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Controlling fever from BRAF/MEK drugs
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Controlling fever from BRAF/MEK drugs

› Forums › Controlling fever from BRAF/MEK drugs

  • Post
    • October 30, 2020 at 6:15 pm
    snoe
    Participant
      Hi all,
      I’ve been taking Tafinlar and Mekinist for a few weeks, and am getting frequent fevers. Does anyone have tips or experiences for controlling this common side effect of this drug combo? (I also experienced it on Zelboraf and Cocentric, along with other side effects.)

      Here’s what my oncology team and the fever FAQ at the drug manufacturer’s website have advised:
      1) reducing dosage – have reduced by 50%. Only change I’ve noticed is the shivering that sometimes precedes a fever is less intense.
      2) Tylenol – I use it reactively, as soon as I spot a high temp. I think it’s working, but seems to take a long time to bring my temp down to normal (3-5 hours).
      I tried using it proactively one day, scheduling doses to max out over a 24 hour period. This didn’t prevent fevers from popping up. (I also don’t want to risk blowing up my liver by doing this every day.)
      3) physical cooling measures (cold cloths, ice packs, fans, removing blankets/clothes/housecat) – seems to quickly help slow or stop a rising fever, but again takes hours for my temp to return to normal.

      I want to stay on this drug combo, at least for a while longer — I haven’t even gotten to the immunotherapy infusions yet! It’s my third treatment combo since I was diagnosed eight months ago, and my second BRAF/MEK inhibitor combo in two months. It seems effective, based on the quick work it made of my latest palpable tumor. And the side effects, even with the fevers, are the least bad I’ve had.

      After writing this up, I wonder if I maybe just need to change my expectations and learn to live with the fevers? Regardless, I’d love any advice or wisdom-from-experience any of you have on this.

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    • Replies
        • October 30, 2020 at 7:45 pm
        ed williams
        Participant
          Hi Snoe, this is pretty good from ASCO 2019 back when people could actually be in the same room together. https://www.youtube.com/watch?v=8wtsnbDw4DQ&feature=emb_logo
            • November 25, 2020 at 6:16 pm
            snoe
            Participant
              Thank you! I will look at encorafenib-binimetinib as an option if I need to change. Sounds like they have lower toxicity.
            • October 31, 2020 at 6:57 pm
            Sdmotorcop
            Participant
              Hi Snoe,
              Earlier in the summer I ran a fever for 3 weeks (after second dose of Yervoy). My oncologist recommended alternating Tylenol and Motrin. For me it worked well (my fevers ranged from 99.6 to 103.2). I used a Tylenol dose of 1000mg and a Motrin dose of 800 mg every 5 hours. I understand you’re on targeted therapy.. a fever is a fever no matter what treatment you take. I’d definitely talk to your oncologist about any medication changes..

              • November 1, 2020 at 1:51 am
              sandyd77
              Participant
                Hello Snoe,

                My husband has Stage IV Melanoma and moved to Taflinar and Mekinist in March of 2020 after 10 months on Opdivo (Nivo) with a limited response (he also had multiple surgeries in 2018). He also experienced fevers with shaking chills for about 5 months with months 1, 2 and 3 being the worst. We did not reduce dosage but did treat with Tylenol every 4 hours when the fevers were at their worst. The fevers ran from 100 to 101.4. He now occasionally hits 99.8/100 around the time of month he starts on a new round of medication (moving into month 9) but the shaking chills have abated and so have the higher fevers. He does have a good bit of itching with rash but is seems to be manageable for him. Before starting on Taf/Mek he had subcutaneous mets on his back, as well as in both lungs and in his liver. For the most part all nodules have shrunk to the point of insignificance so the response has been great. I would suggest you stick with the meds as long as you can manage and hopefully you also will have your side effects reduce over time. Best of luck to you!

                Sandy D.

                  • November 25, 2020 at 6:21 pm
                  snoe
                  Participant
                    Thank you, Sandy! I too have the shaking chills. (They went away, along with the fevers, right after I posted this, then returned just a few days ago — I’m guessing due to my first immunotherapy infusion.)

                    I think trying to manage as best I can is the way to go, at least for now.

                  • November 2, 2020 at 4:42 pm
                  hxcadam
                  Participant
                    I can only give you what’s worked for me. But I started middle of may on Braf/Mek(Tafinlar/Mekinist) while still getting monthly Opdivo infusions. Roughly every 4-6 weeks I’ll get the fevers. I’ve found what works for me is to stop the daily dose and control the fevers rotating tylenol and ibuprofen. It usually takes roughly a week for the fevers to subside. I do get the shivering/shakes at the start generally but they subside mid-week it seems. So far my scan results have been positive although the last scan showed everything shrinking but possibly a new spot on my right kidney.
                      • November 25, 2020 at 6:29 pm
                      snoe
                      Participant
                        Thank you! I will ask my oncologist about using ibuprofen.

                        It’s nice to hear from other people getting the shivering and shakes. They’ve started up over the past 48 hours and it is pretty unpleasant. But I can manage.

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