alectinib hydrochloride at a glance
Medicine class
ALK tyrosine kinase inhibitor
Usual role
Targeted treatment for ALK-positive non-small-cell lung cancer
How it is taken
Swallow the capsules whole with food; do not open or dissolve them
Sun protection
Limit prolonged sun exposure and use broad-spectrum SPF 50 or higher sunscreen and lip balm
What is alectinib hydrochloride used for?
Licensed uses in adults with confirmed ALK-positive non-small-cell lung cancer include:
Adjuvant treatment following complete resection of Stage IB tumours of at least 4 cm through Stage IIIA disease, using the specified staging system in the licence.
First-line treatment of advanced disease.
Treatment of advanced disease previously treated with crizotinib.
How does alectinib hydrochloride work?
Some lung cancers contain an abnormal ALK fusion that continuously signals cancer cells to grow. Alectinib inhibits ALK tyrosine kinase and its downstream signalling, which can slow growth or cause cancer-cell death. It also reaches the central nervous system, and its active metabolite M4 has similar ALK-inhibiting activity.
alectinib hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 150 mg
How to take alectinib hydrochloride
Follow the instructions from the specialist cancer team.
Swallow each capsule whole with water and food.
Do not open, crush or dissolve the capsules.
If vomiting occurs after taking alectinib, do not take an extra amount; continue at the next scheduled time.
Tell the cancer team about prescription, non-prescription and herbal products before starting anything new.
Limit prolonged sunlight exposure during treatment and for seven days afterwards; use broad-spectrum SPF 50 or higher sunscreen and lip balm.
alectinib hydrochloride side effects
Common or expected effects
- Constipation, diarrhoea, nausea or vomiting
- Muscle pain
- Swelling caused by fluid retention
- Rash or increased sensitivity to sunlight
- Anaemia, tiredness or weakness
- Changes in liver, muscle or kidney blood tests
- Slow heartbeat
- Weight gain
- Taste changes, mouth inflammation or visual disturbances
Get urgent medical advice
- New or worsening breathlessness, cough or fever: possible pneumonitis
- Yellow skin or eyes, dark urine, right-sided abdominal pain or unusual bruising: possible liver injury
- Persistent or severe muscle pain, tenderness or weakness
- Fainting, dizziness or low blood pressure: possible symptomatic bradycardia
- Marked tiredness, weakness or breathlessness: possible haemolytic anaemia
- Sudden severe abdominal pain, vomiting or fever: possible pancreatitis or gastrointestinal perforation
alectinib hydrochloride in pregnancy
Human pregnancy data are limited, and alectinib may harm a developing baby. Pregnancy should be avoided during treatment. Highly effective contraception is required for patients who can become pregnant during treatment and for at least five weeks afterwards, and for male patients with partners who can become pregnant during treatment and for at least three months afterwards. Oral contraceptives may be less effective, so contraception should be discussed with the specialist team. Contact the oncology team promptly if pregnancy occurs.
alectinib hydrochloride while breastfeeding
It is not known whether alectinib or its metabolites enter human milk, and risk to an infant cannot be excluded. Breastfeeding is advised against while receiving alectinib; discuss feeding plans with the oncology and maternity teams.
alectinib hydrochloride interactions
Provide the oncology team with a complete list of medicines, supplements and herbal products. Important examples include:
Strong CYP3A inducers, including rifampicin, rifabutin, carbamazepine, phenytoin, phenobarbital and St John’s wort
These can alter alectinib and active-metabolite exposure; appropriate monitoring is recommended.
Strong CYP3A inhibitors, including ritonavir, azole antifungals, grapefruit and Seville oranges
These can alter alectinib and active-metabolite exposure; appropriate monitoring is recommended.
Oral contraceptives
Alectinib may reduce contraceptive effectiveness; discuss a highly effective method with the specialist team.
Common questions about alectinib hydrochloride
Answers are fully visible for fast scanning and source review.
Is alectinib hydrochloride chemotherapy?
No. It is a targeted tyrosine kinase inhibitor that blocks abnormal ALK signalling in susceptible cancer cells.
Why is an ALK test needed before alectinib hydrochloride?
Alectinib is licensed for ALK-positive non-small-cell lung cancer, so a validated test is required to confirm that treatment target.
Can alectinib hydrochloride be used after lung cancer surgery?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.