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Eribulin (Halaven)

Eribulin is a chemotherapy drug. Its full name is eribulin mesylate. It's also known by its brand name Halaven.

It is a treatment for:

  • advanced breast cancer, usually in people who have already had at least one other course of chemotherapy
  • liposarcoma that can't be removed with surgery in people who have had chemotherapy

How eribulin works

Eribulin works by stopping the cancer cells from separating into 2 new cells. So it blocks the growth of the cancer. It is a type of drug called a microtubule inhibitor.

How you have eribulin

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have eribulin

You usually have eribulin in cycles of treatment. Each cycle of treatment lasts 21 days (3 weeks). You have each cycle in the following way:

Day 1
  • You have eribulin as a drip into your bloodstream over 5 minutes
Day 2 to day 7
  • You have no treatment
Day 8
  • You have eribulin as a drip into your bloodstream over 5 minutes
Day 9 to day 21
  • You have no treatment

You then start a new cycle of treatment. 

Tests

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.

Side effects

We haven't listed all the side effects. It's 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 treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist 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

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Common side effects

Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them. They include:

Increased risk of getting an infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

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.

Numbness or tingling in fingers and toes

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Talk to the team looking after you when you first notice this. 

Headaches 

Tell your doctor or nurse if you keep getting headaches. They can give you painkillers to help.

Breathlessness and cough

Tell your doctor or nurse if you’re breathless or have a cough. This could be due to an infection, such as pneumonia. Or it could be caused by changes to the lung tissue, making it less flexible.

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.

Constipation or diarrhoea 

Tell your doctor or nurse if you have diarrhoea or constipation. They can give you medicine to help. 

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before. 

Pain in different parts of your body 

You might get aching or painful joints or muscles. You may also get pain in your back, arms and legs. Tell your doctor or nurse if you have this. They can give painkillers to help.

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.

High temperature (fever) 

If you get a high temperature, let your treatment team know straight away. Ask them if you can take paracetamol to help lower your temperature.

Weight loss 

You might lose weight while having this treatment. Let your doctor or nurse know and they can recommend ways of maintaining your weight. Or they can refer you to a dietitian.

Occasional side effects

Each of these effects happens in more than 1 in 100 people (1 %). You might have one or more of them. They include:

  • low levels of potassium, magnesium and phosphate in your body
  • loss of fluids in your body (dehydration)
  • high blood sugar levels
  • difficulty sleeping
  • low mood (depression)
  • taste changes
  • dizziness and vertigo
  • nerve problems that can cause loss of sensation
  • problems with your eyes such as watery eyes and inflammation (conjunctivitis)
  • ringing or buzzing in the ears
  • high blood pressure
  • hot flushes
  • a blood clot in your lungs (pulmonary embolism)
  • a drop in the levels of platelets which can cause bruising and bleeding
  • mouth ulcers and a dry mouth
  • indigestion or heartburn
  • changes to the way your liver works which are usually mild
  • skin and nail problems such as rash, redness, itching and dry skin
  • soreness, redness and peeling on palms or soles of the feet
  • pain when passing urine
  • swelling (oedema) in your hands and feet
  • flu like symptoms such as chills

Rare side effects

Each of these effects happens in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • a severe infection called sepsis
  • a blood clot in one or more of the deep veins in your body
  • inflammation of the pancreas
  • blood and protein in your urine
  • damage to your liver
  • a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening

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 drinks 

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.

This drug contains small amounts of alcohol. This is not harmful to most people but you should speak to your doctor or pharmacist if you have alcohol problems.

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. Women may be able to store eggs or ovarian tissue but this is rare.

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.

Breastfeeding 

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.

Immunisations 

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).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • 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 oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

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.

Information and help

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