Everolimus: Uses, Dosage, Side Effects, and Treatment Guide

Summary of Key Points

Everolimus is a prescription medication used to treat various cancers and conditions related to organ transplants. It works by slowing the growth of cancer cells and preventing organ rejection. Everolimus is available in tablet form and should be taken exactly as prescribed by your healthcare provider. If you have any questions about your dosage or potential side effects, consult one of our telemedicine providers for guidance.

Names of Medication

US Brand Name: Afinitor, Zortress

Generic Name: Everolimus

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.

Pharmacologic Category

Categories:

1. mTOR Inhibitor
2. Immunosuppressant

Everolimus Dosage and Treatment

Everolimus is prescribed for a range of conditions. The dosage and frequency depend on the specific condition being treated. Always follow your doctor’s instructions and never adjust your dose without consulting a healthcare provider. If you need to speak with a doctor, you can schedule a telemedicine appointment with us.

Renal Cell Carcinoma (Kidney Cancer)

Dosage: 10 mg once daily.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Everolimus for Breast Cancer

Dosage: 10 mg once daily, in combination with exemestane.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Neuroendocrine Tumors

Dosage: 10 mg once daily.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Tuberous Sclerosis Complex (TSC)-Associated Renal Angiomyolipoma

Dosage: 10 mg once daily.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Pancreatic Neuroendocrine Tumors

Dosage: 10 mg once daily.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Hepatocellular Carcinoma (Liver Cancer)

Dosage: 10 mg once daily.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Endometrial Carcinoma

Dosage: 10 mg once daily.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Everolimus for Kidney or Liver Transplant Rejection

Dosage: 0.75 mg twice daily, in combination with other immunosuppressants.

Length of Treatment: Continue as long as immunosuppression is needed to prevent organ rejection.

Lymphangioleiomyomatosis (LAM)

Dosage: 10 mg once daily.

Length of Treatment: Continue until disease progression or unacceptable toxicity.

Cardiac Allograft Vasculopathy

Dosage: 0.75 mg twice daily, in combination with other immunosuppressants.

Length of Treatment: Continue as long as immunosuppression is needed to prevent organ rejection.

Dosage Forms and Strengths

Everolimus is available in the following forms:

1. Tablets: 2.5 mg, 5 mg, 7.5 mg, 10 mg
2. Oral Suspension: 0.25 mg, 0.5 mg, 0.75 mg

Administration Instructions for Everolimus

Take Everolimus at the same time each day, with or without food. Swallow the tablet whole with a glass of water; do not crush, chew, or break it. If you miss a dose, take it as soon as you remember, unless it’s close to your next scheduled dose. Never double up on doses. If you have any questions about how to take your medication, contact one of our telemedicine providers for assistance.

Contraindications for Everolimus

A contraindication is a specific situation where a medication should not be used because it could cause harm. If you have any of the following conditions, you should not take Everolimus, or you may need to discuss alternative treatments with your healthcare provider.

1. Allergic reaction to Everolimus or similar medications: If you have had an allergic reaction to Everolimus or other medications in the same class (such as sirolimus or temsirolimus), taking Everolimus could cause a severe allergic reaction, which may include difficulty breathing, swelling, or rash.
2. Severe liver disease: Everolimus is processed by the liver. If your liver is not functioning properly, the medication may not be cleared effectively, leading to increased side effects or toxicity.
3. Recent live vaccinations: Everolimus weakens your immune system, and receiving live vaccines while on this medication could increase your risk of developing the infection the vaccine is meant to prevent.
4. Uncontrolled infections: Because Everolimus suppresses the immune system, it can make it harder for your body to fight off infections. If you have an active or uncontrolled infection, taking Everolimus could worsen your condition.

Everolimus Drug Interactions

Everolimus can interact with other medications, increasing the risk of side effects or reducing the effectiveness of either Everolimus or the other drug. Be sure to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Here are some common medications that may interact with Everolimus:

1. Rifampin (Rifadin): This antibiotic can reduce the effectiveness of Everolimus by speeding up how quickly your body breaks it down.
2. Ketoconazole (Nizoral): This antifungal medication can increase Everolimus levels in your body, raising the risk of side effects.
3. Verapamil (Calan, Verelan): Used to treat high blood pressure and heart conditions, verapamil can increase the concentration of Everolimus in your bloodstream.
4. Phenytoin (Dilantin): This anti-seizure medication can decrease the effectiveness of Everolimus by speeding up its breakdown in the liver.
5. St. John’s Wort: An herbal supplement often used for depression, St. John’s Wort can reduce the effectiveness of Everolimus.

