Adakras

Indications

Adagrasib is a targeted cancer medicine taken by mouth. It is used in adults with non-small cell lung cancer that is advanced or has spread, when tests show the tumour has a specific gene change called KRAS G12C and after at least one earlier treatment. In some countries it is also used together with Cetuximab for colorectal cancer with the same KRAS G12C change. It is prescribed only by a cancer specialist.

How It Works

KRAS is a protein that acts like a switch telling cells to grow. In tumours with the KRAS G12C change, the switch is stuck in the on position. Adagrasib binds to the faulty KRAS protein and locks it in the off position, which slows or stops the growth of the cancer cells.

Dosage and Administration

Take exactly as prescribed by your cancer specialist. Tablets are usually taken twice a day, about 12 hours apart, with or without food. Swallow them whole; do not crush or chew. If you vomit or miss a dose, do not take an extra dose; take the next dose at the usual time. The doctor may lower the dose or pause treatment if side effects occur.

Interactions

Adagrasib is broken down by the liver enzyme CYP3A4 and also blocks it. Avoid strong CYP3A4 inducers such as Rifampicin, Carbamazepine, Phenytoin and St John's Wort, and strong inhibitors such as Ketoconazole or Clarithromycin, unless the doctor approves. It can raise levels of other medicines such as Midazolam, Simvastatin, Digoxin and some blood thinners. Avoid other medicines that prolong the QT interval of the heart, such as Amiodarone, Haloperidol, Ondansetron or Moxifloxacin, unless monitored. Tell your doctor about every medicine and supplement you take.

Contraindications

• Allergy to Adagrasib or any tablet ingredient.
• Use with caution or avoid in people with a long QT interval or uncorrected low potassium or magnesium.

Side Effects

Common effects include diarrhoea, nausea, vomiting, tiredness, loss of appetite, stomach pain, swelling, shortness of breath, raised liver enzymes, kidney function changes and low blood counts. Less common but serious effects include heart rhythm changes (QT prolongation), liver injury and inflammation of the lungs.

Get urgent medical help if you have severe or continuing diarrhoea or vomiting, fainting, a fast or irregular heartbeat, yellow eyes or skin with dark urine, new or worsening cough, chest pain or breathlessness, or fever.

Pregnancy and Lactation

It may harm an unborn baby. Women who can become pregnant should have a pregnancy test before treatment and use effective contraception during treatment and for at least 1 week after the last dose. Do not breastfeed during treatment and for at least 1 week after the last dose.

Precautions and Warnings

Your doctor will check blood counts, liver and kidney function, salts (potassium, magnesium) and an ECG before and during treatment. Drink plenty of fluids and use anti-diarrhoea and anti-sickness medicines as advised, to avoid dehydration. Report any breathing symptoms promptly.

Overdose

There is no specific antidote. An overdose may increase stomach upset and heart rhythm effects. Contact your doctor or go to a hospital immediately; heart monitoring and supportive care are given.

Therapeutic Class

Antineoplastic, KRAS G12C inhibitor (targeted therapy).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep in the original pack.