Adverse Reaction Management Tips

Patients should be advised to1,2:

  • Take short naps or breaks
  • Eat well and drink plenty of fluids
  • Take short walks or do light exercise if they feel up to it
  • Try to maintain normal work and social schedules

Patients should be advised to1,3,4:

  • Try yogurt containing probiotics
  • Eat low-fiber foods, including yogurt, white toast, and white rice
  • Eat small but frequent meals
  • Avoid spicy foods, fatty foods, caffeine, and fruit
  • Drink lots of fluids, but in small amounts
Over-the-counter medications may help manage this AR.

Patients should be advised to1,5:

  • Avoid hot, spicy, or acidic foods
  • Eat foods that are soft
  • Use a straw for drinking liquids
  • Use an alcohol-free mouthwash, and rinse mouth often with water
  • Avoid toothpastes with whiteners (ie, peroxide) and use a soft toothbrush
Over-the-counter medications may help manage this AR.

Patients should be advised4,6:

  • To eat small meals
  • To avoid foods that are sweet, fried, or fatty
  • To drink lots of fluids, but in small amounts
  • If vomiting occurs, start with small amounts of water, broth, or other clear liquids when they are ready to eat again
    • If that stays down, then they can try soft foods. Examples include gelatin, yogurt, strained soup, and cream of wheat. Slowly work up to eating solid food. Make sure they do not eat any food that they are allergic to

Patients should be advised7:

  • To eat several small meals a day—5 or 6 isn’t out of the question
  • To eat when hungry
  • To enjoy snacks and try to make them nutritious
  • To find calories and protein in dried fruits, nuts, cheeses, and even milkshakes
  • To add gravy, butter, or cheese to favorite foods for added protein and calories
  • To drink fluids between meals rather than filling up with them during meals
  • If too tired to cook, suggest they ask a friend or family member to prepare something
  • If bothered by the smell of a certain food, it may help to eat it cold or at room temperature
  • If having trouble tasting favorite foods, try adding herbs or condiments
A registered dietitian (RD) may have more ideas to offer patients.

Patients should be advised to8,9:

  • Avoid talking while chewing
  • Avoid eating too fast
  • Drink beverages after, rather than during, meals
  • Avoid late-night eating
  • Try to relax after meals
  • Avoid spicy foods
  • Avoid alcohol

Patients should be advised to8:

  • Avoid heavy meals, coffee, and alcohol
  • Sleep in a more upright position, propped up on a pillow
Ask their doctor if there are over-the-counter or prescription medications that might help manage this health condition.

Patients should be advised to1:

  • Wear loose cotton clothes
  • Use sunscreen
  • Clean hands and feet with lukewarm water and gently pat dry
  • Apply creams containing lanolin or urea to their hands and feet liberally and often
  • Avoid tight-fitting shoes and jewelry or rubbing pressure on their hands and feet

Patients should be advised to2:

  • Get regular exercise
  • Keep their weight under control
  • Lower their alcohol intake or avoid alcohol altogether
  • Lower the amount of sodium in their food

Patients should be advised to10:

  • Try cold or frozen foods, as they may taste better than hot foods
  • Flavor their food with herbs, seasonings, sugar, or sauces
  • Keep their mouth clean and healthy by brushing and flossing often

To help manage bleeding, patients may be prescribed11:

  • Vitamin K injections
  • Clotting agents
  • Blood plasma or platelet transfusions
  • Medication for platelet problems

Patients should be advised that to avoid bleeding they should12,13:

  • Ask their doctor before drinking alcohol or taking new medications. These can make bleeding problems worse
  • Use an extra soft toothbrush, and don't floss if gums bleed
  • Blow their nose gently using a soft tissue
  • Be careful using scissors, knives, needles, or other sharp tools
  • Take steps to prevent burns while cooking
  • Shave with an electric razor
  • Avoid contact sports and other activities that might cause injury
Treatment with SUTENT may cause changes in skin or hair color.

Patients should be advised1:

  • To wear thick cotton gloves and/or socks to protect their skin
  • To avoid tight footwear and excessive friction
  • To avoid hot water when washing hands, bathing, or showering
  • That their doctor or nurse may give them specific treatments, which may include lotions, moisturizers, or pain medicines
  • To discuss this AR with their doctor or nurse so he or she can perform a full evaluation

REFERENCES

  1. Kollmannsberger C, Soulieres D, Wong R, Scalera A, Gaspo R, Bjarnason G. Sunitinib therapy for metastatic renal cell carcinoma. Can Urol Assoc J. 2007;1(2 suppl):S41-S54.
  2. Wood LS. Managing the side effects of sorafenib and sunitinib. Commun Oncol. September 2006:558-562.
  3. Mayo Clinic. Diarrhea. www.mayoclinic.org/diseases-conditions/diarrhea/diagnosis-treatment/drc-20352246?p=1. Accessed April 16, 2018.
  4. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment. NIH publication no. 18-7157. January 2018.
  5. Grünwald V, Kalanovic D, Merseburger AS. Management of sunitinib-related adverse events: an evidence- and expert-based consensus approach. World J Urol. 2010;28(3):343-351.
  6. Nausea and vomiting. www.healthline.com/health/nausea-and-vomiting. Accessed April 16, 2018.
  7. American Society of Clinical Oncology (ASCO). Appetite loss. www.cancer.net/navigating-cancer-care/side-effects/appetite-loss. Accessed May 22, 2018.
  8. Cleveland Clinic. Indigestion. www.clevelandclinic.org/health/health-info/docs/1700/1779.asp?index=7316. Accessed July 1, 2018.
  9. Web MD. Indigestion. www.webmd.com/heartburn-gerd/indigestion. Accessed April 16, 2018.
  10. American Society of Clinical Oncology (ASCO). Taste changes. www.cancer.net/navigating-cancer-care/side-effects/taste-changes. Accessed May 22, 2018.
  11. Pereira J, Phan T. Management of bleeding in patients with advanced cancer. Oncologist. 2004;9(5):561-570.
  12. Bleeding during cancer treatment. https://medlineplus.gov/ency/patientinstructions/000022.htm. Accessed June 29, 2018.
  13. Thrombocytopenia. www.cancer.net/navigating-cancer-care/side-effects/thrombocytopenia. Accessed July 25, 2018.