Dacomitinib (Vizimpro)

Dacomitinib is a type of targeted cancer drug. It is also known as Vizimpro.

It is a treatment for locally advanced Open a glossary item or metastatic Open a glossary item non small cell lung cancer (NSCLC) with the EGFR gene change (mutation).

You pronounce dacomitinib as da-koh-mih-tih-nib.

How does dacomitinib work?

Dacomitinib is a tyrosine kinase inhibitor (TKI) Open a glossary item which is a type of cancer growth blocker. It blocks proteins on cancer cells that encourage the cancer to grow.

These proteins are called epidermal growth factor receptors (EGFR). If you have a cancer that has these receptors, you are EGFR positive. You have tests on your cancer cells to check for these receptors before you have this treatment.

How do you take dacomitinib?

Dacomitinib is a tablet. You swallow it whole with a glass of water. You can take it with or without food. You take it at the same time each day.

You must take tablets according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug, or if you miss a dose.

How often do you have dacomitinib?

You take dacomitinib once a day.

You usually keep taking dacomitinib for as long as it's working or until the side effects get too bad. 

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.

What are the side effects of dacomitinib?

Side effects can vary from person to person. They also depend on what other treatment you are having. 

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.

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Sore mouth and ulcers

Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges and lemons; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.

Loss of appetite and weight loss

You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

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.

Feeling or being sick 

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also 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 treat it once it has started.

Diarrhoea

Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a stoma Open a glossary item, you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.

Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables. 

Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.

Nail problems, including swelling around the nails 

Your nails may become brittle, dry, painful, change colour or develop ridges. This usually goes back to normal when you finish treatment.

The skin around your nail might get swollen, red, and sore (paronychia). It may also become infected. Talk to the team looking after you if you notice this.

Skin rash 

Skin problems include a skin rash, dry skin, acne, itching, cracked and peeling skin. 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.

Hair loss

You could lose your hair. This might include your eyelashes, eyebrows, underarms, legs 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.

Changes in the levels of minerals in your blood

Your blood contains different levels of minerals, electrolytes, and proteins. This treatment can change the levels of potassium in your blood and liver enzymes. You will have regular blood tests to check for this.

Eye problems 

You might get dry, red, itchy eyes (conjunctivitis). Tell your healthcare team if you have this. They can give you eye drops or other medication to help.

Soreness, redness and peeling on palms and soles of feet

The skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.

Moisturise your skin regularly. Your healthcare team will tell you what moisturiser to use.

Tiredness and weakness

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 (between 1 and 10%). You might have one or more of them. They include:

  • taste changes
  • extra hair growth on your body
  • loss of body fluid (dehydration)
  • lung problems including shortness of breath 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 you need to know?

Other medicines, food and drink

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility 

It is not known whether this treatment affects fertility Open a glossary item in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Contraception and pregnancy 

This drug may harm a baby developing in the womb. It is important not to become pregnant while you are having treatment. Adequate contraception should be used by both men and women who take dacomitinib during treatment and for 2 months afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you fall pregnant while you're having treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

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 one of the shingles vaccines called Zostavax.

You can have:

  • other vaccines, but they might not give you as much protection as usual
  • the flu vaccine (as an injection)
  • the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system Open a glossary item recovers from treatment.

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. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. 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 and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

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