Ponatinib is used to treat chronic myeloid leukaemia (CML) and Philadelphia-chromosome positive acute lymphoblastic leukaemia. CML is a type of cancer where the bone marrow produces too many white blood cells called granulocytes.
This medicine is used for those who are no longer benefiting from or intolerant to previous treatment or those who have a T315I gene mutation.
Take Ponatinib exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Ponatinib must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Do not breastfeed while you are being treated with this medicine and for 6 days after the last dose.
Inform your doctor if you have the following conditions:
- history of heart disease
- previous heart attack or stroke
- high blood pressure
- high cholesterol level in the blood
- alcohol abuse
- inflamed pancreas
- liver disease
- kidney disease
- hepatitis B (contagious liver infection caused by a virus from contaminated blood and body fluids)
Let your doctor know if you are pregnant. It is important that you do not get pregnant while being treated with Ponatinib. You may wish to discuss birth control methods with your doctor or pharmacist.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver and heart function; uric acid, lipase and electrolyte levels; blood count, eye examination) may be done while you are being treated with this medicine.
- Regular monitoring of signs of liver disease, heart failure, bleeding, fluid retention and nerve problems may also be needed.
Your doctor will advise you about how often you need to have these tests.
Ponatinib may cause dizziness, tiredness or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
Other side effects include any of the following: headache, diarrhoea, vomiting, constipation, nausea, stomach pain, fever, muscle pain, and joint pain, muscle weakness, bone pain, rash, dry skin, and dry eye.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- breathlessness, chest pain, rapid or irregular heartbeat
- fainting, dizziness, palpitations, loss of consciousness
- burning, tingling, pain and loss of feeling in your hands and feet, muscle weakness
- drooping eyelids, double vision and other eyesight problems
- severe pain in the stomach and back
- fits or seizure, changes in consciousness, visual disturbances, headaches
- redness of the face, flushing, difficulty breathing
- abnormal sensations, difficulty to speak or move, migraine
This medicine will cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- certain antibiotics e.g. clarithromycin
- medicines to treat fungal infections e.g. ketoconazole, itraconazole
- medicines for HIV infection e.g. indinavir, nelfinavir, saquinavir
- medicines for depression e.g. nefazodone
- medicines to treat hepatitis C e.g. boceprevir, telaprevir
- medicines to treat TB (a lung disease known as tuberculosis) e.g. rifampin
- medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenobarbital, phenytoin
- blood-thinning medicines e.g. dabigatran
- cholesterol-lowering medicines e.g. pravastatin, rosuvastatin
- digoxin (medicine for heart disease)
- methotrexate (medicine for cancer)
- sulfasalazine (medicine to treat rheumatoid arthritis)
- colchicine (medicine for gout [abnormal metabolism of uric acid])
- St. John’s Wort (herbal medicine)
This list does not include all medicines that may interact with Ponatinib.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol and excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
As this is a cancer medicine, always return any unused or expired tablets to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.