Nilotinib brands and prices in Pakistan

About Nilotinib

Nilotinib is a targeted cancer medicine called a tyrosine kinase inhibitor (TKI). It blocks an abnormal protein (BCR-ABL) made by leukaemia cells that carry the Philadelphia chromosome, which stops these cells from growing. It is taken by mouth. Treatment is started by a specialist doctor experienced in treating chronic myeloid leukaemia, who checks blood tests and heart tracings (ECGs) before and during treatment.

Who should not take it, or should take care

• Do not take it if you are allergic to nilotinib or any other ingredient.
• Tell your specialist if you or a family member have a heart rhythm problem (long QT), or if you have low potassium or magnesium. Your doctor may decide it is not suitable.
• Tell your specialist if you have had a heart attack, angina, stroke or poor blood flow to the legs, or have high blood pressure, diabetes or high blood fats.
• Tell your specialist if you have liver or pancreas problems, bleeding problems, or have had your whole stomach removed.
• Hepatitis B can become active again during treatment, so you will be tested before you start. Tell your team if you have ever had hepatitis B, hepatitis C or HIV.
• The capsules contain lactose. Tell your doctor if you cannot digest some sugars.
• Children: it may slow growth, so a child's growth is checked closely.
• Pregnancy: it may harm an unborn baby. You may need a pregnancy test before starting. Use reliable contraception during treatment and for a time after the last dose, and tell your team at once if you become pregnant.
• Breastfeeding: do not breastfeed during treatment or for a time after the last dose.
• It is not known if nilotinib affects fertility. Talk to your team before starting if you may want children in the future.

Medicines and drinks that can interact

• Grapefruit, grapefruit juice and supplements with grapefruit extract: avoid them, as they can raise nilotinib to harmful levels
• Antacids and H2 blockers for heartburn (such as famotidine): these must be taken at separate times from nilotinib. Your doctor or pharmacist will tell you the timing.
• Proton-pump inhibitors such as omeprazole: talk to your doctor before taking them
• St John's wort (a herbal remedy)
• Medicines that affect heart rhythm, including some antibiotics, antimalarials, antipsychotics and methadone
• Azole antifungals, some macrolide antibiotics and HIV medicines such as ritonavir
• Epilepsy medicines such as carbamazepine, phenytoin and phenobarbital, and rifampicin for tuberculosis
• Some statins (simvastatin, lovastatin), warfarin, and transplant medicines such as ciclosporin and tacrolimus
• Live vaccines should be avoided during treatment. Ask your team before any vaccine.
• Tell your team about every medicine, vitamin, herbal remedy and supplement you take, including ones bought without a prescription

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your specialist team tells you. Do not change the dose or stop it on your own, as the leukaemia could get worse.
• Capsules are taken on an empty stomach, because food changes how much medicine gets into the blood. Your team will explain when to eat. Tablets and dissolving tablets may have different food rules, so check with your pharmacist.
• Swallow capsules whole with water. If you cannot swallow them, ask your team; the capsule contents may be mixed with apple sauce only and swallowed straight away.
• If you miss a dose, do not take two doses together. Follow the advice from your team.
• Go to all your blood tests and ECG appointments. They check how well the medicine is working and pick up side effects early.
• Tell any doctor, dentist or pharmacist that you take nilotinib.
• If it makes you dizzy or affects your sight, do not drive or use machines.
• Keep it in its original container at room temperature, out of the reach of children. Never share it, and return unused medicine to a pharmacy.

Common questions

How long will I need to take nilotinib?
Usually for as long as it keeps working and side effects are manageable. Some adults whose leukaemia has been very well controlled for a long time may be able to stop under close specialist checks, and restart if the leukaemia returns. Only your specialist can decide this.

Why do I need heart tests?
Nilotinib can change the heart's rhythm (QT prolongation), which can cause fainting or, rarely, sudden death. Your team does an ECG before you start and during treatment, and checks your potassium and magnesium.

Can I take indigestion remedies?
Some antacids and heartburn medicines change how nilotinib is absorbed. Do not take them without asking your doctor or pharmacist, who will tell you which ones you can use and how to space them.

Can I have vaccines?
Avoid live vaccines during treatment. Non-live vaccines, such as the flu injection, are usually allowed but may work less well. Ask your team about timing.

Is nilotinib used in the UK health service?
Yes. NICE recommends it as an option for adults with untreated chronic phase Philadelphia chromosome positive CML. It is also used when imatinib has stopped working or could not be tolerated.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.