Torisel-Temsirolimus

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

Uses For This Medication
  • Temsirolimus is used to treat patients with advanced kidney (renal cell) cancer who have not received other chemotherapy medications.
  • Temsirolimus is being studied for the treatment of other tumors including Non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, endometrial cancer, glioblastoma, and melanoma.
  • This medication may also be given for other conditions as determined by your doctor.
 

How This Medication Works

Temsirolimus is a chemotherapy medication that belongs to a group of medications known as mTOR inhibitors. These mTOR inhibitors are a new kind of treatment known as “targeted therapy” which are different from traditional chemotherapy. Most chemotherapy medications work by killing rapidly dividing cells in the body. MTOR inhibitors work by blocking an important protein which helps cancer cells divide, grow, and survive. This leads to tumor cell death.   Benefits Of This Medication Temsirolimus has been shown to slow the growth of tumors. It has also been shown to increase survival in some patients who receive this medication.   Who Should Not Take This Medication You should not take this medication if you are allergic to temsirolimus, sirolimus, or any of its components.   Precautions To Be Aware Of Before Taking This Medication

Allergy related precautions

This medication can cause allergic reactions. These reactions can be serious and can cause symptoms such as rash, skin lesions, itching, difficulty breathing, redness and flushing of skin, facial swelling, and chest pain. These symptoms may occur while the drug is being administered, but may also occur later. Although you will be given an antihistamine just before receiving this medication, it may not completely prevent these side effects from occurring. Your doctor or healthcare provider will watch you carefully during and after the administration of temsirolimus to make sure that you do not experience any allergic reactions. If an allergic reaction occurs it is treatable with medications. Contact your doctor or healthcare provider right away if you have any of these symptoms.

Blood related precautions

  • This medication can cause high blood sugar levels or worsen the blood sugar levels of patients with diabetes. Your doctor or healthcare provider will check your blood regularly while you are on this medication to monitor for this possible problem. If you notice symptoms such as increased thirst, increased hunger, or increased urination, make sure that you tell your doctor or healthcare provider right away. In addition, if you are diabetic, the dose of your diabetes medications may need to be changed. Be sure to check with your doctor or healthcare provider.
  • This medication can cause increases in cholesterol. Your doctor will check your cholesterol levels before you start taking this medication and regularly while you continue on this medication. If necessary, he/she will start you on medication and a dietary program to control your cholesterol levels.
  • Rarely, this medication can increase the risk for bleeding in those who have a brain tumor and/or those who are taking blood thinners. This side effect can be fatal. Notify your doctor if you develop headaches, nausea/vomiting, change in alertness, vision, or sensation, difficulty speaking or swallowing, difficulty with coordination or movement, or seizures.
 

Gastrointestinal related precautions

This medication may cause bowel perforation (a hole in the bowel wall). Notify your doctor or healthcare provider if you develop severe abdominal pain, fever, nausea, vomiting, or bloody stools.  

Organ related precautions

  • Rarely, this medication can cause a serious lung problem known as interstitial lung disease (ILD). Contact your doctor or healthcare provider immediately if you experience symptoms such as a shortness of breath, cough, or fever. These symptoms can get worse quickly and require hospitalization. Make sure that your doctor or healthcare provider is aware if you have any lung problems before starting this medication.
  • Rarely, this medication can cause changes in the ability of your kidneys to work normally. In some cases, dialysis was not effective and resulted in death. Your doctor or healthcare provider will check your kidneys regularly, usually through blood tests, while you are on this medication to make sure that your kidneys are working properly. If you have any kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
  • Rarely, this medication can cause severe allergic skin reactions. These can be serious and can cause symptoms such as skin lesions, itching, fever, joint aches, mouth sores, eye burning, itching, pain and discharge, and vision changes. Contact your doctor or healthcare provider right away if you have any of these symptoms.
 

Miscellaneous precautions

  • This medication may result in slowed or difficult wound healing. Notify your doctor or healthcare providers if you are scheduled to have surgery within a few weeks of starting treatment with this medication or during treatment.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent. You should also avoid close contact with people who have recently received live vaccines. Examples of live vaccines include intranasal influenza, measles, mumps, rubella, oral polio, BCG, yellow fever, varicella, and certain typhoid vaccines.
  • Some of the active ingredients in this medication can be present in your vomit, urine, or stool for up to 7 days after the dose is received. For their protection, advise your caregiver(s) to use caution and avoid direct contact with any of these bodily fluids when assisting you during this time period.
 

