Afatinib

Acne-like rashes (pimples) may appear on the face, upper chest and back.

It usually develops within the first 2 weeks of treatment and will get better after stopping treatment.

Your skin may also become flaky and scaly.
 

• Avoid direct sunlight during and 2 months after treatment. Apply sunscreen with an SPF (Sun Protection Factor) of at least 30. Also, you may wear a hat, long sleeves, and long pants outside on sunny days.
• Apply moisturisers to dry areas.
• You may be prescribed antibiotic cream or oral antibiotics to treat the rashes.
• Inform your doctor if the acne-like rash becomes widespread and is bothering you.
   

• Drink plenty of clear fluids (at least 2 litres or 8 cups every day).
• Eat food that is gentler on the stomach such as porridge or soup.
• Avoid milk, dairy products, high-fibre food and oily or spicy food.
• Your doctor may prescribe medications to help relieve diarrhoea. Take these as instructed.
• Proceed to the A&E Department immediately if you have very bad diarrhoea (for example increase in bowel movement of more than 4 times per day) that does not improve even after taking anti-diarrhoeal medications.

• Take small and frequent meals.
• Avoid foods / smells that may make you feel nauseous, such as oily, fried or strong-smelling food.
• Avoid tight-fitting clothes around the waist.
• Your doctor may prescribe medications to help relieve or prevent nausea or vomiting. Take these as instructed.

Nail changes that may affect both fingernails and toenails.

Your nails may

• Become more brittle and break easily
• Turn darker in colour
• Develop ridges (lines) on the surface, which may give an uneven appearance
• Rarely, nails may come off.

• Try to keep your nails short, clean and dry.
• Avoid contact with harsh chemicals e.g. detergent or dish-washing liquids. Wearing gloves when washing dishes or using detergents can help protect your nails during treatment.
• If you experience pain, redness or swelling around your nails, inform your doctor.

Mouth ulcers or sores. 

• This can occur on the tongue, the sides of the mouth or in the throat and can lead to an infection.
   

• Rinse your mouth regularly with an alcohol-free mouthwash or salt water to help reduce chances of infection.
• Brush your teeth gently after eating and at bedtime with a soft bristle toothbrush.
• Rinse and brush your dentures after eating and soak them in denture solution overnight.
• Avoid spicy food and take soft foods e.g. porridge.
• Your doctor may prescribe medications to help relieve or prevent the mouth sores. Use these as instructed.
• Inform your doctor if you are eating or drinking a lot lesser because of mouth pain.

Proceed to the A&E department immediately if you experience any:

• Dark or tea-coloured urine
• Pale or light-coloured stools
• Yellowing of skin or eyes
• Nausea, vomiting with loss of appetite
• Severe abdominal pain
   

• Your doctor may prescribe eye drops or gels to help moisturize and lubricate the eyes to relieve discomfort.
• Inform your doctor if you experience eye pain, changes in vision and/or sensitivity to light or other changes.

Symptoms of drug allergy including one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body
   

• Inform your doctor if you experience eye pain, swelling, redness, blurred vision, and/or sensitivity to light or other changes.