erlotinib hydrochloride at a glance
Medicine class
EGFR tyrosine kinase inhibitor
Main uses
Selected advanced non-small-cell lung cancers and metastatic pancreatic cancer
How it is supplied
Oral film-coated tablets
Food
Take on an empty stomach, at least one hour before or two hours after food
Smoking
Smoking can substantially reduce erlotinib exposure; patients should be supported to stop
What is erlotinib hydrochloride used for?
UK-licensed uses in adults include:
First-line treatment of locally advanced or metastatic non-small-cell lung cancer with an activating EGFR mutation.
Switch maintenance treatment of locally advanced or metastatic non-small-cell lung cancer with an activating EGFR mutation and stable disease after initial chemotherapy.
Locally advanced or metastatic non-small-cell lung cancer after failure of previous chemotherapy; without an activating EGFR mutation, use is restricted to circumstances where other options are unsuitable.
Metastatic pancreatic cancer in combination with gemcitabine.
How does erlotinib hydrochloride work?
Erlotinib blocks the tyrosine kinase activity of EGFR, a receptor involved in cell growth and survival. In cancers driven by activating EGFR mutations, this interrupts abnormal signalling, limiting cell proliferation and promoting cancer-cell death.
erlotinib hydrochloride preparations and strengths
How to take erlotinib hydrochloride
Follow the oncology team's instructions and check the dispensing label. Food can increase erlotinib exposure.
Swallow the film-coated tablet as directed.
Take it at least one hour before or two hours after food.
Do not change or stop treatment without discussing it with the oncology team.
Tell the team about swallowing difficulties, lactose intolerance and all prescribed, non-prescribed or herbal products.
erlotinib hydrochloride side effects
Common or expected effects
- Acne-like or itchy rash, which may worsen on sun-exposed skin
- Diarrhoea, nausea, vomiting or abdominal discomfort
- Reduced appetite and weight loss
- Sore mouth
- Dry or irritated eyes
- Tiredness, headache or fever
- Abnormal liver blood tests
- Dry skin, nail-fold inflammation or hair changes
Get urgent medical advice
- New or worsening breathlessness, cough or fever, which may indicate interstitial lung disease
- Severe or persistent diarrhoea or vomiting causing dehydration, electrolyte disturbance or kidney injury
- Severe abdominal pain, which may indicate gastrointestinal perforation
- Painful red eyes, light sensitivity, excessive watering or blurred vision
- Jaundice, dark urine or other signs of liver injury
- Severe blistering, peeling or widespread painful skin
- Bleeding, particularly with warfarin or a related anticoagulant
erlotinib hydrochloride in pregnancy
Human pregnancy data are inadequate, and harm cannot be excluded. Pregnancy should be avoided during treatment and for at least two weeks afterwards. Contact the oncology team promptly if pregnant, planning pregnancy or pregnancy occurs.
erlotinib hydrochloride while breastfeeding
It is unknown whether erlotinib enters human milk, and potential harm to a breastfed child cannot be excluded. Breastfeeding is not advised during treatment or for at least two weeks after the final tablet.
erlotinib hydrochloride interactions
A full medicines review is essential because erlotinib exposure and toxicity can be altered substantially.
Proton-pump inhibitors, such as omeprazole
Reduced stomach acidity can markedly reduce erlotinib absorption; combined use should generally be avoided.
H2-receptor antagonists and antacids
These may reduce absorption; discuss alternatives or carefully planned separation with the oncology pharmacist.
Strong CYP3A4 inhibitors, including some azole antifungals and macrolide antibiotics
They may increase erlotinib exposure and toxicity.
Common questions about erlotinib hydrochloride
Answers are fully visible for fast scanning and source review.
Why is EGFR testing needed?
For first-line or maintenance treatment of advanced non-small-cell lung cancer, an activating EGFR mutation identifies tumours most likely to respond. A negative plasma test may require confirmation using tumour tissue where possible.
Can erlotinib be taken with food?
No. Food can increase erlotinib exposure, so take the tablet at least one hour before or two hours after eating.
Why should smoking be avoided?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.