Dacocent 45

Indications

Dacomitinib is a targeted cancer medicine used to treat adults with non-small cell lung cancer (NSCLC) that has spread locally or to other parts of the body, when the tumour has certain changes (mutations) in the epidermal growth factor receptor (EGFR) gene, such as exon 19 deletion or exon 21 L858R substitution. A test on the tumour is needed before starting.

How It Works

EGFR is a receptor on cells that, when switched on, tells them to grow and divide. In EGFR-mutated lung cancer this signal is stuck in the "on" position. Dacomitinib is a tyrosine kinase inhibitor that binds permanently to EGFR and related receptors (HER2 and HER4) and blocks their signals, slowing or stopping the growth of cancer cells.

Dosage and Administration

Take exactly as prescribed by your cancer specialist (oncologist). It is taken by mouth once a day, at about the same time each day, with or without food. The doctor may lower the dose or pause treatment if side effects occur. If a dose is missed or vomited, do not take an extra dose; take the next one at the usual time. Treatment usually continues while it is working and side effects are manageable.

Interactions

• Proton pump inhibitors such as Omeprazole and Esomeprazole reduce its absorption and should be avoided; antacids or H2 blockers may be used with timing advised by the doctor.
• Dacomitinib increases blood levels of medicines broken down by the CYP2D6 enzyme, such as Metoprolol, some antidepressants and Codeine-type painkillers; some may need to be avoided.
• Tell your doctor about all medicines, supplements and herbal products.

Contraindications

• Allergy to Dacomitinib or any ingredient.

Side Effects

Very common side effects are diarrhoea, acne-like rash, dry or itchy skin, painful swelling around the nails (paronychia), mouth sores, reduced appetite, weight loss, hair changes and eye irritation. Rare but serious effects include inflammation of the lungs (interstitial lung disease), severe diarrhoea with dehydration and severe skin reactions.

Get urgent medical help if you develop new or worsening shortness of breath, cough or fever; diarrhoea that does not settle with medicine or causes dizziness or very little urine; a severe, blistering or peeling rash; or painful red eyes or changes in vision.

Pregnancy and Lactation

Dacomitinib can harm an unborn baby. Women who can become pregnant should use effective contraception during treatment and for at least 17 days after the last dose. Do not breastfeed during treatment and for at least 17 days after the last dose.

Precautions and Warnings

• Start antidiarrhoeal medicine (as advised by your doctor) at the first sign of diarrhoea and drink plenty of fluids.
• Use gentle moisturisers and sun protection to reduce skin problems.
• Your doctor will monitor you closely, especially in the first months.
• Use with care in severe liver or kidney disease.

Overdose

An overdose is likely to cause more severe diarrhoea, rash and other side effects. Contact your doctor or go to the nearest hospital straight away.

Therapeutic Class

Antineoplastic (anti-cancer) agent, EGFR tyrosine kinase inhibitor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Return unused tablets to a pharmacy for safe disposal.