This page tells you about the biological therapy erlotinib and its possible side effects. There is information about
Erlotinib 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 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. So it is important to 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 that you are only likely to have a few of them.
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 and weakness (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 become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
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 – it usually goes back to normal after the treatment ends. You will have regular blood tests to check how your liver is working. Your doctor may stop the 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
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
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. 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.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
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.
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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