Alectinib is a type of targeted cancer drug. It is a treatment for non small cell lung cancer (NSCLC) that has spread.
You can only have alectinib if you have a change (mutation) in the anaplastic lymphoma kinase (ALK) gene. Your doctor sends tissue samples to check for this gene change.
How alectinib works
Alectinib is a type of cancer growth blocker called a tyrosine kinase inhibitor. It works by blocking certain chemical messengers that tell cells to grow. This stops or slows down the cancer.
How you have alectinib
Alectinib is a capsule that you take twice a day. You swallow it whole with a glass of water. You must take alectinib with food.
Taking your tablets
You should take the right dose, not more or less.
Talk to your specialist or advice line before you stop taking a cancer drug.
When you have alectinib
You usually take alectinib for as long as it is working and the side effects aren’t too bad.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We haven't listed all the side effects. It is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.
When to contact your team
Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Common side effects
These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.
Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.
Rarely the liver can get injured causing it to not work properly.
You have regular blood tests to check for any changes in the way your liver is working.
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your nurse will tell you what products you can use on your skin to help.
Joint or muscle pain
You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.
Muscle weakness, spasms and pain
Let your doctor or nurse know if you have any weakness, spasms or pain in your muscles during or after having treatment.
Your blood tests might show that you have high levels of an enzyme in your blood called creatinine kinase (CK). This is mainly found in the heart, brain or skeletal muscles.
Your doctor might do a blood test to check why you might have chest pain, muscle aches or pains, muscle tenderness or weakness or dark reddish – brown urine.
Fluid build up
A build up of fluid may cause swelling in your arms, hands, ankles, legs, face and other parts of the body. Contact your doctor if this happens to you.
You may gain weight while having this treatment. You may be able to control it with diet and exercise. Tell your doctor or nurse if you are finding it difficult to control your weight.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:
- changes to your sense of taste
- problems with your eyesight such as blurred vision, redness, irritation, floaters, sensitivity to light or pain
- low blood pressure and a slower heart rate (bradycardia)
- a sore mouth and ulcers
- skin sensitivity to sunlight
- increased levels of ALK phosphatase in your blood which can affect your liver or bones
- changes in the way your kidneys work
Rare side effects
These side effects happen in fewer than 1 in 100 people (1%). You have one or more of them. They include:
- lung problems such as a cough or breathlessness due to inflammation and scarring of the lungs
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Other medicines, food and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Grapefruit and grapefruit juice
You should not eat grapefruit or drink grapefruit juice when you are taking this drug because it may increase the side effects.
This drug contains lactose (milk sugar). If you have intolerance to lactose, contact your doctor before taking this medicine.
Seville oranges and Seville orange juice
Seville oranges and Seville orange juice when you are taking this drug because it may increase the side effects.
Pregnancy and contraception
This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for at least 3 months afterwards. Talk to your doctor or nurse about contraception before starting treatment.
It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.
It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Driving and use of machinery
This drug can cause tiredness and dizziness. Don’t drive or operate heavy machinery if you have these symptoms.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.