• About IXEMPRA
• How IXEMPRA May Help
  • IXEMPRA Used Alone
  • IXEMPRA Used
    With Xeloda
• How IXEMPRA Is
  Thought to Work
• How IXEMPRA Is Given
• Possible Side Effects
  of IXEMPRA
  • Serious Side Effects
    of IXEMPRA
  • Common Side Effects
    of IXEMPRA
• Tips for Coping
  With Certain Side Effects
• IXEMPRA Reimbursement

Tiredness/fatigue

Talk with your healthcare provider if you are feeling very tired. Your healthcare team will want to know about any side effects you may have. If you are feeling very tired, below is a list of tips that you may want to discuss with your healthcare provider.

Try to pace yourself. Decide on the most important things to do each day. Let others help with shopping, cooking, and driving

Take short walks. For some people, being active can help more than resting. Ask your healthcare provider about exercise. Research shows that the right amount, type, and time of exercise may help lessen fatigue and also help you sleep better. Your healthcare provider may be able to suggest other ways to be more active

Sleep at least 8 hours at night. You may not be used to sleeping a full 8 hours. Your body may need more sleep than it needed before you started chemotherapy

Keep track of how you feel. This may help you plan your activities for the day

Loss of appetite

Talk with your healthcare provider if you are having trouble eating because you have a loss of appetite. Your healthcare team will want to know about any side effects you may have. If you are having a loss of appetite, below is a list of tips that you may want to discuss with your healthcare provider.

Eat frequent mini meals or snacks, instead of 3 big meals

Eat high-calorie, high-protein foods and drinks, like chicken, ice cream, peanut butter, and milk shakes, when you do feel like eating. If you have diarrhea or constipation, you may need to be careful about the foods you eat. Talk with your healthcare provider about what you should eat

Have liquid meals, such as smoothies, juices, soup, or nutritional drinks

Take a short walk before meals to increase your appetite

Problems with your toenails and fingernails

Talk with your healthcare provider if you have problems with your toenails and fingernails. Your healthcare team will want to know about any side effects you may have. If you are having problems with your nails, below is a list of tips that you may want to discuss with your healthcare provider.

Wear gloves when washing dishes, gardening, or cleaning the house

Use a nail strengthener. For brittle or cracked nails, use products that you apply to your nails that make them stronger

Hair loss

Talk with your healthcare provider early on about your chances for hair loss. You will feel more prepared when you start to lose your hair. Below is a list of tips that you may want to discuss with your healthcare provider.

Consider cutting your hair. This may help you adjust to the physical and emotional changes that happen with hair loss

Buy a wig while you still have some hair. Then you can match the color and style of the wig to your own hair. Check to see if your insurance covers the cost of a wig, which may be called a hair prosthesis

Fever

If you have a fever above 100.5°F, contact your healthcare provider right away or go to the nearest hospital emergency room. If you get a fever or infection when your white blood cell count is very low, you can become seriously ill and die. You may need treatment in the hospital with medicines. Your healthcare provider will monitor your white blood cell count often with blood tests. If you have fever, below is a list of tips that you may want to discuss with your healthcare provider.

Drink lots of liquids, such as soup, juice, water, or soda, or eat ice pops

Take your temperature every 2 to 3 hours and record the readings. Share this information with your healthcare provider

Use cold compresses on your forehead if you feel hot

Decreased red blood cell count (anemia)

If your healthcare provider has told you that you have anemia, you may want to discuss the following tips with him or her:

Stand up slowly after lying down. This may prevent you from feeling dizzy or faint

Get enough rest. Try to sleep for at least 8 hours every night

Eat the right foods. You need enough calories to keep your weight up. You also need enough protein to help your body heal. Let your healthcare provider or a dietitian help you plan a healthy menu

Joint and muscle pain

Talk with your healthcare provider if you have joint and muscle pain. Your healthcare team will want to know about any side effects you may have. Below is a list of tips that you may want to discuss with your healthcare provider.

Use heat packs or a heating pad. Be sure that the heating pad is not too hot. Do not put a heating pad on bare skin. Do not fall asleep with a heating pad on

Take warm baths to help soothe aching muscles. Be sure that the water is not too hot

Distract yourself. Try meditation, watching TV, listening to music, or visiting with family and friends

Headache

Talk with your healthcare provider if you have headaches. Your healthcare team will want to know about any side effects you may have. Below is a list of tips that you may want to discuss with your healthcare provider.

Practice relaxation exercises to help relieve tension. Try deep breathing or picturing a peaceful place

Distract yourself with music. Listen to music that is slow and quiet

Bleeding and bruising easily

Talk with your healthcare provider if you are bleeding or bruising easily. This could be a sign that your platelet count is low. Your healthcare team will want to know about any side effects you may have. Your healthcare provider will monitor your blood cell count often with blood tests. Below is a list of tips that you may want to discuss with your healthcare provider.

Blow your nose gently

Apply gentle pressure on any cuts until the bleeding stops

Use a very soft toothbrush. Before you brush, run hot water over the bristles to soften them more. Avoid flossing and using toothpicks. Talk with your healthcare provider about ways to care for your mouth and teeth during treatment

Use an electric shaver instead of a razor

Be careful when you’re active. Choose activities that have less chance for injury

Nausea and vomiting

Talk with your healthcare provider if you have nausea and vomiting. Your healthcare team will want to know about any side effects that bother you. Below is a list of tips that you may want to discuss with your healthcare provider.

