Everolimus (Afinitor)

Everolimus is pronounced e-ve-ro-li-mus. It’s brand name is Afinitor. It is a type of treatment called a signal transduction inhibitor. Signal transduction inhibitors stop some of the signals within cells that make them grow and divide. Everolimus stops a particular protein called mTOR from working properly. mTOR controls other proteins that trigger cancer cells to grow. So everolimus helps to stop the cancer growing or may slow it down.

Everolimus is a treatment for advanced kidney cancer that has come back either during or after treatment. Researchers are also looking at it as a treatment for breast cancer, head and neck cancer and food pipe cancer (oesophageal cancer).

You take everolimus as a tablet once a day. You should try to take it at the same time each day and swallow it whole with a glass of water. You can take it with or without food.

You usually continue taking everolimus for as long as it works. It is very important that you take tablets according to the instructions your doctor or pharmacist gave you. For example, whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

The side effects associated with everolimus are listed below. You can use the links to find out more about each side effect. If there is no link, go to our cancer drug side effects section or type the name of the side effect into the search box at the top of the page.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these effects. Your doctor will check your blood counts before and during treatment to see how well your bone marrow is working.

Other common side effects include

• A sore mouth (stomatitis) in more than 4 out of 10 people (44%)
• Feeling weak in 3 out of 10 people (30%)
• Fatigue during and after treatment – this happens in 3 out of 10 people (30%)
• Cough and shortness of breath in about 1 in 4 people (25%)
• Some kind of skin reaction in 1 to 3 out of 10 people (10 to 30%) – you may have a rash or itchy or dry skin
• Loss of appetite happens in 1 in 4 people (25%)
• Feeling or being sick happens in about 2 out of every 10 people (20%) but is usually well controlled with anti sickness medicines
• Headaches
• Taste changes
• Diarrhoea in about 2 out of 10 people (20%) – drink plenty of fluids and tell your doctor or nurse if it becomes severe, or continues for more than 3 days
• Taking everolimus may affect your blood sugar levels so your nurse will check the levels regularly – if you are diabetic, talk to your diabetes doctor or nurse about the best way to control your diabetes
• This drug may have a harmful effect on a developing baby – do talk to your doctor or nurse about contraception before having treatment if there is any chance that you or your partner could become pregnant
• Loss of fertility – we don’t know exactly how this drug affects fertility so do talk with your doctor before starting treatment if having a baby is important to you

Between 1 and 10 in every 100 people have one or more of these.

• Inflammation of the lungs (pneumonitis) happens in about 1 in 10 people (10%) – let your doctor know if you have breathlessness, a high temperature and chills, extreme tiredness, a dry cough or pain in your lungs when you take a deep breath
• Kidney changes – you will have regular blood tests to check how well your kidneys are working and will have fluids to flush the drugs through
• Fluid retention – your ankles may be swollen and you may put on weight
• Liver changes – you are unlikely to notice any symptoms and your liver function will almost certainly go back to normal when you finish treatment. You will have regular blood tests to check how well your liver is working
• Sore, red eyes or dry eyes – steroid eye drops can help
• Difficulty sleeping

A few people may have heart problems that cause chest pain, swollen ankles, breathlessness and a fast heart rate. Tell your doctor or nurse if you have any of these symptoms.

You will not get all these side effects and those that you have may be mild. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

• How many times you've had a drug before
• Your general health
• How much of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. Your nurse will give you a contact number. You can ring them if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.