afatinib dimaleate at a glance
Medicine class
Irreversible ErbB-family protein kinase inhibitor
Usual role
Targeted treatment for selected advanced non-small cell lung cancers
Food
Take without food, observing the prescribed food-free window
Important early effect
Report diarrhoea promptly because dehydration and kidney impairment can follow
What is afatinib dimaleate used for?
UK-licensed uses as monotherapy in adults include:
Locally advanced or metastatic non-small cell lung cancer with activating EGFR mutations in patients who have not previously received an EGFR tyrosine kinase inhibitor.
Locally advanced or metastatic squamous non-small cell lung cancer that has progressed during or after platinum-based chemotherapy.
How does afatinib dimaleate work?
Afatinib binds irreversibly to the ErbB receptor family, including EGFR and HER2, and blocks signals that can drive cancer-cell growth and spread. Tumour EGFR testing helps identify cancers likely to respond in the mutation-positive indication.
afatinib dimaleate preparations and strengths
Tablet
Route: Oral
Strengths: 20 mg, 30 mg, 40 mg
How to take afatinib dimaleate
Follow the oncology team's prescription and do not alter or stop treatment without discussing it with them.
Take without food: avoid food for at least three hours beforehand and one hour afterwards.
Swallow the tablet whole with still water; do not chew, break or crush it.
If swallowing is difficult, place the tablet uncrushed in about 100 mL of still water, stir occasionally until dispersed, drink immediately, then rinse the glass with about 100 mL of water and drink the rinse.
The dispersion may be given through a gastric tube by a healthcare professional.
afatinib dimaleate side effects
Common or expected effects
- Diarrhoea
- Rash or acne-like skin changes, itching and dry skin
- Sore mouth or mouth ulcers
- Inflammation or infection around the nails
- Reduced appetite
- Nausea or vomiting
- Nosebleeds
Get urgent medical advice
- Severe or persistent diarrhoea, dehydration or reduced urine output
- New or worsening breathlessness, cough or fever, which may indicate interstitial lung disease
- Blistering, peeling or extensive painful skin reactions
- Acute eye pain, redness, watering, blurred vision or light sensitivity
- Severe abdominal pain or rigidity, particularly with fever or vomiting
- Symptoms or blood-test evidence of significant liver impairment
afatinib dimaleate in pregnancy
Afatinib could harm a developing baby, and human pregnancy data are limited. Pregnancy should be avoided during treatment; effective contraception is required during treatment and for at least one month after the final tablet. Tell the oncology team immediately if pregnancy occurs or is planned.
afatinib dimaleate while breastfeeding
Breastfeeding is not advised during afatinib treatment because transfer into human milk is considered likely and harm to the child cannot be excluded. Discuss feeding options with the oncology team.
afatinib dimaleate interactions
Tell the oncology team and pharmacist about prescribed, non-prescription and herbal products. Important examples include:
Strong P-glycoprotein inhibitors, including ritonavir, itraconazole, erythromycin, verapamil, amiodarone, ciclosporin and tacrolimus
These may increase afatinib exposure and adverse effects; the specialist may need to separate administration times.
Strong P-glycoprotein inducers, including rifampicin, carbamazepine, phenytoin and phenobarbital
These may lower afatinib exposure and reduce its effect.
St John's wort
This herbal product may lower afatinib exposure and should be discussed with the oncology team before use.
Common questions about afatinib dimaleate
Answers are fully visible for fast scanning and source review.
What type of treatment is afatinib dimaleate?
It is an oral targeted anticancer treatment and an irreversible ErbB-family protein kinase inhibitor.
Which lung cancers is afatinib dimaleate licensed to treat?
It is licensed for selected locally advanced or metastatic non-small cell lung cancers: activating EGFR mutation-positive disease in EGFR-inhibitor-naive adults and squamous disease progressing during or after platinum chemotherapy.
Is an EGFR test needed before afatinib dimaleate?
Yes for the mutation-positive indication. EGFR status should be established using a validated testing method before treatment starts.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.