Taking Cancer Tablets at Home: Food, Missed Doses, Interactions and Safe Handling

Many cancer treatments now come as tablets or capsules you take at home. That is more convenient than hospital visits, but it also means you are in charge of getting the details right: when to take them, what to eat, what to avoid, and how to handle them safely. This guide covers the practical side. The leaflet that comes with your own medicine, and your cancer team’s advice, always come first.

Food rules: with food, after food or on an empty stomach

Food can change how much of a medicine your body absorbs, so the timing matters. Some common examples:

For palbociclib, the rule depends on the form: capsules with food, tablets with or without. See our guide to Ibrance, Kisqali and Verzenio. Whatever the rule, try to take your doses at the same times each day, and ask your pharmacist which foods or drinks to avoid¹.

Missed doses and vomiting

The general rule from Cancer Research UK: if you miss a dose or are sick soon after taking it, contact your cancer team for advice. Do not take a double dose next time, and do not carry on for longer than planned to make up for it¹. Labels for individual medicines say, for example:

• Capecitabine: do not take an extra dose after vomiting, and do not replace missed doses; carry on with the next planned dose⁴.
• Imatinib and olaparib: take the next dose at the usual time, and never two doses at once³⁸.
• Ibrutinib: take a missed dose as soon as possible on the same day, then go back to your normal schedule the next day⁹.

Crushing, splitting and dissolving

Swallow cancer tablets and capsules whole. Never crush tablets or open capsules unless your doctor or pharmacist tells you to¹. The labels for capecitabine, dasatinib, olaparib and ibrutinib all say not to cut, crush or chew them⁴⁶⁸⁹.

A few medicines have an approved way round swallowing problems. Imatinib, for example, can be dissolved in water or apple juice for people who have difficulty swallowing³. Only do this if your team has explained how, and tell them early if you struggle to swallow your tablets.

Interactions to know about

• Grapefruit and Seville oranges. These can raise the levels of several cancer tablets. The labels say to avoid grapefruit juice with imatinib, dasatinib and nilotinib, and grapefruit and Seville oranges with olaparib and ibrutinib³⁵⁶⁸⁹.
• St John’s wort. This herbal remedy can lower the level of imatinib in your blood³.
• Indigestion and acid medicines. Some cancer tablets need stomach acid to be absorbed. Omeprazole-type medicines (PPIs) should be avoided with dasatinib and erlotinib, and indigestion remedies (antacids) should not be taken at the same time as dasatinib⁶⁷. With nilotinib, short-acting antacids or H2 blockers are suggested instead of PPIs⁵. If an H2 blocker is needed with erlotinib, the doses have to be spaced: erlotinib 10 hours after the H2 blocker and at least 2 hours before the next one⁷.
• Blood thinners. Capecitabine can affect warfarin, and serious bleeding has been reported, so blood clotting tests need close checking⁴.
• Smoking lowers the level of erlotinib⁷.
• Surgery and dental work. Ibrutinib can increase bleeding, and it may need to be paused for 3 to 7 days before and after surgery⁹.

Tell your cancer team and pharmacist about every medicine, vitamin and herbal product you take, and check before starting anything new¹.

Safe handling at home

Cancer Research UK’s advice applies to chemotherapy, hormone therapy, targeted drugs and immunotherapy taken at home²:

• Touch the tablets as little as possible. Push them from the packet into a small cup kept only for this, and tip them into your mouth. If you do touch them, wash your hands well².
• Carers should wear disposable gloves when helping you¹².
• Pregnancy. Anyone who is pregnant, planning a pregnancy or breastfeeding should not touch the tablets. If they must help, they should wear gloves and use a medicine cup¹².
• Body fluids. Some of the medicine leaves the body in urine, stools, vomit and other fluids for a while after each dose. Close the lid and flush twice after using the toilet, sit down to urinate to avoid splashing, and wear gloves to clean up any spills or the toilet².
• Sex. Use condoms or other barrier methods for as long as your team advises, and effective contraception to prevent pregnancy².

Storage, travel and disposal

• Follow the storage instructions: some medicines need the fridge, most do not¹.
• Keep them out of reach of children and pets, ideally in a locked cupboard if children are around¹.
• Return unused tablets to the pharmacy. Never put them in the bin or flush them down the toilet¹².
• Empty boxes and bottles can go in household waste, not recycling².
• When you travel, keep your medicines in their original packaging with your prescription, and check the rules of the country you are visiting. Our guides to importing medicines for personal use in the UK and US explain more.

Keep a diary, and know when to call

A simple diary of when you took each dose, any missed doses and any side effects makes it easier to spot problems and to answer your team’s questions. Ask your team which side effects you should report straight away, and keep your advice line number handy. Contact the advice line if you take too many tablets by mistake².

For more on specific medicines, see our guides to imatinib, dasatinib, erlotinib and abiraterone. We stock capecitabine, including Cacit 500 mg and Capixet 500 mg; see also our capecitabine, dasatinib, nilotinib, erlotinib and olaparib pages. All need a prescription.

Frequently asked questions

Can I take imatinib with food?

Yes. Imatinib should be taken with a meal and a large glass of water.

Can capecitabine be crushed?

No. Capecitabine tablets should be swallowed whole with water within 30 minutes after a meal. Do not chew, cut or crush them. Tell your team if you have trouble swallowing.

Can I drink alcohol while taking cancer tablets?

It depends on the medicine and how you are feeling. Ask your cancer team or pharmacist about your own medicine, and avoid grapefruit and any other foods or drinks your leaflet lists.

What if I vomit after my dose?

Do not take another dose unless your team has told you to. For many medicines you simply take the next dose at the usual time. Contact your team if vomiting keeps happening.

Is it safe for my family to be around me?

Yes. Ordinary contact is fine. The precautions are about the tablets themselves and body fluids: keep the tablets away from others, ask helpers to wear gloves, and follow the toilet and cleaning advice above.

Sources & references

1. Cancer Research UK. Chemotherapy tablets and capsules. Last reviewed 28 November 2023.
2. Cancer Research UK. Chemotherapy safety at home. Last reviewed 1 February 2024.
3. US National Library of Medicine, DailyMed. Gleevec (imatinib) prescribing information.
4. US National Library of Medicine, DailyMed. Xeloda (capecitabine) prescribing information.
5. US National Library of Medicine, DailyMed. Tasigna (nilotinib) prescribing information.
6. US National Library of Medicine, DailyMed. Sprycel (dasatinib) prescribing information.
7. US National Library of Medicine, DailyMed. Erlotinib tablets prescribing information.
8. US National Library of Medicine, DailyMed. Lynparza (olaparib) prescribing information.
9. US National Library of Medicine, DailyMed. Imbruvica (ibrutinib) prescribing information.
10. US National Library of Medicine, DailyMed. Zytiga (abiraterone acetate) prescribing information.

Related reading

• Capecitabine side effects and hand-foot syndrome
• CML treatment: imatinib vs dasatinib vs nilotinib
• Ibrutinib vs acalabrutinib for CLL
• Is it chemotherapy?
• When a cancer medicine stops working
• Abiraterone vs enzalutamide

This content is for informational purposes only and is not medical advice. Always follow the leaflet that comes with your medicine and your cancer team’s instructions. Used as prescribed by a licensed medical professional.