Ceritinib is a cancer treatment and is also known by its brand name Zykadia. It is a treatment for a type of lung cancer called non small cell lung cancer that has an enzyme called anaplastic lymphoma kinase (ALK).
How it works
Ceritinib is a tyrosine kinase inhibitor. It works by blocking an enzyme called anaplastic lymphoma kinase (ALK). Ceritinib only works in cancer cells that have an overactive version of ALK. About 5 in 100 people (5%) with NSCLC have this. It is called ALK positive disease.
Your doctor might recommend you have ceritinib if you have advanced non small cell lung cancer that is ALK positive and you have already had treatment with a drug called crizotinib.
You might also have certinib if you have not had any other treatments before.
How you have it
Ceritinib is a capsule or tablet. You swallow your capsules or tablets whole with a glass of water.
You take it once a day, at the same time every day. Ceritinib should be taken with food (light to full meal). If ceritinib is taken on an empty stomach, then have it at least 2 hours before eating or 1 hour after eating.
Do not take this drug with grapefruit or grapefruit juice.
Taking your tablets or capsules
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
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 it
You usually carry on taking ceritinib for as long as it is still working and your side effects are not too severe.
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:
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.
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.
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.
Loss of appetite
You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Contact your doctor or pharmacist if you have indigestion or heartburn. They can prescribe medicines to help.
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.
Tiredness and weakness (fatigue)
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
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 in blood sugar levels
- high levels of enzymes (lipase and amylase) in the blood
- eyesight changes such as blurred vision or vision loss
- low phosphate levels in the blood
- kidney changes
- cough and breathlessness due to changes in the lung tissue
- slow heart rate
- inflammation of the fluid filled sac that surrounds your heart which can cause chest pain
Rare side effects
This side effect happens in fewer than 1 in 100 people (1%):
- inflammation of the pancreas (pancreatitis)
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, foods 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 can react with the drug.
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 at least 3 months afterwards. Talk to your doctor or nurse about effective contraception before starting 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.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
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.