Patient specific precautions

  • It is not known if this medication is safe and effective in children.
 

Pregnancy and breastfeeding precautions

  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy.
  • Women should avoid becoming pregnant throughout treatment and for 3 months after stopping this medication. Men with partners of childbearing potential should use reliable methods of contraception throughout treatment and for 3 months after stopping this medication. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
 

Medication And Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with temsirolimus and the following medications:
  • Amiodarone (Cordarone?)
  • Aprepitant (Emend?)
  • Atazanavir (Reyataz?)
  • Carbamazepine (Tegretol®)
  • Clarithromycin (Biaxin?)
  • Dexamethasone
  • Erythromycin
  • Grapefruit or grapefruit juice
  • Imatinib mesylate (Gleevec?)
  • Indinavir (Crixivan?)
  • Itraconazole (Sporanox?)
  • Ketoconazole (Nizoral?)
  • Nefazodone (Serzone?)
  • Nelfinavir (Viracept?)
  • Posaconazole (Noxafil?)
  • Phenytoin (Dilantin?)
  • Phenobarbital
  • Rifampin (Rifadin?)
  • Rifabutin (Mycobutin?)
  • Ritonavir (Norvir?)
  • Saquinavir (Invirase®)
  • Sunitinib (Sutent®)
  • St.John’s wort
  • Telithromycin (Ketek®)
  • Voriconazole (Vfend?)
Caution should also be used when combining temsirolimus with ACE inhibitors, i.e. benazepril (Lotensin?), captopril (Capoten?), enalapril (Vasotec?), fosinopril (Monopril?), lisinopril, quinapril (Accupril?), ramipril (Altace?) and anticoagulants, i.e. warfarin (Coumadin?). NOTE: This list may not include all medications that can have interactions with temsirolimus.

Side Effects

  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you. Side effects can occur when temsirolimus is given alone or together with other chemotherapy medications.
 

More common side effects

  • Rash
  • Asthenia (weakness)
  • Nausea, mouth sores, anorexia (loss of appetite)
  • Diarrhea
  • Water/fluid retention
  • Decreased red cell count, white blood cell and platelet levels which can cause infections, anemia, bruising and bleeding
  • Increased blood sugar (see Precautions To Be Aware Of Before Taking This Medication)
  • Increased cholesterol (see Precautions To Be Aware Of Before Taking This Medication)
  • Increased liver function and kidney function tests (see Precautions To Be Aware Of Before Taking This Medication)
  • Decreased phosphorus levels
  • Difficulty breathing, cough
 

Less common side effects

  • Fever, Infection
  • Vomiting, weight loss
  • Taste changes
  • Headache, insomnia
  • Pain, including chest pain, back pain, and abdominal pain
  • Joint aches
  • Constipation
  • Inflamed nasal passages, bloody nose
  • Itching
  • Dry skin, acne, nail changes
  • Decreased potassium levels in the blood
 

Rare side effects

This is not a complete list of the rare side effects reported with temsirolimus. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert. 
  • Lung problems (see Precautions To Be Aware Of Before Taking This Medication) 
  • Serious allergic reactions (see Precautions To Be Aware Of Before Taking This Medication)
  • Bowel perforation (see Precautions To Be Aware Of Before Taking This Medication) 
  • Impaired wound healing (see Precautions To Be Aware Of Before Taking This Medication) 
  • High blood pressure 
  • Conjunctivitis 
  • Muscle aches 
  • Depression 
  • Blood clots 
 

How To Take This Medication

  • This medication is given by injection into a vein (IV) over 30 – 60 minutes once a week by a healthcare professional. This medication can be given in different doses depending on whether it is given in combination with certain other medications which can affect how the drug is cleared by the body.
  • You will be given an antihistamine just prior to receiving your injection. Tell your doctor or healthcare provider if you have an allergy to antihistamines. You should also arrange a ride home following your treatment, as antihistamines can cause drowsiness and can impair your ability to drive.
  • In the unlikely event of an overdose of this medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately. Symptoms of overdose can include seizures or an altered mental state, but may also include any of the side effects listed previously for this medication.
 

Proper Storage

  • It is unlikely that you will need to store this medication. However, in the event that you do, the unopened containers should be stored in the refrigerator at 36° – 46° Fahrenheit (2° – 8° Celsius).
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.