erlotinib, Tarceva (cont.)

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Cigarette smoking also reduces the concentration of erlotinib in the blood. Patients are advised to quit smoking.

Drugs that reduce the production of acid in the stomach will reduce the absorption of erlotinib. Therefore, proton pump inhibitors (PPI's, for example, omeprazole [Prilosec, Zegerid]) should not be administered with erlotinib, and erlotinib should be administered 10 hours before H2-receptor blockers (for example, ranitidine [Zantac]) or two hours after taking the H2-receptor blocker.

Administration of antacids should be separated from administration of erlotinib by several hours.

Erlotinib has been associated with increased risk of bleeding, especially in patients also taking warfarin (Coumadin). Patients taking warfarin should be monitored closely.

PREGNANCY: Erlotinib has been shown to cause maternal toxicity and fetal death in rabbits given high doses of erlotinib. Even though there are no well-controlled studies in pregnant women using erlotinib, women of childbearing age should be advised to avoid pregnancy while on erlotinib.

NURSING MOTHERS: It is not known whether erlotinib is excreted in human milk. Because many medicines are excreted in human milk and because the effects of erlotinib on infants have not been studied, women should abstain from breastfeeding while receiving erlotinib.

SIDE EFFECTS: The most common side effects of erlotinib are rash, diarrhea, loss of appetite, weight loss, nausea, vomiting, stomach pain, fatigue, shortness of breath, mouth sores, dry skin, itching, and cough. Any of these can occur in about half of all patients who receive the medicine, but these effects are usually mild. There have been rare reports of serious lung disease, including deaths, in patients receiving erlotinib for treatment of NSCLC or other tumors. Liver failure, kidney failure, increased bleeding rates, gastrointestinal perforation, and corneal perforation or ulceration has also been reported.

Reference: FDA Prescribing Information

Last Editorial Review: 6/22/2012

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