Erlotinib

Erlotinib is a type of medicine known as a tyrosine kinase inhibitor. It is used for:

• Treating non-small cell lung cancer that has spread to other areas of the body.
• Treating pancreatic cancer that has spread to other areas of the body. It should be used in combination with a medicine called gemcitabine.

As a tyrosine kinase inhibitor, Erlotinib works by preventing cancer cells from growing and by destroying them in the process. In cancer, certain cells in the body grow and multiply in the body abnormally. Cancer cells have structures called epidermal growth factor receptors (EGFRs) on their surfaces. The receptors allow the protein to attach to healthy cells. Once attached, it activates an enzyme in the cell called tyrosine kinase. The tyrosine kinase enzyme triggers chemical processes inside the cells for the cells to grow and multiply in abnormal ways.

Erlotinib is specifically used for NSCLC with mutations in the epidermal growth factor receptor (EGFR) that has spread to other parts of the body. Ii attaches to the enzyme to stop the epidermal growth factor from activating. This stops the cancer cells from growing and multiplying.

It has been approved for medical use in the US in 2004 and is listed in the World Health Organization’s list of essential medicines. It’s one of the safest and most effective medicines needed in the health system.

When and How to Use Erlotinib

Your dose is based on your condition, how you respond to the initial treatment, and the severity of your condition. The recommended dose for an adult in treating lung cancer is 150mg a day. The dose in treating pancreatic cancer is 100mg a day along with gemcitabine. Your doctor may decrease your dose during your treatment depending on how well the medicine works for you and its side effect.

Take Erlotinib exactly as directed by your physician. Take it at least 1 hour before or 2 hours after having your meal. Take it at around the same time each day. Do not stop taking Erlotinib without telling your doctor. Continue to take it even if you feel well.

What to know before taking Erlotinib

• Erlotinib must be used only after at least one regimen of chemotherapy has been unsuccessful in treating cancer.
• Do not take Erlotinib if you are using a proton pump inhibitor.
• Erlotinib is not recommended for breastfeeding women unless deemed necessary. Discuss with your doctor all the benefits and risks that you can get before taking this medicine.
• Smoking may decrease the amount of medicine in your blood making it less effective in treating cancer. Smoking can also worsen your condition. It is very important therefore for you to stop smoking while receiving this treatment.
• Do not use Erlotinib if:
  • You are allergic to any of its ingredients
  • You have a severely decreased liver or kidney function
  • You have a rare hereditary problem of galactose intolerance, glucose-galactose malabsorption or Lapp lactase deficiency
  • You are under 18 years of age
• Use this with caution in:
  • Patients with a history of diverticular disease or peptic ulcer
  • Patients being treated with NSAIDs, corticosteroid, anti-angiogenic agents
  • Patients with glucuronidation disorder like Gilbert’s syndrome
• Some medical problems may affect the use of this medication. Tell your doctor if you have:
  • Eye or vision problems
  • Lung or breathing problems
  • History of heart attack
  • History of stroke
  • Bleeding problems such as hemolytic anemia
  • Intestinal or stomach problems

Possible Side Effects of Erlotinib

Erlotinib is very strong and can have many side effects. If any of these symptoms are severe or do not go away tell your doctor:

• Nausea and vomiting
• Weight loss
• Diarrhea
• Hair loss
• Mouth sores
• Loss of appetite
• Headache
• Anxiety
• Darkening of skin
• Extreme tiredness
• Bone and muscle pain
• Depression
• Swelling of hands, arms, feet or ankle
• Changes in the appearance of nails and hair

Some side effects can be serious. Call your doctor if you will experience any of the following side effects:

• Decreased urination
• Chest pain
• Fever or chills
• Shortness of breath
• Dry mouth
• Unusual bleeding or bruising
• Sensitivity to light
• Cough
• Hives
• Sunken eyes
• Jaundice
• Dizziness
• Irritated, painful, red, dry or teary eyes
• Swelling in one leg
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Getting the Best Result from Erlotinib

• Your doctor may have to check the EGFR level on your cancer cells to determine if cancer will respond to the treatment.
• Use a reliable method of contraception to avoid getting pregnant while using Erlotinib and for at least two weeks after you finish your treatment.
• You are likely to get mild diarrhea as a side effect. If this happens, let your doctor know. Your doctor may likely to reduce your dose or will give you medicine to control it. It is also very important to drink plenty of fluids so you won’t be dehydrated. In case of severe diarrhea, loss of appetite, vomiting, and nausea, let your doctor you right away. You may need to be treated in the hospital.
• This medicine is not suitable for used by patients below 18 years of age. It’s not also prescribed for patients who are hypersensitive to any of its ingredient or is undergoing platinum-based chemotherapy.
• This is a prescription cancer drug and you should not use this without the consent of your doctor.
• Patients with renal or hepatic impairment should use this with caution due to an increased risk of severe adverse effects or worsening of the condition.
• Patients with the gastrointestinal disease must use this medicine with extreme care due to an increased risk of gastrointestinal perforations.
• Patients receiving anticoagulants must use this with caution due to an increased risk of bleeding.
• A serious skin reaction may occur while you are using this medicine. If you have peeling, blistering, or loosening of the skin, lesion, or severe acne check with your doctor.