Momelotinib (Ojjaara®)

How to Take Momelotinib (Ojjaara^®)

Momelotinib (Ojjaara^®) comes in tablet form and is available in multiple dosage strengths. It can be taken with or without food. Take the tablets whole; do not cut, crush, or chew tablets. Your blood counts and liver function will be monitored closely while on therapy, and your dose may be adjusted based on these results. If you miss a dose, do not take an additional dose to make up for it; instead, take your next dose as scheduled. It is important to make sure you are taking the correct amount of medication every time.

The blood levels of this medication can be affected by certain medications, supplements, and foods, so they should be avoided. These include grapefruit and grapefruit juice, ketoconazole, rifampin, St. John's Wort, and many antifungal medications like fluconazole. 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 in a dry location, away from light. Do not store this medication in a pillbox. Keep the containers out of the reach of children and pets.

If a caregiver prepares your dose for you, they should consider wearing gloves or pour the tablets directly from the bottle into the cap, a small cup, or your hand. They should avoid touching the tablets directly. They should always wash their hands before and after handling the medication. Pregnant or nursing women should not prepare the dose for you. Ask your oncology team or pharmacist where to return any unused medication for proper disposal. Do not flush the medication down the toilet or throw it in the trash.

Where do I get this medication?

Momelotinib (Ojjaara^®) is available through select specialty pharmacies. Your healthcare team will work with your prescription drug plan to identify an in-network specialty pharmacy that can distribute this medication and ship it either to the oncology clinic or directly to your home.

This medication may be covered under your prescription drug plan. Patient assistance programs may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which can reduce the patient's co-pay responsibility for eligible, commercially insured patients, are also available. Your care team can help you find these resources if they are available.

Possible Side Effects of Momelotinib

There are a number of things you can do to manage the side effects of momelotinib. Talk to your care team about these recommendations and if you experience any of these side effects. They can help you decide what will work best for you. These are some of the most common or important side effects:

Low Platelet Count (Thrombocytopenia)

Platelets help your blood clot, so when the count is low, you are at a higher risk of bleeding. Let your oncology care team know if you have any excess bruising or bleeding, including nose bleeds, bleeding gums, or blood in your urine or stool. If your platelet count becomes too low, you may receive a transfusion of platelets.

• Do not use a razor (an electric razor is fine).
• Avoid contact sports and activities that can result in injury or bleeding.
• Do not take aspirin (salicylic acid), non-steroidal, anti-inflammatory medications (NSAIDs) such as Motrin/Advil (ibuprofen), Aleve (naproxen), Celebrex (celecoxib), etc., as these can all increase the risk of bleeding. Please consult with your healthcare team regarding the use of these agents and all over-the-counter medications/supplements while on therapy.
• Do not floss or use toothpicks, and use a soft-bristle toothbrush to brush your teeth.

Diarrhea

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, uncaffeinated fluid a day to prevent dehydration.

Fatigue

Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, 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 combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.

Nausea

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 doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Important but Less Common Side Effects

• Infection: Let your provider 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.
• Liver Toxicity: This medication can cause liver toxicity, which your doctor may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or pain in your abdomen, as these can be signs of liver toxicity.
• Severe Cutaneous Adverse Reactions (SCARs): This medication can cause rare, but serious allergic reactions that affect the skin and mucous membranes. These skin reactions often start as a rash or painful blister and can progress (get worse) to serious damage to the skin and, in some cases, death. If you notice a new rash, have a fever and flu-like symptoms, lesions on mucous membranes, or swollen lymph nodes, call your care team right away.
• Major Adverse Cardiac Events (MACE): If you are a smoker or have other heart issues, be sure to let your team know. This medication can increase the risk of a heart attack or stroke.
• Blood Clots:This medication can cause blood clots. Blood clots can cause stroke, heart attack, deep vein thrombosis (DVT), or pulmonary embolism (PE). Symptoms include swelling, redness, or pain in an extremity, chest pain or pressure, pain in your arm, back, neck, or jaw, shortness of breath, numbness or weakness on one side of the body, trouble talking, confusion, or mental status changes. If you experience these symptoms, contact your healthcare provider immediately or go to an emergency room.
• Secondary Malignancies:There is a low risk of developing another cancer due to treatment with this medication, which can occur many years after treatment. This is most often associated with repeated treatments or high doses. Your oncology care team will provide instructions on how to follow up and be monitored for this.

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. Effective birth control is necessary during treatment and for 1 week after treatment is completed. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.