Afinitor Disperz

  • CNS cancers

Afinitor Disperz Generic Name & Formulations

General Description

Everolimus 2mg, 3mg, 5mg; tabs for oral susp.

Pharmacological Class

mTOR kinase inhibitor.

See Also

How Supplied

Tabs, Disperz—28 (4 blister cards x 7 tabs)

Generic Availability


Afinitor Disperz Indications


Patients ≥1yr with tuberous sclerosis complex (TSC) for the treatment of subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but cannot be curatively resected. Adjunct treatment of patients ≥2yrs with TSC-associated partial-onset seizures.

Afinitor Disperz Dosage and Administration

Adults and Children

Do not combine the 2 dosage forms to achieve the desired total dose. Swallow tabs whole with water or use Disperz tabs administered as a suspension only. Take at the same time each day either consistently with or without food. Prepare suspension using 5mL of water in an oral syringe or 25mL of water in a drinking glass; max 10mg dose per syringe or glass. Use therapeutic drug monitoring to guide subsequent dosing. Adjust dose at 1–2 week intervals as needed to achieve and maintain trough concentrations of 5–15ng/mL; max 5mg increment per titration (see full labeling). Continue until disease progression or unacceptable toxicity. SEGA: <1yr: not established. ≥1yr: initially 4.5mg/m2 once daily. Partial-onset seizures: <2yrs: not established. ≥2yrs: initially 5mg/m2 once daily. Severe hepatic impairment: initiate at 2.5mg/m2 once daily. Concomitant CYP3A4/PgP inhibitors (strong): avoid; (moderate): reduce daily dose by 50% (or change to every other day if reduced dose unavailable in tab strength); if moderate inhibitor is discontinued, after 3 days, resume dose used prior to initiating inhibitor. Concomitant strong CYP3A4/PgP inducers: double daily dose by increments of 5mg or less; if strong inducer is discontinued, after 5 days, resume dose used prior to initiating inducer. Dose modifications for adverse reactions: see full labeling.

Afinitor Disperz Contraindications


Allergy to other rapamycin derivatives.

Afinitor Disperz Boxed Warnings

Not Applicable

Afinitor Disperz Warnings/Precautions


Monitor for new or worsening respiratory symptoms; discontinue, reduce dose, and/or manage with corticosteroids if non-infectious pneumonitis occurs. Increased risk of infections (may be severe or fatal); monitor and treat promptly if occur. Pre-existing invasive fungal infections: treat before starting. Give PJP prophylaxis with concomitant corticosteroids or other immunosuppressants. Use dexamethasone mouthwash at initiation to reduce the incidence and severity of stomatitis; use alcohol-, peroxide-, iodine-, or thyme-free products if occurs. Impaired wound healing: withhold for ≥1 week prior to elective surgery; do not give for ≥2 weeks after major surgery and until adequate healing. Peri-surgical period. Hepatic impairment (see Adult). Diabetes. Monitor CBCs, renal function, lipids, and blood glucose prior to starting and annually thereafter (more frequently if clinically indicated). Risk of radiation sensitization/recall (including radiation esophagitis or pneumonitis); monitor closely during or sequentially with radiation treatment. Avoid close contact with those who have received live vaccines. Pediatrics: complete childhood vaccination series according to ACIP guidelines prior to initiation. Elderly. Embryo-fetal toxicity. Advise to use effective contraception during and for 8 weeks (females) or 4 weeks (males w. female partners) after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 2 weeks after the last dose).

Afinitor Disperz Pharmacokinetics

See Literature

Afinitor Disperz Interactions


Avoid live vaccines. Potentiated by strong CYP3A4/PgP inhibitors (eg, ketoconazole), grapefruit or grapefruit juice; avoid. Caution with moderate CYP3A4/PgP inhibitors (eg, erythromycin, verapamil); see Adult. Antagonized by strong CYP3A4/PgP inducers (eg, rifampin); see Adult. Avoid St. John's Wort. Increased risk of angioedema with concomitant ACEI; avoid.

Afinitor Disperz Adverse Reactions

Adverse Reactions

Stomatitis, infections, rash, fatigue, diarrhea, edema, abdominal pain, nausea, fever, asthenia, cough, headache, decreased appetite, RTI; non-infectious pneumonitis, impaired wound healing, hyperglycemia, hypercholesterolemia, hypertriglyceridemia, myelosuppression, renal failure, angioedema or severe hypersensitivity reactions (discontinue if occur), radiation sensitization/recall (may be severe).

Afinitor Disperz Clinical Trials

See Literature

Afinitor Disperz Note

Not Applicable

Afinitor Disperz Patient Counseling

See Literature