Lapatinib (Tykerb ) ( la PA ti nib )

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Lapatinib (Tykerb ) ( la PA ti nib ) How drug is given: by mouth Purpose: stops growth of cancer cells in breast cancer and other cancers How to take the drug by mouth Take this medication on an empty stomach (at least 1 hour before food or 1 hour after food). Swallow each tablet whole; do not crush or chew. If you are unable to swallow the tablet, the pharmacist will give you specific instructions. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double dose. Lapatinib can interfere with many drugs, which may change how this works in your body. Talk with your doctor before starting any new medications or supplements, including over thecounter drugs, natural products, herbal supplements, and vitamins. Do not drink grapefruit juice or eat grapefruit while taking this drug. Also, do not take St. John s wort. These may increase the amount of medication in your body and worsen side effects. Storage Store at room temperature, away from heat and moisture. Keep this medicine in its original container, out of the reach of children and pets. If you have unused oral chemotherapy pills (tablets or capsules), please return them to the pharmacy where the prescription was filled. Do not flush down the toilet, dump in the sink, or throw away in the trash. Things that may occur during treatment 1. The palms of your hands or the soles of your feet may become red and painful. This is called hand foot syndrome. Tingling and peeling of the skin may occur. Avoid tight fitting shoes. Use thick (moisturizing) creams on hands and feet. Developed by Dana Farber Cancer Institute Last Revised 2/2018 Patient and Family Education Committee

Lapatinib Page 2 of 2 2. Loose stools or diarrhea may occur. You can take loperamide (Imodium A D ) to help control diarrhea. You can buy this at most drug stores. It is also important to drink more fluids (water, juice, sports drinks). If these do not help within 24 hours, call your cancer care team. 3. Mild to moderate nausea, vomiting, and loss of appetite may occur. You may be given medicine to help with this. 4. Some patients may feel very tired, also known as fatigue. You may need to rest or take naps more often. Mild to moderate exercise may also help you maintain your energy. 5. Skin changes, such as dryness, itching or a rash on your body, may occur. Ask your cancer care team what lotions or creams you may use to help with this. 6. Your liver may be affected by this drug. On occasion, blood work will be taken to monitor your liver function. 7. This drug may affect your heart. Your heart function will be followed. You should let your cancer care team know if you are coughing, having trouble breathing, have chest pain and/or swelling in the feet or ankles. Things that may occur after treatment ends (even months to years later) Fertility and Related Precautions: It is very important to use birth control if you are having sex, because this drug can be harmful to an unborn baby. Women should not breastfeed while receiving this drug. If you are concerned about any of this, please talk with your cancer care team. The above information includes some, but necessarily all, of the possible side effects of this medication. The side effects listed in this teaching sheet may not be the same ones you experience. Your side effects may be different, depending on how often you receive treatment (your schedule) and how much you receive each time (your dosage). Side effects may also vary if you are taking other medications. Please speak with your doctor or nurse if you have questions about possible side effects you may experience. This document should not take the place of conversations with members of your health care team. If you experience any significant change in your health during or after treatment, contact a member of your health care team right away. Managing your oral chemotherapy schedule at home can be challenging. To help with this, consider using tools to help you keep track of your schedule and any side effects you may have. You can find these tools online at www.dana farber.org/oralchemodiary. THIS SPACE RESERVED FOR WRITTEN COMMENTS OR NOTES FOR THE PATIENT AND FAMILY: Developed by Dana Farber Cancer Institute Last Revised 2/2018 Patient and Family Education Committee

Oral Chemotherapy Fact Sheet Oral chemotherapy medicines are given by mouth in the form of capsules, tablets, or liquid. These safety tips will help you understand what to do when you are taking oral chemotherapy. Please note: If you are on a clinical trial, you may be given special instructions. How to take this drug Swallow each tablet or capsule whole. Do not break, crush, or chew. Prepare your drug away from food and food prep areas. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double the dose. If you are on a clinical trial, you will be given special instructions if you miss a dose. If you are unable to swallow the pill, speak with your nurse or pharmacist about other ways to take your medication. If you vomit or throw up your medication, call your physician for further instructions. Wash your hands after taking the medication. Avoid handling crushed or broken pills (tablets or capsules). Storage Most oral chemotherapy medicine is stored at room temperature, away from excess heat and moisture. You will be told if the medication you are taking needs special storage or handling. Keep this medicine in its original container, in a safe place, away from other family medications. All medications need to be kept out of the reach of children and pets.

Oral Chemotherapy Fact Sheet Page 2 of 3 Disposal If you have unused oral chemotherapy pills (tablets or capsules), please return them to the pharmacy where the prescription was filled. Do not flush down the toilet, dump in the sink, or throw away in the trash. Safe handling of body waste in the home after chemotherapy Chemotherapy stays in the body for hours or even days, and is found in vomit, urine, stool, and sweat (body wastes). Special care must be taken to prevent the patient s body waste from coming into accidental contact with the patient or caregiver. Body wastes Patient and caregiver: You can use the toilet (septic tank or city sewage) as usual. There is no research to support double flushing to prevent accidental contact (although this may be suggested for certain medications). Ask your doctor or nurse what they suggest for your medication. Wash your hands well with soap and water after using the toilet. If urine, vomit, or stool gets on your body, wash with soap and water. Always wear gloves when cleaning equipment or disposing waste from a urinal or commode. Pregnant caregivers should not handle patient body waste. It is safe for family and friends to use the same toilet, as long as all body waste is cleaned from the toilet. To absorb urine or stool, use a disposable, plastic-backed pad, diaper, or sheet. Change it immediately when soiled. Then wash skin with soap and water. If you have an ostomy, you or your caregiver may want to wear gloves when emptying or changing appliances. Laundry Always wear disposable gloves when handling sheets or clothes that have been soiled with body waste. Soiled items should be kept and washed separately from the other laundry. Oral chemotherapy is a serious drug that requires extra caution. If you have questions or concerns about your oral chemotherapy, do not hesitate to call your clinician. For more tips, tools and short videos to help you manage oral chemotherapy visit our web page at http://www.dana-farber.org/oralchemo

Oral Chemotherapy Fact Sheet Page 3 of 3 The materials included on this page are for informational purposes only. The content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. THIS SPACE RESERVED FOR WRITTEN COMMENTS OR NOTES FOR THE PATIENT AND FAMILY: