crizotinib at a glance
Medicine class
Targeted protein kinase inhibitor.
Patient selection
A validated test must confirm the relevant ALK or ROS1 alteration before treatment.
Administration
Swallow the hard capsule whole with water. It may be taken with or without food.
Food to avoid
Avoid grapefruit and grapefruit juice because they can increase crizotinib exposure.
Specialist treatment
Treatment is started and supervised by a clinician experienced in anticancer therapy.
What is crizotinib used for?
UK-licensed uses represented by the selected product include:
First-line treatment of adults with ALK-positive advanced non-small cell lung cancer.
Treatment of adults with previously treated ALK-positive advanced non-small cell lung cancer.
Treatment of adults with ROS1-positive advanced non-small cell lung cancer.
Treatment of patients aged 1 to under 18 years with relapsed or refractory systemic ALK-positive anaplastic large cell lymphoma.
Treatment of patients aged 1 to under 18 years with recurrent or refractory ALK-positive inflammatory myofibroblastic tumour that cannot be surgically removed.
How does crizotinib work?
Crizotinib inhibits receptor tyrosine kinases, particularly abnormal ALK and ROS1 proteins. Blocking these growth signals can reduce tumour-cell growth and promote tumour-cell death when the cancer is driven by a susceptible alteration.
crizotinib preparations and strengths
Capsule
Route: Oral
Strengths: 200 mg, 250 mg
How to take crizotinib
Follow the specialist team’s prescription. Swallow the hard capsule whole, preferably with water; do not crush, dissolve or open it. It may be taken with or without food. Avoid grapefruit, grapefruit juice and St John’s wort. If vomiting occurs after taking it, do not take an extra capsule.
Take the capsule consistently as directed by the oncology team.
Do not alter or stop treatment without discussing it with the specialist team.
Tell the team if swallowing capsules becomes difficult.
crizotinib side effects
Common or expected effects
- Visual effects such as flashes, blurred vision, double vision or floaters
- Nausea, vomiting, diarrhoea or constipation
- Swelling caused by fluid retention
- Tiredness, dizziness or reduced appetite
- Altered taste, tingling, numbness or other neuropathy symptoms
- Reduced white or red blood cells
- Raised liver enzymes
- Slow heart rate
Get urgent medical advice
- Liver injury or liver failure
- Lung inflammation
- Severe infection associated with reduced white blood cells
- Abnormal heart rhythm, fainting or symptomatic slow heart rate
- Heart failure
- New severe visual impairment or loss of vision
- Gastrointestinal perforation
- Severe kidney impairment
crizotinib in pregnancy
Crizotinib may harm a developing baby and is generally avoided during pregnancy unless the mother’s clinical condition requires treatment. Effective contraception is advised for people who could become pregnant or father a child during treatment and for at least 90 days afterwards. Oral contraceptives may be less effective. Contact the specialist team promptly if pregnancy occurs.
crizotinib while breastfeeding
Breastfeeding should be avoided while receiving crizotinib because it is unknown whether crizotinib enters human milk and there is potential for serious harm to the infant.
crizotinib interactions
A full review of prescription, over-the-counter and herbal products is required before and during treatment.
Clarithromycin, azole antifungals and strong antiviral CYP3A inhibitors
These can increase crizotinib exposure and adverse effects; concurrent use should generally be avoided or closely managed by specialists.
Rifampicin, carbamazepine, phenytoin, phenobarbital and St John’s wort
These can substantially reduce crizotinib exposure and effectiveness, so concurrent use should be avoided.
Grapefruit and grapefruit juice
These may increase crizotinib concentrations and should be avoided.
Common questions about crizotinib
Answers are fully visible for fast scanning and source review.
What cancers is crizotinib licensed to treat in the UK?
It is licensed for ALK-positive or ROS1-positive advanced non-small cell lung cancer in adults and specified ALK-positive anaplastic large cell lymphoma and inflammatory myofibroblastic tumours in children and adolescents.
Does treatment require a genetic test?
Yes. A validated test must confirm the relevant ALK or ROS1 alteration before treatment starts.
Can the hard capsules be opened or crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.