In Treatment of:
Gefitinib is used to treat some people with non-small cell lung cancer (NSCLC). It only works for NSCLCs that have changes called EGFR mutations on the surface of their cells. EGFR mutations are most likely in NSCLC in:
2. people who have never smoked
3. people with adenocarcinoma
4. people of Asian ethnicity.
Tests may be done to check the level of EGFR. These will tell if you're likely to benefit from gefitinib. Testing can be done at the time the cancer is diagnosed, or samples of cancer cells from previous biopsies or surgery may be used.
The National Institute for Health and Clinical Excellence (NICE) currently gives advice on which new drugs or treatments should be available on the NHS. They recommend gefitinib as a possible first treatment for people with NSCLC that is EGFR positive and has spread to surrounding tissues or other parts of the body.
Each person’s reaction to cancer treatment is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone having this treatment.
We've outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed below, discuss them with your doctor or specialist nurse.
An acne-like rash that mainly affects the head, chest and back is the most common side effect of gefitinib. This usually begins during the first 2-3 weeks of treatment and goes away once treatment ends.
Your skin may also become dry and itchy or feel tender and peel. Some people find that the nails on their hands or feet become red, sore and brittle.
Taking the following steps may help reduce the severity of skin changes, although they can’t prevent them altogether.
Use tepid water and mild non-scented soap for bathing and washing.
Avoid skincare products that contain alcohol.
Don’t use anti-acne products, as they can dry your skin and make your symptoms worse.
Sunlight can make skin symptoms worse. During treatment with gefitinib, and for several months afterwards, you will be more sensitive to the sun, and your skin may burn more easily than normal. You can still go out in the sun, but should wear a sun cream with a high sun protection factor (SPF) and cover up with clothing and a hat. If you are having radiotherapy, don't apply sunscreen to any skin in the area being treated.
Moisturise your skin regularly and after bathing. Your doctor or specialist nurse can advise you on which moisturisers are best.
Protect your hands and fingernails from detergents by wearing rubber gloves when washing dishes.
Let your doctor know as soon as possible if you develop skin or nail changes. They can prescribe treatment to help. In people who have more severe side effects, treatment with gefitinib can be stopped for a few days to allow their skin to recover.
Your eyelashes may grow longer and more curly than usual. Men may notice they have less beard growth. You may notice your head and body hair is finer, curlier or more brittle.
Some people have hair thinning or hair loss. If this happens, it usually develops gradually. These changes are usually temporary and gradually improve once treatment is over.
This can usually be easily controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea.
This can usually be easily controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have .
Loss of appetite
A dietitian or specialist nurse at your hospital can giva advice about how to boost your appetite and maintain your weight.
Feeling sick (nausea) and being sick (vomiting)
This is usually mild. Let your doctor know if it isn't controlled as they can prescribe effective anti-sickness medication.
Some people feel tired and lack energy while taking gefitinib.
Let your doctor know if you have nosebleeds or notice blood in your urine while taking gefitinib.
If you notice any change to your vision, or pain or redness of your eyes, let your doctor know immediately.
Always let your doctor or nurse know about any side effects you have. There are usually ways in which they can be controlled or improved.
GRFTINIB is contraindicated in patients with severe hypersensitivity to gefitinib or to any other component ofGeftinib.
The acute toxicity of gefitinib up to 500 mg in clinical studies has been low. In non-clinical studies, a single dose of 12,000 mg/ m 2 (about 80 times the recommended clinical dose on a mg/ m 2 basis) was lethal to rats. Half this dose caused no mortality in mice. There is no specific treatment for an IRESSA overdose and possible symptoms of overdose are not established.
However, in phase 1 clinical trials, a limited number of patients were treated with daily doses of up to 1000 mg. An increase in frequency and severity of some adverse reactions was observed, mainly diarrhoea and skin rash. Adverse reactions associated with overdose should be treated symptomatically; in particular, severe diarrhoea should be managed appropriately.
Before taking gefitinib,
1. tell your doctor and pharmacist if you are allergic to gefitinib or any other medications.
2. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); antifungals such as itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend); carbamazepine (Carbatrol, Equetro, Tegretol); amiodarone (Cordarone, Pacerone); clarithromycin (Biaxin); diltiazem (Cardizem, Dilacor, Tiazac); erythromycin (E.E.S, E-Mycin, Erythrocin); fluvoxamine (Luvox); medications for heartburn and ulcers such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac); metoprolol (Lopressor, Toprol XL); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane); medications for human immunodeficiency virus (HIV) such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); nefazodone; phenobarbital; phenytoin (Dilantin); verapamil (Calan, Covera, Isoptin, Verelan); and vinorelbine (Navelbine). Many other medications may interact with gefitinib, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
3. tell your doctor what herbal products you are taking, especially St. John's wort.
4. tell your doctor if you have or have ever had pulmonary fibrosis (scarring of the lungs), or liver or kidney disease.
5. tell your doctor if you are pregnant or plan to become pregnant. You should use birth control to prevent pregnancy during your treatment with gefitinib and for some time after you stop using the medication. If you become pregnant while taking gefitinib, call your doctor. Gefitinib may harm the fetus and increase the risk of pregnancy loss.
6. tell your doctor if you are breast-feeding. You should not breast-feed while you are taking gefitinib.
"Gefitinib may increase the blood-thinning effects of warfarin (Coumadin) and increase the risk of bleeding. Therefore, patients receiving gefitinib and warfarin at the same time should have more frequent testing of the ""thinness"" of their blood.
Patients who receive drugs that increase an enzyme in the liver called CYP 3A4 that destroys gefitinib (for example, rifampin or phenytoin (Dilantin) may need a higher dose of gefitinib to maintain the effectiveness of gefitinib.
Similarly, patients who receive drugs that reduce CYP 3A4, for example, ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan), erythromycin, clarithromycin (Biaxin), ritonavir (Norvir), nelfinavir (Viracept), indinavir (Crixivan), nefazodone (Serzone), as well as grapefruit juice, may need a lower dose of gefitinib to prevent side effects from increased levels of gefitinib.
Gefinitib is taken as a tablet once a day. You should take the tablet at the same time each day.