Erlotinib

Erlotinib is a prescription medication used for treating non-small cell lung cancer and pancreatic cancer. 

• Erlotinib is available under the following different brand names: Tarceva

Adult dosage

Tablet

• 25mg
• 100mg
• 150mg

Non-Small Cell Lung Cancer

Adult dosage

• 150 mg orally every day 1 hr before or 2 hrs after meals

Pancreatic Cancer

Adult dosage

• 100 mg/day orally with gemcitabine

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Erlotinib include:

• nausea,
• vomiting,
• diarrhea,
• loss of appetite,
• cough,
• trouble breathing,
• rash,
• weakness, and
• tiredness

Serious side effects of Erlotinib include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• fever,
• sore throat,
• burning eyes,
• skin pain,
• red or purple skin rash with blistering and peeling,
• sudden chest pain or discomfort,
• wheezing,
• dry cough,
• shortness of breath,
• severe stomach pain,
• fever,
• chills,
• coughing up blood,
• severe ongoing nausea,
• vomiting,
• diarrhea,
• eye pain,
• irritation of the eye,
• vision problems,
• chest pain or pressure,
• pain spreading to the jaw or shoulder,
• nausea,
• sweating,
• sudden numbness or weakness (especially on one side of the body),
• sudden severe headache,
• slurred speech,
• problems with balance,
• little or no urination,
• swelling,
• rapid weight gain (especially in the face and midsection),
• dark urine, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Erlotinib include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Erlotinib has severe interactions with the following drugs:
  • dexlansoprazole
  • esomeprazole
  • lansoprazole
  • omeprazole
  • pantoprazole
  • rabeprazole
• Erlotinib has serious interactions with at least 30 other drugs.
• Erlotinib has moderate interactions with at least 104 other drugs.
• Erlotinib has minor interactions with no other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• None

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Erlotinib?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Erlotinib?”

Cautions

• Risk of potentially fatal interstitial lung disease (ILD); withhold therapy for acute onset of new or progressive unexplained pulmonary symptoms, such as dyspnea, cough, and fever; discontinue therapy if ILD diagnosed
• Potentially fatal GI perforations
• Severe bullous, blistering, or exfoliating skin conditions
• Ocular disorders include decreased tear production, abnormal eyelash growth, corneal perforation/ulceration, keratoconjunctivitis sicca, keratitis
• Diarrhea
• Smoking reduces erlotinib plasma concentration; advise patient to quit smoking
• Monitor renal function and electrolytes, particularly in patients at risk of dehydration; withhold therapy for severe renal toxicity
• Hepatotoxicity with or without hepatic impairment including hepatic failure and hepatorenal syndrome; monitor periodic liver testing; withhold or discontinue therapy for severe or worsening liver tests
• Coadministration with CYP3A4 inhibitors/inducers
• CYP1A2 inducers may decrease the plasma concentration
• The risk of myocardial infarction (MI)/ischemia is increased in patients with pancreatic cancer
• The risk of cerebrovascular accident is increased in patients with pancreatic cancer
• The risk of microangiopathic hemolytic anemia (MAHA) is increased in patients with pancreatic cancer
• No evidence drug has any benefit after disease progression
• Monitor if on warfarin or other coumarin-derived anticoagulants for changes in PT/INR
• Avoid pregnancy; can cause fetal harm; advise females of reproductive potential of the potential risk to the fetus and to use highly effective contraception during therapy and for 1 month after the last dose

Pregnancy & Lactation

• Based on animal data and its mechanism of action, erlotinib can cause fetal harm when administered to a pregnant woman
• Advise females of reproductive potential to use effective contraception during treatment and for 1 month after the last dose
• Lactation
  • No data exist on the presence of erlotinib in human milk, or the effects of erlotinib on the breastfed infant or milk production
  • Because of the potential for serious adverse reactions in breastfed infants, including interstitial lung disease, hepatotoxicity, bullous and exfoliative skin disorders, microangiopathic hemolytic anemia, thrombocytopenia, ocular disorders, and diarrhea
  • Advise a lactating woman not to breastfeed during treatment and for 2 weeks after the final dose