Everolimus in Pregnancy

Is it safe to take Everolimus when pregnant?

Everolimus is generally not considered safe during pregnancy. It is classified as a category D medication, meaning there is evidence of potential harm to the fetus based on human studies. Taking Everolimus while pregnant may increase the risk of birth defects or miscarriage. If you are pregnant or planning to become pregnant, it is crucial to consult your healthcare provider to discuss alternative treatment options. Should you become pregnant while taking Everolimus, contact your healthcare provider immediately for guidance.

Everolimus while Breastfeeding

Is it safe to take Everolimus while breastfeeding?

Everolimus is not recommended for use during breastfeeding. Although it is unclear whether Everolimus passes into breast milk, its immunosuppressive effects could potentially pose risks to a nursing infant. If you are breastfeeding or planning to breastfeed, it is important to discuss your options with your healthcare provider. You may need to consider stopping breastfeeding or switching to a different medication.

Estimated Cost of Everolimus Medication

The cost of Everolimus can vary depending on the dosage and the pharmacy. Without insurance, a 30-day supply of Everolimus typically ranges from $1,200 to $2,500 when using a GoodRx coupon. For the most accurate pricing, check with your pharmacy, and explore financial assistance programs if needed.

Possible Alternatives to Everolimus

Depending on your condition, there may be alternative medications or lifestyle changes that can help manage your symptoms or disease. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore your options.

Renal Cell Carcinoma

Alternative treatments may include medications such as sunitinib (Sutent) or pazopanib (Votrient). Additionally, lifestyle changes like maintaining a healthy weight and quitting smoking can support the management of your condition.

Breast Cancer

Depending on the type of breast cancer, other treatment options may include hormone therapies like tamoxifen or aromatase inhibitors. Incorporating regular exercise and a balanced diet can also promote overall health during treatment.

Neuroendocrine Tumors

Somatostatin analogs, such as octreotide (Sandostatin) or lanreotide (Somatuline), may be considered as alternatives. Dietary adjustments, such as reducing sugar intake, may also help manage symptoms.

Tuberous Sclerosis Complex

Medications like vigabatrin (Sabril) or sirolimus (Rapamune) may be viable alternatives. Additionally, managing stress and maintaining a healthy lifestyle can be beneficial in controlling symptoms.

Pancreatic Neuroendocrine Tumors

Alternative treatments may include sunitinib (Sutent) or streptozocin. Dietary changes and regular monitoring can also play a role in managing symptoms effectively.

Hepatocellular Carcinoma

Sorafenib (Nexavar) or lenvatinib (Lenvima) may be considered as alternatives. In addition, avoiding alcohol and focusing on liver health through diet and exercise are important steps in managing this condition.

Endometrial Carcinoma

Hormone therapy or chemotherapy may be alternative treatment options. Maintaining a healthy weight and engaging in regular physical activity can also help manage symptoms and improve overall well-being.

Transplant Rejection

Alternatives to Everolimus may include tacrolimus (Prograf) or cyclosporine (Neoral). Following your healthcare provider’s recommendations regarding lifestyle changes, such as avoiding certain foods and supporting a healthy immune system, is essential for managing transplant rejection.

Lymphangioleiomyomatosis

Sirolimus (Rapamune) may be an alternative treatment option. Pulmonary rehabilitation and regular exercise can also help improve lung function and overall quality of life.

Cardiac Allograft Vasculopathy

Alternatives may include statins or other immunosuppressive medications. Regular monitoring and adopting a heart-healthy lifestyle are crucial for managing this condition effectively.

Recent Updates on Everolimus Research

Recent studies are exploring the expanded use of Everolimus in various cancers and ways to improve its effectiveness. For instance, ongoing research is investigating the combination of Everolimus with other targeted therapies to enhance its ability to treat breast cancer and neuroendocrine tumors. Additionally, researchers are studying the potential benefits of combining Everolimus with immunotherapy for certain cancers, which could lead to better outcomes for patients with advanced disease. As these studies are still in progress, staying informed about new developments is important. If you have questions about how recent research may impact your treatment, consider scheduling a telemedicine appointment with one of our providers to discuss the latest findings.

James Kingsley

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