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Erlotinib is used to treat individuals with metastatic non-small cell lung cancer (NSCLC) with an epidermal growth factor receptor (EGFR) genetic mutation. It is also used in combination with another medication, Gemcitabine (Gemzar®), to treat pancreatic cancer.
Dose and Schedule
Taking Erlotinib as prescribed is crucial to ensure the treatment is as effective as possible. Please follow these guidelines:
- Your dose may vary. The usual dosages are:
- 150 milligrams daily for NSCLC.
- 100 milligrams daily for pancreatic cancer.
- Timing: Take Erlotinib without food—at least one hour before or two hours after a meal—at the same time each day.
- Do not crush, cut, or dissolve Erlotinib tablets. If swallowing is difficult, consult your doctor for alternative options.
- Missed a dose? Do not take extra tablets or double the dose. Take the next dose at the regular time and inform your doctor of any missed doses during your next appointment.
- If you are planning surgery, inform your doctor. Erlotinib may need to be temporarily stopped until your wound heals.
Drug and Food Interactions
- Erlotinib interacts with several medications. Inform your doctor about all prescription drugs, over-the-counter medications, vitamins, and herbal products you are taking.
- Avoid grapefruit, grapefruit juice, and proton pump inhibitors (e.g., Omeprazole).
- If taking a histamine blocker (e.g., Ranitidine, Famotidine), take Erlotinib 10 hours after the blocker and at least 2 hours before the next dose of the blocker.
- If taking an antacid (e.g., Tums®, magnesium hydroxide), separate doses of Erlotinib and the antacid by several hours.
- Smoking interacts with Erlotinib. Avoid smoking; consult your doctor if you plan to quit or continue smoking.
- Erlotinib may increase bleeding risk if taken with warfarin. Regular INR checks are essential. Seek medical attention for any signs of bleeding.
- Consult your doctor or pharmacist before starting new medications, supplements, or vaccines.
Storage and Handling
- Store Erlotinib at room temperature (below 25°C) in a dry place away from light.
- Keep it out of reach of children and pets, and leave it in its original packaging until ready to use.
- If a caregiver is administering the tablets, they should wear gloves.
- Do not dispose of unused Erlotinib in household waste or flush it. Return it to your healthcare provider for proper disposal.
- When traveling, seal the medication in a plastic bag and consult your pharmacist about additional precautions.
Side Effects of Erlotinib
You may not experience these side effects, but it is important to be aware of them.
Decreased white blood cells (WBCs) Increased risk of infection | Regular blood tests to monitor blood count, liver, and kidney function. Take precautions: Wash hands frequently.Avoid crowds and sick individuals.Maintain good hygiene. Contact your doctor if you experience fever, chills, sore throat, or unusual fatigue. |
Liver function changes | Report symptoms such as yellowing of the skin or eyes, or dark urine. |
Nausea or vomiting | Eat bland, small meals, stay hydrated, and avoid lying down or vigorous activity after eating. Avoid strong odours. |
Fatigue | Stay active, rest as needed, and plan activities for when you have more energy. |
Diarrhoea | Drink fluids, eat bland foods (e.g., bananas, rice, chicken), avoid high-fibre and spicy foods, and use over-the-counter remedies like Loperamide if necessary. Contact your doctor if symptoms persist. |
Acne-like rash | Keep affected areas clean, avoid harsh products, and limit sun exposure. Use sunscreen (SPF 30+). Consult your doctor for appropriate treatments. |
Decreased appetite | Eat small, frequent meals, keep snacks nearby, and consider liquid nutritional supplements. |
Rash or itchy skin | Moisturise regularly, wear loose clothing, and avoid perfumed products. Contact your doctor if the rash worsens. |
Cough or shortness of breath | Report persistent cough or difficulty breathing to your doctor immediately. |
Handling Body Fluids and Waste
Erlotinib may remain in your body fluids for several days after ingestion. To ensure safety:
- Pregnant women should avoid contact with soiled materials.
- Flush the toilet twice with the lid closed. Clean any spills immediately.
- Wash hands after using the toilet or touching soiled items.
Soiled linens should be washed separately.
Pregnancy, Sexual Activity, and Contraception
- Avoid pregnancy: Women should not become pregnant, and men should not father a child during treatment.
- Use effective contraception during therapy and for 1 month after the last dose.
- Do not breastfeed while on Erlotinib and for 2 weeks after the last dose.
- Inform your doctor immediately if pregnancy occurs.
Compiled by : Karin Mouton
Registered Oncology Nurse