Erlotinib (Generic Name)

Other Names: Tarceva®

About This Drug

Erlotinib is used to treat cancer. It is given by mouth.

Possible Side Effects (More Common)

  • Loose bowel movements (diarrhea) that may last for a few days or more.  
  • Rash, itchy skin,or dry skin.  A rash that looks like acne may happen on your face and upper back when taking this medicine.  Your doctor can give you medicine to help treat this. 
  • Decreased appetite (decreased hunger)
  • Fatigue
  • Nausea or throwing up (vomiting). These symptoms are generally mild with erlotinib.
  • Sore mouth and throat
  • Eye irritation.  You may have watery eyes.  Your eyes and eye lids may become read and painful. 
  • Abdominal pain
  • Weakness

Possible Side Effects (Less Common)

  • Breathing problems, cough, or a worsening of your shortness of breath or cough. This may be due to a rare side effect called interstitial lung disease.
  • Headache
  • Muscle pain
  • Changes in your liver function.  Your doctor will check your liver function as needed.

Allergic Reactions

Allergic reactions including anaphylaxis are rare but may happen in some patients.  Signs of allergic reactions to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way.  If you get these symtpoms, do not take another dose of this drug.  You should get urgent medical treatment.

Treating Side Effects

  • Ask your doctor or nurse about medicine to help stop or lessen loose bowel movements, rash, itchy or dry skin, nausea, throwing up, eye irritation, and abdominal pain.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Do not put anything on a rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.

Food and Drug Interactions 

  • Taking this drug with food and raise the levels of the drug in your body. Take this drug on an empty stomach.
  • Do not eat grapefruit or drink grapefruit juice while taking this drug. Grapefruit can alter the level of erlotinib in your body.
  • Erlotinib may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s help.
  • Drugs that treat heartburn and stomach upset such Maalox®, Mylanta®, Protonix®, Nexium®, Dexliant® Prilosec®, Pepcid®, Tagamet®, and Zantac® may lower the effect of your cancer treatment if taken with erlotinib. Call your doctor to find out what drug you may take with erlotinib to help with heartburn or stomach upset.

Important Information

  • Take this drug on an empty stomach, at least 1 hour before eating or 2 hours after eating.
  • Take this drug with water and swallow tablets whole. Do not chew, break or crush it.
  • MIssed dose: If you miss a dose, take it as soon as you think about it.  If it is close to the time for your next dose, skip the missed dose and go back to your normal time.  Do not take 2 doses at the same time or extra doses.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Feeling confused or agitated
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause.  If you have any of these symptoms for 2 minutes, call 911. 
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin.

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Change in hearing, ringing in the ears
  • Decreased urine
  • Unusual thirst or passing urine often
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period that lasts longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Sexual Problems and Reproductive Concerns

  • Infertility warning: Sexual problems and reproduction concerns may happen. In men and women both, this drug may affect your ability to have children. This cannot be determined before your therapy. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

 

Revised August 2014

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