Afanix 40

Indications

Afatinib is a targeted cancer medicine used to treat adults with advanced or spreading non small cell lung cancer (NSCLC) whose tumour has activating changes (mutations) in the EGFR gene, confirmed by a test. It is also used for advanced squamous cell lung cancer that has got worse after platinum based chemotherapy.

How It Works

Afatinib blocks a family of growth signal proteins on cancer cells called ErbB receptors (including EGFR and HER2). These receptors send messages that make cancer cells grow and divide. Afatinib binds to them permanently (an irreversible tyrosine kinase inhibitor), switching off these signals, which can slow or stop tumour growth.

Dosage and Administration

Take Afatinib exactly as prescribed by your cancer specialist, usually once a day. It must be taken on an empty stomach: at least 1 hour before or 3 hours after food. Swallow the tablet whole with water. If you cannot swallow it, it can be dispersed in water as your pharmacist explains. The doctor may lower the dose if side effects occur. Do not take a missed dose within 8 hours of the next one.

Interactions

Medicines that block P glycoprotein, such as Ritonavir, Ciclosporin, Ketoconazole, Itraconazole, Erythromycin, Verapamil and Amiodarone, can raise Afatinib levels; they should be taken apart from Afatinib as advised. Rifampicin, Carbamazepine, Phenytoin, Phenobarbital and St John's Wort can lower its levels. Tell your doctor about all medicines and herbal products.

Contraindications

• Allergy to Afatinib or any ingredient of the tablet.

Side Effects

Very common effects are diarrhoea, acne like rash, dry or itchy skin, nail infections (paronychia), mouth sores, loss of appetite, nosebleeds and weight loss. Diarrhoea usually starts in the first weeks; your doctor will give you anti diarrhoea medicine (such as Loperamide) to keep at home and use at the first sign.

Get urgent medical help if you have diarrhoea that lasts more than 48 hours or is severe, signs of dehydration (dizziness, little urine), sudden breathlessness or cough with fever (possible lung inflammation), severe blistering or peeling skin, yellowing of the skin or eyes, or a painful red eye or change in vision.

Pregnancy and Lactation

Afatinib may harm an unborn baby. Women who could become pregnant should use effective contraception during treatment and for at least one month after the last dose. Do not breastfeed during treatment.

Precautions and Warnings

Drink plenty of fluids if diarrhoea occurs. Protect your skin from the sun and use gentle moisturisers. Your doctor will check liver function and may check heart function if you have heart disease. Tell your doctor about any lung, liver, kidney, eye or heart problems. Dizziness or eye problems may affect driving.

Overdose

Overdose may cause more severe diarrhoea, rash, nausea and tiredness. There is no specific antidote; contact a doctor or hospital immediately.

Therapeutic Class

Antineoplastic (anticancer) agent; irreversible ErbB family (EGFR, HER2) tyrosine kinase inhibitor.

Storage

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