ERiNLAR

Indications

Ceritinib is a targeted cancer medicine used to treat adults with a type of advanced or metastatic non-small cell lung cancer (NSCLC) that is ALK-positive, meaning the tumour has a specific gene change confirmed by a laboratory test.

How It Works

In ALK-positive lung cancer, an abnormal protein called anaplastic lymphoma kinase (ALK) sends constant growth signals to cancer cells. Ceritinib blocks this protein, which slows or stops the growth and spread of the cancer.

Dosage and Administration

Take by mouth exactly as prescribed by the cancer specialist, usually once a day with food at the same time each day. Swallow capsules whole. The doctor may lower or pause the dose if side effects occur. Do not change the dose yourself.

Interactions

• Strong CYP3A inhibitors such as Ketoconazole, Clarithromycin and Ritonavir, and grapefruit juice, can raise ceritinib levels.
• Strong inducers such as Rifampicin, Carbamazepine and St John's Wort can lower its effect.
• Medicines that slow the heart or prolong the QT interval, such as Amiodarone, some antibiotics and Ondansetron, increase heart rhythm risks.
• It can raise levels of some medicines such as Warfarin and Midazolam.

Contraindications

• Allergy to ceritinib.
• Congenital long QT syndrome, or conditions where the doctor judges the risk too high.

Side Effects

Common effects include diarrhoea, nausea, vomiting, stomach pain, tiredness, loss of appetite, weight loss, raised liver enzymes, raised blood sugar and a slow heartbeat.

Get urgent medical help for severe or ongoing diarrhoea or vomiting, yellow skin or eyes, new or worsening cough, chest pain or shortness of breath (possible lung inflammation), fainting, a very slow or irregular heartbeat, severe stomach pain, or very high blood sugar symptoms such as extreme thirst.

Pregnancy and Lactation

Ceritinib can harm an unborn baby. Women should use effective contraception during treatment and for several months after the last dose, as advised by the doctor; men with female partners should also use contraception. Do not breastfeed during treatment and for some time after.

Precautions and Warnings

• Regular blood tests (liver, blood sugar, pancreas enzymes) and heart tracings (ECG) are needed.
• Tell the doctor about heart, liver or lung disease and diabetes.
• Manage diarrhoea and vomiting early with the doctor's advice and drink enough fluid.
• Handle with care; caregivers should avoid touching broken capsules.

Overdose

Overdose may cause severe stomach upset, liver problems and heart rhythm changes. Seek medical help immediately; treatment is supportive in hospital.

Therapeutic Class

Antineoplastic, ALK tyrosine kinase inhibitor.

Storage

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