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Dabrafenib (Tafinlar)

Dabrafenib is a type of targeted cancer drug called a cancer growth blocker. You might have it as a treatment for:

  • melanoma skin cancer that can’t be removed with surgery (unresectable) or has spread to another area of the body (metastatic or advanced melanoma)
  • stage 3 melanoma skin cancer that has been removed with surgery (to reduce the risk of the cancer coming back)
  • advanced non small cell lung cancer (NSCLC)

You can only have dabrafenib if your cancer has a change (mutation) in the BRAF gene. Your doctor will check for this mutation before you can start this drug.

How dabrafenib works

Dabrafenib is a type of cancer growth blocker. It works by targeting certain proteins made by the changed BRAF gene that helps cancer cells to grow. By blocking these proteins, dabrafenib stops or slows down the growth of cancer cells.

How you have dabrafenib

You take dabrafenib as a capsule.

You have it on its own or with another drug called trametinib.

You swallow it whole with a full glass of water. You take it on an empty stomach. This means you take it at least 1 hour before a meal or 2 hours after a meal.

When you have dabrafenib

You usually take dabrafenib twice a day, morning and evening, 12 hours apart.

For advanced cancer, you take dabrafenib for as long as it is working and the side effects aren’t too bad.

You take dabrafenib for up to 12 months if you are having it to try to prevent melanoma skin cancer coming back after surgery.

Tests

You have regular blood tests, scans and other tests during this treatment.

Your doctor or nurse will explain what tests you need.

Side effects

We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Common side effects

These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:

High temperature and chills

You might get a high temperature. Or you might feel cold or start shivering (chills). 

Contact your doctor or nurse straight away if you have signs of infection, including a temperature above 37.5C or below 36C.

Loss of appetite

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Headaches and dizziness

Let your doctor or nurse know if you have headaches. They can give you painkillers. Don’t drive or operate machinery if you feel dizzy.

Cough

It is important to tell your doctor or nurse if you have a cough. This could be due to an infection, such as pneumonia.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques, can all help.

Diarrhoea

Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days. Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.

Skin problems

Symptoms of skin problems can include wart-like growths and thickening of the skin. Less commonly your skin might be more sensitive to the sun, you might develop a rash, dry skin, itching, reddening, or skin tags.

Your doctor will check your skin regularly through treatment.

Let your doctor or nurse know if you’re worried about an area of skin. They might be able to give you something to help.

Hair thinning 

Your hair may thin or you might lose hair in certain areas (patches). You're unlikely to lose all your hair. It usually grows back when you finish treatment. 

Other areas of hair that might be affected include your eyelashes, eyebrows, underarm, leg and sometimes pubic hair.

Soreness, redness and peeling on palms and soles of feet

The skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.

Arm, leg, joint or muscle pain

You might have aches or pain in your arms, legs, muscles or joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

Tiredness and weakness

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Talk to your doctor or nurse if this effect is stopping you from doing your usual daily activities.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:

  • types of skin cancer called squamous cell carcinoma and basal cell carcinoma
  • low levels of a type of mineral salt (phosphate) in your blood
  • high blood sugars
  • difficulty having a poo (constipation)
  • flu-like symptoms - you might have symptoms such as headaches, aching muscles, a high temperature or runny nose

Rare side effects

These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • melanoma skin cancer
  • an allergic reaction – you may get a rash, shortness of breath, redness or swelling of the face
  • eye problems – such as blurred vision, eye pain, redness in your eye, changes in vision, and flashes of light
  • inflammation of your pancreas – you might get severe tummy pain, feel or be sick, a high temperature or you may have loose poo (stool)
  • kidney problems – your blood test results may show your kidneys aren’t working properly, or symptoms might include confusion, not passing enough urine or shortness of breath

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Fertility

It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant while you are having treatment with this drug and for at least 4 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

If you’re taking hormonal contraceptives like the pill, injections or patches you should use an additional barrier contraceptive such as a condom. It’s not known if dabrafenib affects the way hormone contraceptives work.

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment or other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • be in contact with other people who have had live vaccines as injections

Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

Information and help

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