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Erlotinib (Tarceva)

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This page tells you about the biological therapy erlotinib and its possible side effects. There is information about

 

What erlotinib is

Erlotinib is also known by its brand name, Tarceva (tar-see-vah). It is a type of biological therapy called a tyrosine kinase inhibitor (TKI). Tyrosine kinases are proteins that cells use to signal to each other to grow. They act as chemical messengers.

Erlotinib blocks tyrosine kinase from sending growth signals. So the cancer cells don’t grow.

Erlotinib is a treatment for

 

How you take erlotinib

Erlotinib is a tablet. You take it once a day, at least 1 hour before eating, or 2 hours after eating. You usually carry on taking it for as long as it is still working.

Some drugs may increase the harmful effects of this drug, including antibiotics and anti fungal medicines. Avoid grapefruit and grapefruit juice because they can increase the side effects. Some drugs can reduce how well erlotinib works. These include

  • Some antibiotics
  • Some anti epileptic medicines
  • Some indigestion medicines (you can take some at a different time to erlotinib to stop the interaction – speak to your pharmacist or doctor about this)
  • The anti clotting drug, warfarin
  • St John's Wort
  • Smoking

You should let your doctor, nurse or pharmacist know about any other drugs or complementary medicines you are taking.

It is very important that you take tablets according to the instructions your doctor or pharmacist gave you. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

The side effects of erlotinib are listed below. Remember you are only likely to have a few of them.

 

Common side effects

More than 10 in every 100 people have one or more of these.

  • Skin changes occur in about 3 in 4 people (75%) – you may have a rash, blistering, or red, dry, skin, which usually starts within 10 days of starting erlotinib. If it is severe your doctors may reduce the dose or stop treatment
  • Itching affects just over 1 in 10 people (13%)
  • Diarrhoea affects up to 1 in 2 people (50%), but is usually mild – do tell your doctor or nurse as you can have medicines to stop it
  • Loss of appetite happens in about 1 in 2 people who take this drug (50%)
  • Tiredness (fatigue) happens in up to 1 in 2 people (50%)
  • Sickness affects just over 3 in 10 (33%) people, but is usually well controlled with anti sickness drugs – let your doctor or nurse know if it is not controlled
  • Sore, red eyes or dry eyes affect up to1 in 4 people (25%) – eye drops can help
  • A sore mouth occurs in 1 in 5 people (20%)
  • Sadness, anxiety and depression affect about 1 in 10 people (10%) who have erlotinib combined with gemcitabine
  • Loss of fertility – you may not be able to get pregnant or father a child after treatment with this drug. It is important to talk to your doctor about your fertility before starting treatment
  • We don’t know whether erlotinib can harm a developing baby – do talk to your doctor or nurse about contraception before having treatment if there is any chance you or your partner could become pregnant
 

Rare side effects

Fewer than 1 in 100 people have these.

  • Severe lung problems occur in fewer than 1 in 100 (1%) people – if you have a cough, high temperature and are short of breath contact your treatment centre urgently
  • An effect on the liver, which is unlikely to cause symptoms, and usually goes back to normal after the treatment ends – you will have regular blood tests to check how your liver is working and may stop treatment if tests show that your liver is being affected by the drug
  • Brittle or loose nails occur in fewer than 1 in 10 people (10%)
  • A hole in the bowel wall has occurred but this is very rare and usually happens if people are also having steroids, non steroidal anti inflammatory drugs, or taxane based chemotherapy. People who have had peptic ulcers or diverticular disease are more likely to have this problem
  • Abnormal eyelash growth, eye pain, or ulcers on the surface of the eye occur but this is rare – if it is severe your doctors may reduce the dose or stop treatment
 

Important points to remember

You will not get all the effects mentioned above. Any that occur may be mild. A side effect may get worse through your course of treatment, or more side effects may develop as the course goes on. The side effects depend on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)
  • Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your nurse will give you a phone number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies – some drugs can react together.

 

Immunisations

You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.

 

More information about erlotinib

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 28 August 2012