dose or delay further treatment.
Diarrhea (Common. Symptoms can be mild, moderate or severe.)
  • Loose or watery stools several times a day
  • Abdominal cramping, gas and bloating
  • Eat small, frequent meals and bland foods—such as bananas, rice, applesauce and toast.
  • Avoid caffeine; alcohol; raw fruits and vegetables; raw eggs; undercooked meats; spicy, fatty and greasy foods; milk and dairy products; foods that cause gas, such as beans and other legumes; high fiber and high-fat foods; foods left un-refrigerated for more than two hours (one hour for egg dishes and cream or mayonnaise-based foods); bulk laxatives; and stool softeners.
  • • Drink eight to ten glasses of clear
  • liquids every day.
  • • Your healthcare provider may prescribe
  • medicine to help treat diarrhea.
Nausea/Vomiting (Common. Symptoms are generally mild to  moderate but can be severe.)
  • Feeling queasy or sick to your stomach
  • Eat small, frequent meals and bland foods— such as bananas, rice, applesauce and toast.
  • Eat food cold or at room temperature so the smell of food will not bother you.
  • Avoid fried, spicy or fatty foods.
  • Eat and drink slowly.
  • Drink plenty of liquids during the day, but to avoid bloating, do not drink during meals.
  • You will be given medicine to help reduce nausea and vomiting.
Constipation (Less Common. Symptoms are generally mild to moderate but can be severe.)
  • No bowel movement for one to two days
  • Small, hard, dry stools
  • Bloating, gas, cramps and pain
  • Drink plenty of fluids to help loosen your bowels.
  • Drink warm or hot liquids if you do not have mouth sores.
  • Your healthcare provider may suggest eating foods that are high in fiber, such as bran, vegetables, whole wheat breads and fruit.
  • Have prunes or prune juice, which act like laxatives.
  • Exercise can help loosen bowels.
  • Your healthcare provider may recommend a stool softener.
Mouth Sores and Pain (Less Common. Symptoms are generally mild to moderate.)  
  • Pain, swelling or redness of the mouth, tongue and throat
  • “Coated tongue”
  • Difficulty talking, swallowing or eating
  • Bleeding ulcers and infection
  • Brush teeth two to four times a day using a soft bristle brush and fluoride toothpaste.
  • Use non-waxed dental floss daily.
  • Ask your healthcare provider to recommend a mouthwash that does not contain alcohol.
  • Sip water during the day and use sugar-free candy or gum to keep your mouth wet.
  • Eat food cold or at room temperature.
  • Eat soft or pureed food.
  • Avoid food that is acidic, spicy, salty, dry or rough, such as toast.
  • You may be given medicine to help treat pain.
  • You may be given medicine to  treat fungal or viral infections.
Anorexia or Appetite Loss (Less Common. Symptoms are generally mild to moderate.)  
  • Not having an appetite
  • Feeling too nauseated to eat
  • Metallic or medicinal taste
  • Change in taste causing dislike for certain foods
  • Try eating six to eight small meals or snacks each day instead of three larger meals.
  • Vary your diet and try new foods and recipes.
  • Take a walk before meals, when possible. This may make you feel hungrier.
  • Eat with friends or family. When eating alone, listen to the radio or watch TV.
  • Cook dinners ahead of time and  freeze them in small portions so that cooking smells are minimized.
  • Let others help with food, but ask that foods be prepared in small portions that can be frozen. And don’t hesitate to let them know which foods to avoid.
  • Add mild spices to change flavor.
  • It might be helpful to have a program, such as Meals on Wheels, deliver food to you.
Neuropathy (Less Common. Symptoms are generally mild to moderate.)  
  • Numbness or tingling feeling in the hands or feet
  • Muscle cramps
  • Loss of balance
  • Difficulty buttoning buttons  or picking up objects
  • Decreased awareness of heat or cold in fingertips and toes
  • Difficulty hearing
  • Try to avoid the cold or extreme heat.
  • Wear mittens or gloves, socks and scarves.
  • If your fingers are numb, be careful with sharp objects.
  • Beware of hot coffee mugs, pots and pans and dishwater—you may not feel the heat until you are burned.
  • If you fee unsteady, be careful on stairs and in the shower
  • Your healthcare provider may decrease your dose or delay further treatment.
Fluid Retention (Less Common. Symptoms are generally mild to moderate.)  
  • Swelling around the eyes, lower legs, ankles, feet or abdominal area
  • Slight weight gain
  • Check your weight regularly.
  • Try to avoid eating salty foods, as this can cause fluid retention.
  • You may be given a diuretic (water pill) to reduce the amount of fluid in your body.
  • Your healthcare provider may decrease your dose or delay further treatment.
Alopecia or Hair Loss (Less Common. Hair loss is generally mild to moderate.)  
  • More than normal amount of hair loss in your brush, in the shower or on your pillow after sleeping
  • Loss of body hair
Alopecia cannot be prevented but here are tips to help with hair loss:
  • Use a soft hairbrush. Do not use brush rollers, color treat your hair or get a permanent.
  • Avoid daily hair washing, use a mild shampoo and avoid using a hairdryer, or use a low setting if you must use one.
  • Have your hair cut short; this will make it look fuller.
  • Your insurance might cover a wig. Ask your healthcare provider for a prescription for a “hair prosthesis”. Your hair color and style can be better matched if you shop for a wig before losing a lot of hair.
  • Use sunscreen or wear a hat or scarf to protect your scalp from the sun.
Anemia (Less Common)
  • Fatigue or weakness
  • Dizziness
  • Pale skin
  • Feeling out of breath
  • Feeling cold
 
  • Plan rest periods throughout the day.
  • Organize daily activities so that you conserve your energy.
  • Try to eat a well balanced diet and drink plenty of fluids.
  • Stand up slowly to avoid getting dizzy.
  • You may be given medicine to increase your red blood cell count.
  • Your healthcare provider may decrease your dose or delay further treatment.
Risk of Bleeding (Rare)
  • Unusual bleeding or easy bruising
  • Black or tar-like stools
  • Blood in your urine
  • Pinpoint red spots on your skin
  • Bleeding gums or nosebleeds
  • Avoid aspirin and aspirin-like drugs, such as ibuprofen.
  • Use caution with sharp objects, such as razors and nail cutters.
  • Avoid activities that can cause cuts, bumps and bruises.
  • You may be given medicine to increase your platelet count.
  • Your healthcare provider may decrease your dose or delay further treatment.
 

What Are the Other Possible Side Effects?

The following chart lists additional side effects found with the individual drugs in this treatment. It does not list all possible side effects. For more information, talk with your healthcare provider.

Common Side Effects

  • Fatigue
  • Changes in liver function tests
  • Increased appetite
  • Nervousness, restlessness or insomnia
 

Less Common Side Effects

  • Weakness
  • Back or joint pain
  • Stomach pain or indigestion
  • Blood in the urine or painful urination
  • Muscle spasms
  • Headache or dizziness
  • Eye infections, glaucoma or cataracts
  • Changes in taste
  • Dehydration
  • Abnormal heartbeat
  • Low blood pressure
 

Rare Side Effects

  • Yellowing of the skin or whites of the eyes
  • Heart failure
  • Hiccups