Afatinib


What is Afatinib?

Afatinib is a medication used for non-small cell lung cancer that has metastasized outside the lungs and that has certain EGFR mutations as per specified testing. The trade name for Afatinib is Gilotrif. Afatinib is a tyrosine kinase inhibitor, an epidermal growth factor receptor (EGFR) inhibitor.

This medication can be used by patients that have not been treated previously for metastases or by patients that have a metastasized squamous type of cancer and have already tried chemotherapy that contained platinum.

Afatinib attaches to the EGFR molecules and blocks the cancer causing proteins and discourages the cancer from growing. EGFR positive means that the cancer has the EGFR receptors. About 10 to 15 % of people with non-small cell lung cancer have EGFR positive cancer.

The doctor needs to check for these receptors before choosing Afatinib as a treatment. Afatinib may shrink the cancer or slow down its growth for a while. [1, 2, 3, 4]

Afatinib Medicines

Taking Afatinib

Afatinib is available in tablet form. There are different strengths of the oral tablet. Patients take this medication once a day on an empty stomach, at least one hour before the patient eats or two hours after the patient eats. If a dose is missed, the patient is to take it as soon as remembered.


If the next dose was supposed to be within twelve hours, they should skip that dose and start taking them again at the regular time. Patients are not to take two doses at once. If a patient takes too much Afatinib, they need to go to the hospital at once.

Tips for Patients:


  • Limit time in the sun, people could get severe sun burns
  • This medication can make skin sensitive to the sun, wear sun screen, clothes to cover the skin and a hat
  • Some people get worsening acne or skin rashes
  • Take the medication as prescribed
  • Swallow the medication whole with water
  • Take the medication at the same time everyday
  • Don’t take this medication with food
  • Don’t change the dose or stop taking the medication unless your doctor says so
  • Store the medication between 20-25 C or 68-77 F
  • Keep the container closed tight in the original bottle
  • Store away from light and moisture
  • Safely throw away any un-used or expired medication [1, 2, 3]

Side Effects

Very Common and Common Side Effects

  • Diarrhea
  • Skin rash
  • Mouth sores or ulcers
  • Nail infections, nails can also change color/shape
  • Itchy skin, dry skin, blistering skin
  • Loss of appetite
  • Nose bleeds
  • Swollen lips and mouth
  • Weight loss
  • Skin conditions resembling acne and actual acne
  • Nausea and vomiting
  • Dehydration
  • Taste changes
  • Dry eyes, pink eye infection
  • Urinary tract infections
  • Fever
  • Runny nose
  • Low potassium levels
  • Increased AST and ALT levels
  • Hand foot syndrome
  • Muscle spasms
  • Sore, red and peeling skin to palms and soles
  • Stomach pain and indigestion

Afatinibr nose bleed

Serious Side Effects

  • Kidney failure or impairment
  • Liver problems leading to yellowing of the eyes/skin, dark urine, abdominal pain, easy bruising and fatigue that can cause possible death
  • Blurry vision, eye pain, light sensitivity and changes in vision
  • Shortness of breath, cough, fatigue, swelling, heart palpitations and sudden weight change, all can be caused by heart problems

Uncommon Side Effects

  • Inflammation of the cornea (eye pain and redness)
  • Lung disease leading to trouble breathing, cough and fever that can cause possible death

Call a doctor immediately if these symptoms occur:


  • Fever of 100 F / 38 C of higher and chills
  • Shortness of breath, cough or trouble breathing
  • Chest pain or palpitations

The following symptoms require medical attention within 24 hours:

  • Diarrhea (4-6 episodes in 24 hours)
  • Nausea that interferes with eating/unrelieved with medications
  • Vomiting (more than 4-5 times in 24 hours)
  • Unable to eat/drink for 24 hours and have signs of dehydration
  • Yellow skin or eyes
  • Dark urine
  • Decreased appetite
  • Abdominal pain
  • Easy bruising
  • Skin or nail changes
  • Cough
  • Mouth sores
  • Pain or burning urination
  • Eye changes
  • Extreme fatigue
  • Swelling in the legs, feet or ankles
  • Sudden weight gain [1, 2, 3, 4]

Afatinib yellow eye disease

Precautions

Patients must tell their doctor if they already have kidney problems, liver problems, breathing/lung problems other than from cancer, history of very dry eyes/other eye problems/if they wear contact lenses, heart problems, other medical conditions, are pregnant or plan to become pregnant or are breast feeding.

Before taking Afatinib, the patient must tell the doctor about the other medications they are taking to prevent interactions. While taking this medication, the patient should not get any immunizations without their doctor’s approval. Patients need to limit time in the sun, use sun screen, wear clothes that cover the skin and wear a hat.

Patients must tell their doctor if they are pregnant or if they may be pregnant. This medication is a class D pregnancy drug that means it can cause severe harm to a fetus. Male and female patients need to use contraception to avoid pregnancies while using this medication. Patients should not breast feed while on this medication to avoid passing the medication to the baby through the breast milk. [1, 2, 3]

Tips

  • Drink plenty of water daily
  • Wash hands before and after taking the medication
  • Avoid crowds and sick people to avoid infections
  • Use a soft toothbrush and frequently rinse the mouth to minimize bleeding and to prevent mouth sores
  • Use an electric razor for shaving to minimize bleeding
  • Avoid contact sports/activities that could cause injuries
  • Take prescribed anti-nausea medications and eat small frequent meals
  • Eat foods that help lessen diarrhea, follow prescribed anti-diarrhea medicine regimens
  • Avoid sun exposure
  • Alcohol consumption minimal or not at all
  • Good rest
  • Proper nutrition
  • Discuss side effects with doctor or pharmacist [1, 2, 3]

Reference List:

  1. Cancer Research UK, Available from: http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/cancer-drugs/afatinib
  2. Chemocare, Available from: http://chemocare.com/chemotherapy/drug-info/afatinib.aspx
  3. Gilotrif.com, Available from: http://www.gilotrif.com/
  4. Wikipedia, Available from: https://en.wikipedia.org/wiki/Afatinib
  5. MPR, Available from: http://www.empr.com/gilotrif/drug/22862/
  6. Netdoctor, Available from: http://www.netdoctor.co.uk/conditions/heart-and-blood/a1154/nosebleeds-epistaxis/
  7. Noksid, Available from: http://noksid.net/jaundice-yellow-skin-and-eyes.html

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