Oral chemotherapy (chemo) is any cancer-fighting drug that the patient will take by mouth. It can be in the form of a tablet, capsule, or liquid.
It is always best to swallow each dose of this medicine all at one (1) time in the form that you receive it. Some patients may not be able to swallow the capsule or tablet. If this is the case, please tell your doctor, nurse, or pharmacist. They can give you guidelines about whether the drug can be cut or dissolved to make it easier to swallow. Be sure to ask, because some drugs should not be cut or dissolved. You cannot give all oral chemo drugs the same way. Be careful to follow the guidelines you receive for preparing the medicine.
Your child must take all oral chemo drugs exactly as the doctor prescribes. Do not skip any doses.
Taking oral chemo
- Read the label carefully each time you take a dose out of the bottle. If the medicine is being given to your child by someone other than the regular caregiver, be sure the new caregiver reviews the medicine directions carefully. This should be done every time a caregiver changes, even if it is a close family member.
- Your child should take each dose at the same time each day.
- The doctor or pharmacist will tell you if your child should take the oral chemo drug with or without food. Follow these directions closely.
- You may add certain oral chemo drugs to liquids, such as water or juice, or to some foods to make it easier for your child to swallow. Closely follow any guidelines the doctor or pharmacist gives you. Only add the drug to those foods that they tell you are OK.
- Sometimes these drugs will make your child sick to his stomach. The doctor may prescribe a medicine to help with nausea and vomiting. Your child should take it 30 minutes to an hour before taking the oral chemo drug.
- If your child misses or forgets a dose, the dose should be taken as soon as possible unless it is almost time to take the next dose. (The Patient Medication sheet should give you guidelines for the drug your child is taking.) The doctor may give you different guidelines for some medicines. Always tell the doctor if your child has missed a dose.
- Be aware that some oral chemo drugs may need different sized tablets to make up the total dose. You may be given 2 or 3 bottles. Then, you will have to take a certain number of tablets or capsules out of each bottle to make the total dose. Read the label on each bottle closely. If you feel confused by this process, please ask the pharmacy for a sectioned pillbox, so you can keep each day’s dose separate.
When you are in the hospital, the staff is guided by federal regulations for handling chemo drugs. You might see nurses wearing full gowns and face masks to give a chemo dose to your child, but this should not be needed at home. The following precautions will help keep you and your child safe when dealing with these drugs at home.
You should regard all oral chemo drugs as a possible hazard. Be careful when handling these drugs. Try to avoid contact with the skin. Women who are pregnant or could become pregnant should avoid contact with these drugs.
Please, use these precautions to protect both you and your child from harm:
- Wash your hands before handling the drug.
- Prepare a clean surface where you can handle the drug safely. Do not choose an area close to where food is prepared. Do not handle the drug under air vents or fans.
- Use gloves when handling oral chemo drugs.
- When giving pills to your child, pour them into a small cup or the cap of the medicine bottle rather than into your hand
- If you are cutting tablets or adding the medicine to food or liquid, your child should always take the oral chemo drug as soon as you prepare it. Do not cut tablets or add to food or liquid unless your doctor tells you it is OK to do so.
- If you are cutting or crushing tablets, wear a mask.
- After your child takes a dose, thoroughly clean the surface where you handled the drug.
- If you have parts of tablets left over, return them to the medicine bottle. They may be needed for the next dose.
- Always wash your hands after handling any oral chemo drugs, whether your skin makes contact with the drug or not.
- Any items used with the medicine – dosing cups, tablet cutters, spoons – should be washed with warm soapy water and left to dry. Do not use them for any other medicines.
- For liquid chemo medicine, use each oral syringe only one (1) time. Then, throw it away in the trash. Do not try to wash and reuse the syringes.
After giving oral chemo
- Wear gloves when handling your child’s body fluids, soiled linens, or diapers.
- Change diapers often to reduce the time body fluids are in contact with the skin. Completely clean the diaper area with each diaper change.
- Dispose of diapers, gloves, and wipes in your regular trash. Limit your exposure to the trash by emptying it to outside containers often.
- If any of your child’s body fluids touch your skin during clean up or diaper changes, wash the skin well with soap and water.
- If any of your child’s body fluids get in your eyes, flush with water for 15 minutes while holding the eyelid open. Then, call your personal doctor and explain what has happened.
- After your child uses the toilet, put the toilet lid down before flushing.
- Keep all medicines out of the reach of children. Chemo drugs can be very harmful if large amounts are taken at one (1) time.
- Store the drugs in a cool dry place unless the label says otherwise. Some drugs may need to be stored in the refrigerator.
- The Pharmacy will place all chemo and hazardous medicine bottles in a yellow resealable bag. For safe handling, medicine should be stored in this yellow bag after each use. Return medicine as instructed by your clinic. Liquid, tablets, and capsules should be carried in the yellow bag to prevent spills.
- Return oral chemo medicines your child did not use to the Outpatient Pharmacy, and the staff will dispose of them.
- Throw away empty chemo medicine bottles and syringes in your regular trash. Mark out all personal information on the prescription label so no one can read it.
- Return all investigational study medicine bottles to the pharmacy.
What to do if your child vomits after taking dose
If your child vomits within 30 minutes of taking the chemo, give another dose. The doctor may give you different guidelines for certain oral chemo drugs. Wear gloves to clean up the vomit containing the chemo drugs. Wash the area completely with warm soapy water and dispose of all paper towels in the trash. Any soiled clothing or towels should be washed right away in the laundry with warm water and detergent.
If you have questions or concerns about giving oral chemo drugs at home, please talk to your child’s doctor, nurse, or pharmacist. If you are in the local area, call 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected. For general information about safety with chemo drugs in the hospital, see "Do You Know… Protecting Caregivers from Drug Hazards."
To make sure that you understand all directions for giving the oral chemo medicines that are mailed to you, we ask that you call the pharmacy when the drugs arrive. During that call you will be asked to verify that you received the correct medicine and that you know how to give the medicine to your child properly. It is very important that you return this call to the pharmacy. If you are in the local area, dial 901-595-4166. If you are outside the Memphis area, dial the pharmacy’s toll-free number 1-866-820-2442.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).
تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1 (الهاتف النصي: 1040-595-901-1).