Eat when it is right for you. Some people may feel better eating before treatment. Other people may feel better having treatment on an empty stomach. Decide what works best for you

Keep away from foods with a strong odor, like onions, coffee, fish, and garlic. Strong odors can trigger nausea

Eat a diet of bland, easy-to-digest foods. These could include clear broth, cranberry juice, broiled/baked chicken without the skin, instant oatmeal, white toast, saltine crackers, noodles, gelatin, canned fruit, and sherbet or sorbet

Suck on ice chips, or try taking small bites of ice pops or fruit ices

Diarrhea

Tell your healthcare provider if your diarrhea lasts more than 24 hours or if you have pain or cramping. Below is a list of tips that you may want to discuss with your healthcare provider.

Drink at least 8 cups of liquid every day to stay hydrated. Choose water, clear broth, or sports drinks. Have your drinks at room temperature

Eat low-fiber foods. High-fiber foods can worsen diarrhea. Try eating chicken or turkey (skinless), eggs, cottage cheese, white rice, potatoes (without the skin), bananas, clear juice, canned fruit, gelatin, saltine crackers, and sherbet or sorbet

Eat foods high in sodium and potassium to replace what you may lose with diarrhea. Examples are bananas, oranges, peach or apricot nectar, and boiled or mashed potatoes

Avoid alcohol, caffeine (coffee, tea, cola, chocolate), milk products, and spicy, greasy, or fried foods

Avoid grapefruit juice while you are receiving IXEMPRA. Drinking grapefruit juice may cause you to have too much IXEMPRA in your blood and lead to side effects

Constipation

Talk with your healthcare provider if you are having fewer bowel movements than normal. Your treatment team may suggest additional ways to deal with your constipation. Below is a list of tips that you may want to discuss with your healthcare provider.

Drink at least 8 cups of water or other fluids every day. Drinks that may help with constipation include warm or hot coffee or tea, and prune juice. Avoid grapefruit juice while you are receiving IXEMPRA. Drinking grapefruit juice may cause you to have too much IXEMPRA in your blood and may lead to side effects

Eat high-fiber foods to help soften your stools. Choose foods such as raw or cooked vegetables, cooked dried beans and peas, whole-grain breads and cereals, brown or wild rice, dried fruit, nuts, and popcorn

Try to be active every day. Ask your healthcare provider about the type and amount of activity that is right for you. He or she can suggest chair or bed exercises, if needed

Abdominal pain

Talk with your healthcare provider if you are having abdominal pain. He or she can provide you with tips to help cope with the side effect.

Sores on the lips, in the mouth, and in the throat

Talk with your healthcare provider if you have sores on your lips, in your mouth, or in your throat. Your healthcare team will want to know about any side effects you may have. Below is a list of tips that you may want to discuss with your healthcare provider.

Puree cooked foods in a blender to make them easier to eat

Clean your teeth with cotton swabs if brushing with a toothbrush is too painful

Choose foods you can eat cold or at room temperature if hot foods hurt your mouth or throat

Suck on ice chips or ice pops to help soothe mouth pain

Avoid eating foods that may hurt your mouth. Examples are sharp, crunchy foods, spicy foods, citrus fruit or juices (such as orange, lemon, and grapefruit), high-sugar foods and drinks, alcoholic drinks, and tobacco products

Gently floss every day, avoiding any areas that hurt or bleed

Tender, red hands and feet (hand-foot syndrome)

Talk with your healthcare provider if you have tender, red hands and feet. Your healthcare team will want to know about any side effects you may have. Below is a list of tips that you may want to discuss with your healthcare provider.

Keep out of the sun as much as possible

Apply sunscreen of at least 30 SPF at least 1 to 2 hours before you go outside. Wear protective clothing and a hat when you are outside

Put gel inserts in your shoes if your feet are sensitive

Avoid wearing tight-fitting shoes

Bathe in lukewarm or cool water instead of hot water

Use mild soaps and body wash that do not have perfume, alcohol, or dye

Moisturize twice a day with a thick lotion or a cream that does not contain perfume, dye, or alcohol

Apply lotion when skin is still damp

Tingling, numbness, or burning in the hands or feet, or extreme sensitivity to touch (peripheral neuropathy)

Tell your healthcare provider as soon as you notice symptoms of peripheral neuropathy. When they do happen, these symptoms often appear early in treatment and may be new or get worse. Your dose of IXEMPRA may need to be decreased, stopped until your symptoms get better, or stopped totally. Below is a list of tips that you may want to discuss with your healthcare provider.

Be careful when you handle sharp objects, like scissors and knives

Avoid slipping hazards. Remove small rugs; use no-slip mats; use handrails

Wear shoes with rubber soles inside and outside the house

Use a thermometer to check your bath or shower water temperature, instead of your hand

Wear gloves for household chores like dish washing, gardening, and cleaning

Low white blood cell count (neutropenia)

Having a low white blood cell count means that your body cannot fight infections very well and you have a greater chance of getting an infection. Tell your healthcare provider right away or go to the nearest hospital emergency room if you have any signs of infection, such as a fever of 100.5°F or higher, chills or sweats, rash, cough, earache, stiff neck, or sinus pain or pressure. If you get a fever or infection when your white blood cell count is very low, you can become seriously ill and die. You may need treatment in the hospital with medicines. Your healthcare provider will monitor your white blood cell count often with blood tests.

Your healthcare team will want to know about any side effects you may have.

Below is a list of tips that you may want to discuss with your healthcare provider.

Stay away from people who are sick. Do not be around people with colds, flu, measles, or chicken pox

Be careful not to cut or nick yourself. Use an electric shaver, and be careful using scissors, needles, or knives

Clean cuts right away, using warm water, soap, and an antiseptic

Do not get any vaccine without first talking with your healthcare team. Some vaccines contain live viruses, which may make you sick

Please see the complete Important Safety Information, including boxed WARNING regarding liver disease.