Torisel

1 What is Torisel?

Brand: Torisel

Generic: Temsirolimus

Torisel injection is used to treat advanced kidney cancer. It interferes with the growth of cancer cells, which are eventually destroyed by the body. 

Torisel is an antineoplastic (cancer medicine). This medicine is to be given only by or under the direct supervision of a doctor. This product is available in the following dosage forms:

  • Solution

2 What to Know Before Using

Before using Torisel, you must know all about the risks and complications associated with it. This is a decision you and your doctor will make.

For this medicine, the following should be considered:

Allergies: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric Population: Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of temsirolimus injection in children.

Geriatric Population: Appropriate studies on the relationship of age to the effects of temsirolimus injection have not been performed in the geriatric population. However, elderly patients are more likely to have some unwanted effects, which may require caution in patients receiving temsirolimus injection.

Pregnancy: All Trimesters: Category D: Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease may outweigh the potential risk.

Breastfeeding: There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions: Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose or other precautions may be necessary. 

When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Atazanavir
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Carbamazepine
  • Ceritinib
  • Clarithromycin
  • Cobicistat
  • Crizotinib
  • Dabrafenib
  • Dexamethasone
  • Fluconazole
  • Fosphenytoin
  • Idelalisib
  • Indinavir
  • Influenza Virus Vaccine, Live
  • Itraconazole
  • Ketoconazole
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Nefazodone
  • Nelfinavir
  • Nilotinib
  • Osimertinib
  • Phenobarbital
  • Phenytoin
  • Piperaquine
  • Poliovirus Vaccine, Live
  • Rifabutin
  • Rifampin
  • Ritonavir
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Saquinavir
  • Smallpox Vaccine
  • St John's Wort
  • Telithromycin
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Voriconazole
  • Yellow Fever Vaccine

Other Interactions: Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice

Other Medical Problems: The presence of other medical problems may affect the use of this medicine.

Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems 
  • Brain tumor—Use with caution. May cause side effects to become worse
  • Bowel pain 
  • Diabetes 
  • Hyperglycemia (high blood glucose) 
  • Hyperlipidemia (high blood cholesterol) 
  • Infection 
  • Kidney disease 
  • Lung disease (eg, interstitial lung disease)—Use with caution. May make these conditions worse
  • Liver disease, mild—Use with caution. The effects may be increased because of slower removal of the medicine from the body
  • Liver disease, severe—Should not be used in patients with this condition

3 Proper Usage

Proper usage of Torisel requires strict adherence to your doctor’s orders. Medicines used to treat cancer are very strong and can have many side effects.

Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

You will receive this medicine in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

You will receive a medicine to help prevent allergic reactions (eg, diphenhydramine, Benadryl®) from the injection.

4 Precautions to Take

Before using Torisel, there are some precautions you must take. It is very important that your doctor check your progress at regular visits to see if the medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. The medicine may also cause birth defects if it is used by the father when his sexual partner becomes pregnant. 

Men and women should use effective birth control during treatment and for at least 3 months after the last dose. Tell your doctor right away if pregnancy occurs while you are using this medicine.

Temsirolimus may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. 

Tell your doctor right away if you have a rash, itching, swelling of the face, tongue, and throat, trouble breathing, or chest pain after the injection.

This medicine may cause flushing, headaches, and lightheadedness or faintness while you are receiving the injection or within 24 hours after you receive it. Check with your doctor or nurse right away if you have any of these symptoms.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or urination. Diabetic patients should check their blood sugar more frequently with this medicine.

While you are being treated with temsirolimus, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Temsirolimus may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. 

In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include: 

Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Temsirolimus may increase the risk of getting infections, including an infection called Pneumocystis jiroveci pneumonia or PJP. Try to avoid people with colds or other infections. If you think you are getting an infection, check with your doctor right away.

This medicine may cause a serious lung problem. Check with your doctor right away if you have tightness in the chest or difficulty with breathing.

Temsirolimus may increase your cholesterol and fats in the blood. If this occurs, your doctor may give you a medicine to lower the blood levels.

Check with your doctor right away if you start having: 

  • severe abdominal or stomach burning, cramps, or pains
  • bloody or black, tarry stools
  • diarrhea
  • fever
  • nausea
  • vomiting of material that looks like coffee grounds

These could be symptoms of a serious bowel problem. This medicine may increase your chance of having acute kidney disease that is not related to your kidney cancer. Talk to your doctor about this risk.

This medicine may affect the way your body heals from cuts and wounds. Make sure any doctor who treats you knows that you are using this medicine.  You may need to stop using this medicine several weeks before and after having surgery.

Grapefruit juice may increase the effects of temsirolimus by increasing the amount of medicine in your blood. You should not drink grapefruit juice with this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's Wort) or vitamin supplements.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Torisel. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common:

  • bladder pain
  • bloody nose
  • bloody or cloudy urine
  • body aches or pain
  • blurred vision
  • chest pain
  • chills
  • congestion
  • a cough or hoarseness
  • cracked lips
  • diarrhea
  • difficult or labored breathing
  • difficult, burning, or painful urination
  • the difficulty with swallowing
  • dizziness
  • dryness or soreness of the throat
  • ear congestion
  • fever or chills
  • frequent urge to urinate
  • headache
  • joint or muscle pain
  • lack or loss of strength
  • loss of voice
  • lower back or side pain
  • nasal congestion
  • nausea
  • nervousness
  • numbness or tingling of the face, hands or feet
  • pounding in the ears
  • runny nose
  • skin rash
  • slow or fast heartbeat
  • sneezing
  • sores, ulcers, or white spots on the lips, tongue or inside the mouth
  • sore throat
  • stomach pain
  • stuffy or a runny nose
  • swelling of the hands, ankles, feet or lower legs
  • swelling or puffiness of the face
  • tender, swollen glands in the neck
  • tightness in the chest
  • voice changes
  • vomiting

Less common:

  • abdominal or stomach cramps
  • black, tarry stools
  • bloody stools
  • changes in skin color
  • delayed wound healing
  • pain, tenderness, or swelling of the foot or leg
  • seizures
  • severe vomiting, sometimes with blood
  • vomiting of blood or material that looks like coffee grounds

Incidence not known:

  • blistering, peeling or loosening of the skin
  • convulsions
  • dark-colored urine
  • itching
  • muscle cramps or spasms
  • muscle stiffness
  • pain or redness at the injection site
  • pale skin at the injection site
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. 

Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common:

  • back pain
  • blemishes on the skin
  • burning, dry, or itching eyes
  • change in taste
  • difficulty having a bowel movement (stool)
  • the difficulty with moving
  • discharge or excessive tearing
  • discoloration of the fingernails or toenails
  • dry skin
  • loss of appetite
  • loss of taste
  • pimples
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • swollen joints
  • trouble sleeping
  • weight loss

Less common:

  • discouragement
  • feeling sad or empty
  • irritability
  • loss of interest or pleasure
  • tiredness
  • trouble concentrating

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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