Neratinib (oral route)
Available brands
Nerlynx
About this medication
Neratinib is used to treat patients with HER2-overexpressed or amplified breast cancer that has been previously treated with trastuzumab. Neratinib is also used in combination with capecitabine to treat advanced or metastatic HER2-positive breast cancer (breast cancer that has already spread) in patients who have received two or more anti-HER2 based regimens. It belongs to the group of medicines, called antineoplastics. Neratinib interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal cells may also be affected by the medicine, other unwanted effects will also occur. Some of these may be serious and must be reported to your doctor. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms:
Before using this medication
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Appropriate studies have not been performed on the relationship of age to the effects of neratinib in the pediatric population. Safety and efficacy have not been established. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of neratinib in the elderly. However, elderly patients are more likely to have serious unwanted effects (including kidney problems, vomiting, diarrhea, and dehydration), which may require caution in patients receiving this medicine. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
How to use this medication
Medicines used to treat cancer are very strong and can have many side effects. Before using this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment. Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. This medicine comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have any questions. Full Dose:You will be given medicines to help prevent diarrhea (including loperamide) during your first dose of neratinib. Continue taking these medicines for 2 cycles (56 days) of treatment with neratinib. Keep the number of your bowel movements at 1 to 2 per day and take anti-diarrhea medicines only as directed by your doctor. Lower starting dose:Your doctor may also give you a lower starting dose for the first 2 weeks of treatment and then increase you to a full dose to help prevent diarrhea. Swallow the tablet whole. Do not crush, break, or chew it. Take the medicine with food and at the same time each day. If you are also using an antacid, take it 3 hours before using neratinib. Take neratinib at least 2 hours before or 10 hours after an H2 blocker (eg, ranitidine). Do not eat grapefruit or drink grapefruit juice while you are using this medicine. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use.
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