Erlotinib - Oral

Erlotinib is used to treat a certain type of lung cancer. It is used for those whose tumour has spread to other parts of the body or who have failed previous therapy.

This medicine is also used together with another medicine to treat cancer of the pancreas.

Take Erlotinib exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take it on an empty stomach, at least 1 hour before or 2 hours after a meal. Try to take it at the same time each day.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the type of your condition and your response to the medication.

Erlotinib must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Inform your doctor if you have the following conditions:

• history of peptic ulcer (open sores in the lining of the stomach, small intestine, or lower food pipe)
• history of eye problems e.g. sore or inflammation in the cornea (clear front surface of the eye), severe dry eyes
• active cigarette smoker
• kidney disease
• liver disease

Let your doctor know if you are pregnant.

It is important that you do not get pregnant while being treated with this medicine. You must use proven birth control methods while taking Erlotinib and for at least 2 weeks after stopping the treatment. You may wish to discuss birth control methods with your doctor or pharmacist.

Inform your doctor if you are breastfeeding. Do not breastfeed while you are being treated with this medicine and for at least 2 weeks after the last dose.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Certain genetic tests must be done before treatment to know if this medicine is suited for you to take.
• Routine tests (e.g. liver or kidney function, electrolyte levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring of signs and symptoms of skin, eyes or lung problems may also be needed.

Erlotinib may cause any of the following side effects: headache, nausea, vomiting, diarrhoea, stomach wind, indigestion, mouth sores, back, muscle or joint pain, weakness, loss of appetite, and weight loss.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• signs and symptoms of heart problems e.g. chest pain, tightness or pressure, pain that may spread to the arms, jaw, neck, shoulder or back, shortness of breath, lightheadedness
• weakness or numbness on one side of the body, trouble speaking, vision problems, changes in balance or coordination
• signs and symptoms of lung problems e.g. shortness of breath or breathing problems, cough, fever
• severe or persistent diarrhoea
• pass out bloody or black as tar stools, vomiting blood or ground coffee-like material
• rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
• eye pain or irritation, changes in vision
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• blood-thinning medicines e.g. warfarin
• medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, phenobarbital
• medicines for HIV infection e.g. ritonavir, saquinavir
• medicines to treat fungal infection e.g. ketoconazole, voriconazole
• certain antibiotics e.g. clarithromycin, ciprofloxacin
• corticosteroids (anti-inflammatory medicines)
• NSAIDs (medicines for pain and inflammation)
• other medicines for cancer e.g. capecitabine
• certain cholesterol-lowering medicines
• ciclosporin (medicine used in organ transplants or certain immune disorders)
• verapamil (medicine for heart disease)
• rifampicin (medicine to treat TB, a lung infection known as tuberculosis)
• St. John's wort (herbal medicine)

This list does not include all medicines that may interact with Erlotinib.

This medicine should not be taken with medicines that reduce stomach acid production (e.g. omeprazole, ranitidine) and antacids (medicines that neutralise stomach acids) as they could reduce the effectiveness of Erlotinib. If you must take these types of medicine, your doctor may advise you to take them separately for several hours. Your doctor will advise you on how you should take these medicines while being treated with Erlotinib.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.

As Erlotinib is a cancer medicine, always return any unused or expired tablets to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.