Indications
Erlotinib is a cancer medicine used in adults for:
- advanced or spread (metastatic) non-small cell lung cancer whose cancer cells have certain changes (activating mutations) in the EGFR gene, either as first treatment or as continuing (maintenance) treatment;
- advanced pancreatic cancer that has spread, together with Gemcitabine.
A test of the tumour is usually needed before treatment. It is started and supervised by a cancer specialist.
How It Works
Erlotinib is a tyrosine kinase inhibitor. Some cancer cells depend on a protein on their surface called the epidermal growth factor receptor (EGFR) to receive signals telling them to grow and divide. Erlotinib blocks the signal from this receptor, which slows or stops the growth of these cancer cells.
Dosage and Administration
As prescribed by the cancer specialist. It is taken once a day.
Take it on an empty stomach, at least 1 hour before or 2 hours after food, with a glass of water, at about the same time each day.
The specialist may reduce the dose or pause treatment if side effects such as rash or diarrhoea are severe. If a dose is missed, take the next one at the usual time; do not take two doses together. Children: not for use.
Interactions
- Smoking lowers Erlotinib levels a lot. Stop smoking; if you continue, tell your doctor.
- Omeprazole, Esomeprazole and other proton pump inhibitors lower absorption and should be avoided. If Famotidine is needed, take Erlotinib at least 2 hours before or 10 hours after it. Antacids should be taken several hours apart.
- Ketoconazole, Clarithromycin, Ciprofloxacin and grapefruit juice can raise Erlotinib levels.
- Rifampicin, Carbamazepine, Phenytoin and St John’s wort can lower its levels.
- Warfarin may cause more bleeding; INR should be checked.
- Statins may increase the risk of muscle problems.
Contraindications
Do not use Erlotinib if you are allergic to Erlotinib or any ingredient of the product.
Side Effects
Common: an acne-like rash, dry or itchy skin, diarrhoea, tiredness, loss of appetite, nausea, mouth sores, nail changes and dry or sore eyes.
Get urgent medical help if you have:
- new or sudden shortness of breath, cough or fever (possible inflammation of the lungs, called interstitial lung disease);
- severe or long-lasting diarrhoea, or signs of dehydration;
- severe stomach pain (rarely, a tear in the bowel);
- a severe rash with blisters or peeling skin;
- eye pain, very red eyes or changes in vision;
- yellow skin or eyes or dark urine.
Pregnancy and Lactation
Erlotinib may harm an unborn baby. Avoid pregnancy; women who could become pregnant should use effective contraception during treatment and for at least 2 weeks after the last dose. Do not breastfeed during treatment and for at least 2 weeks after the last dose.
Precautions and Warnings
- Tell your doctor if you have liver or kidney disease, lung disease, stomach ulcers or a history of bowel problems.
- Use a gentle moisturiser and sunscreen, and avoid strong sunlight, to reduce skin problems.
- Regular blood tests for liver and kidney function are needed.
- Tell your doctor if you are taking steroids, NSAIDs or other cancer medicines that may raise the risk of bowel injury.
Overdose
Overdose may cause severe diarrhoea, rash and raised liver enzymes. Contact the treating specialist or go to the nearest hospital at once.
Therapeutic Class
Anticancer medicine; epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor.
Storage
Store below 30°C in a dry place, away from light, in the original pack. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.