Classification: Kinase Inhibitor
About: Capivasertib (Truqap™)
Capivasertib is a kinase inhibitor. A kinase is an enzyme that promotes cell growth. There are many types of kinases, which control different phases of cell growth. Capivasertib interferes with the growth and spread of cancer cells by inhibiting PIK3CA/AKT1/PTEN. By inhibiting these proteins, this medication can slow or stop cell growth and division of cancer cells. Your cancer will be tested for changes (mutations) in the PIK3CA/AKT1/PTEN proteins before starting this medication.
Capivasertib is often given in combination with a medication called fulvestrant, which is given as an injection in a muscle (intramuscular or IM). Fulvestrant blocks estrogen receptors in breast tissue, slowing or stopping cancer growth. Please see the medication sheet for fulvestrant at OncoLink.org.
How to Take Capivasertib (Truqap™)
Capivasertib is taken by mouth two times a day. It comes in tablet form and can be taken with or without food. It should be taken around the same times each day. You will likely take the medication for 4 days, followed by 3 days off.
If you miss a dose and realize within 4 hours of the scheduled time, take the missed dose. If you miss a dose more than 4 hours from the scheduled time, skip that dose and take the next dose at its normal scheduled time. If you vomit after taking a dose, don’t take another one. Take your next dose at its scheduled time.
It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.
The blood levels of this medication can be affected by certain foods and medications. Do not eat grapefruit or drink grapefruit juice while you are taking this medication. Be sure to tell your healthcare provider about all medications and supplements you take.
Storage and Handling
Store your medication in the original, labeled container at room temperature and in a dry location (unless otherwise directed by your healthcare provider or pharmacist). This medication should not be stored in a pillbox. Keep containers out of reach of children and pets.
If a caregiver prepares your dose for you, they should consider wearing gloves or pour the pills directly from their container into the cap, a small cup, or directly into your hand. They should avoid touching the pills. They should always wash their hands before and after giving you the medication. Pregnant or nursing women should not prepare the dose for you. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.
Where do I get this medication?
Capivasertib is available through select specialty pharmacies. Your oncology team will work with your prescription drug plan to identify an in-network specialty pharmacy for the distribution of this medication and shipment directly to your home.
This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals depending upon prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources if they are available.
Possible Side Effects of Capivasertib
There are a number of things you can do to manage the side effects of capivasertib. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:
Your oncology care team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods and absorbs fluid, which can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange sections, boiled potatoes, white rice, products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses of non-alcoholic, un-caffeinated fluid a day to prevent dehydration.
Blood Sugar Changes
This medication can cause elevated blood sugar levels in patients with and without diabetes. Your oncology care team will monitor your blood sugar. Signs of high blood sugar are increased thirst, urination or hunger, blurry vision, headaches or your breath smells like fruit. If you have any of these symptoms you should notify your healthcare team. Diabetics should monitor their blood sugar closely and report elevations to the healthcare team.
Some patients will develop skin rash, redness, eczema, Hand-Foot Syndrome, cracking of skin, skin discoloration, ulcers, itchy skin, etc. This rash can become severe and result in a skin infection and hospitalization. Your skin may become very dry. Use an alcohol-free moisturizer on your skin and lips; avoid moisturizers with perfumes or scents. If your skin does crack or bleed, be sure to keep the area clean to avoid infection. Be sure to notify your healthcare provider of any rash that develops, as this can be a serious reaction. They can give you more tips on caring for your skin and prescribe topical or oral therapy to help with the itching and rash.
Notify your healthcare team right away if you notice any skin reactions so they can make recommendations or dose changes to prevent them from getting worse.
Low White Blood Cell Count (Lymphocytopenia, leukocytopenia, neutropenia)
White blood cells (WBC) are important for fighting infection. While receiving treatment, your WBC count can drop, putting you at a higher risk of getting an infection. You should let your care team know right away if you have a fever (temperature greater than 100.4°F or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
Tips to preventing infection:
- Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.
- Avoid large crowds and people who are sick (i.e.: those who have a cold, fever or cough or live with someone with these symptoms).
- When working in your yard, wear protective clothing including long pants and gloves.
- Do not handle pet waste.
- Keep all cuts or scratches clean.
- Shower or bathe daily and perform frequent mouth care.
- Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
- Ask your oncology care team before scheduling dental appointments or procedures.
- Ask your oncology care team before you, or someone you live with, has any vaccinations.
Low Red Blood Cell Count (Anemia)
Your red blood cells are responsible for carrying oxygen to the tissues in your body. When the red cell count is low, you may feel tired or weak. You should let your oncology care team know if you experience any shortness of breath, difficulty breathing, or pain in your chest. If the count gets too low, you may receive a blood transfusion.
Fatigue can occur with this medication and you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help with fatigue. Talk to your healthcare team for helpful tips on dealing with this side effect.
Nausea and/or Vomiting
Talk to your oncology care team so they can prescribe medications to help you manage nausea and vomiting. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try saltines, or ginger ale to lessen symptoms.
Call your oncology care team if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.
This medication can cause a temporary increase in your triglyceride levels, which typically come back down after you stop taking the medication. Your healthcare team may monitor these levels while you are taking capivasertib.
Mouth Ulcers (Mucositis)
Certain cancer treatments can cause sores or soreness in your mouth and/or throat. Notify your oncology care team if your mouth, tongue, inside of your cheek or throat becomes white, ulcerated, or painful. Performing regular mouth care can help prevent or manage mouth sores. If mouth sores become painful, your doctor or nurse can recommend a pain reliever.
- Brush with a soft-bristle toothbrush or cotton swab twice a day.
- Avoid mouthwashes that contain alcohol. A baking soda and/or salt with warm water mouth rinse (2 level teaspoons of baking soda or 1 level teaspoon of salt in an eight ounce glass of warm water) is recommended 4 times daily.
- If your mouth becomes dry, eat moist foods, drink plenty of fluids (6-8 glasses), and suck on sugarless hard candy.
- Avoid smoking and chewing tobacco, drinking alcoholic beverages and citrus juices.
Sexual & Reproductive Concerns
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Women will be asked to take a pregnancy test prior to receiving this medication. For women, effective birth control is necessary during treatment and for 1 month after your last treatment, even if your menstrual cycle stops. For men, effective birth control is necessary during treatment and for 4 months after your last treatment, even if you believe you are not producing sperm. You may want to consider sperm banking or egg harvesting if you may wish to have a child in the future. Discuss these options with your oncology team. You should not breastfeed while receiving this medication.