Erlotinib: Uses, Dosage, Side Effects, Precautions and Price in India

Erlotinib is a targeted cancer medicine (EGFR tyrosine kinase inhibitor) used for advanced non-small cell lung cancer with specific EGFR mutations and, together with gemcitabine, for advanced pancreatic cancer. This guide covers erlotinib uses, how it works, dosage, side effects, precautions, drug interactions, use in pregnancy and breastfeeding, brand names and its approximate price in India.

What is Erlotinib?

Erlotinib is a targeted therapy used to treat non-small cell lung cancer (NSCLC) and pancreatic cancer. It blocks the EGFR (epidermal growth factor receptor), which helps some cancer cells survive and multiply. It is not a traditional chemotherapy drug.

How Erlotinib Works

Erlotinib inhibits EGFR signalling inside cancer cells. This helps slow the growth and division of cancer cells and slows tumour progression.

When is Erlotinib Used?

• Lung cancer: Used for metastatic non-small cell lung cancer whose tumour has certain EGFR mutations (exon 19 deletions or exon 21 L858R). A test on tumour or blood samples is done first to check for these mutations.
• Pancreatic cancer: Used for advanced pancreatic cancer (unresectable or metastatic), together with the chemotherapy medicine gemcitabine.

Erlotinib is not suitable for every person with lung or pancreatic cancer. Your oncologist decides whether it is appropriate for you.

Erlotinib Dosage in Adults

The doses below are general reference only. Take erlotinib only as prescribed by your doctor.

• NSCLC: 150 mg once a day.
• Pancreatic cancer: 100 mg once a day, along with gemcitabine.

Erlotinib is taken on an empty stomach, at least one hour before or two hours after food. Treatment generally continues until the disease progresses or side effects become unacceptable. The doctor may change the dose depending on side effects, other medicines and whether the person smokes.

Take this medicine only as advised by your oncologist. Do not start, stop, or change the dose on your own.

Use in Children

The safety and effectiveness of erlotinib have not been established in children and adolescents.

Side Effects of Erlotinib

Common: Rash, diarrhoea, loss of appetite, fatigue, nausea, vomiting, cough and breathlessness. The rash can worsen in sun-exposed areas, so protective clothing and sunscreen may help. Hair thinning and changes in nails or eyelashes can also occur.

Serious (seek medical help promptly):

• Lung problems: New or worsening breathlessness, cough or fever can be signs of interstitial lung disease, which can be serious.
• Severe or persistent diarrhoea: This can cause dehydration and may lead to kidney problems. Contact your doctor early, and seek urgent care if you are unable to keep fluids down or feel very weak or dizzy.
• Liver problems: Serious liver injury can occur, including in people with no previous liver disease. Report any signs of liver problems to your doctor immediately.
• Severe skin reactions: Severe blistering or peeling of the skin.
• Severe abdominal pain: This can be a sign of a hole (perforation) in the stomach or intestine.
• Eye problems: Eye pain, redness, light sensitivity, watering or changes in vision.

Erlotinib Precautions and Monitoring

Do not take erlotinib if you are allergic to it or to any of its ingredients.

Liver monitoring: Your doctor will check liver function tests periodically during treatment, and more often if you have existing liver problems or a blocked bile duct. Treatment may be paused or stopped if liver tests become severely abnormal.

Kidney and hydration: Your doctor may check kidney function and blood salts (electrolytes), especially if you are at risk of dehydration.

Tell your doctor if you have liver problems, kidney problems, a history of stomach ulcers or diverticular disease, or eye problems, including dry eye or contact lens use.

Erlotinib Drug Interactions

Other medicines and habits can change how much erlotinib your body absorbs or how long it stays active. Do not stop or add any medicine on your own.

• Medicines that can increase erlotinib levels (CYP3A4 inhibitors): For example, ketoconazole, itraconazole, clarithromycin, and grapefruit or grapefruit juice. These are usually avoided. If they cannot be avoided, your doctor may adjust the erlotinib dose.
• Medicines that can lower erlotinib levels (CYP3A4 inducers): For example, rifampicin, phenytoin, carbamazepine and phenobarbital, and the herbal product St. John’s wort. These are usually avoided because they may make erlotinib less effective.
• Cigarette smoking: Smoking lowers erlotinib levels in the blood and may reduce its effect. Tell your oncologist if you smoke or if your smoking status changes.
• Acid-reducing medicines:
  • Proton pump inhibitors (PPIs) such as omeprazole can substantially reduce erlotinib absorption and are generally avoided.
  • H2 blockers (such as ranitidine or famotidine) and antacids can also reduce absorption. If one is needed, your oncologist or pharmacist will advise how to time it around erlotinib.
• Warfarin and similar blood thinners: Erlotinib can raise INR and increase the risk of bleeding. Regular INR monitoring is needed.

Tell your doctor or pharmacist about all prescription medicines, over-the-counter medicines, supplements and herbal products you use. This list is not complete.

Erlotinib in Pregnancy and Breastfeeding

Erlotinib can harm an unborn baby. Women who can become pregnant should use effective contraception during treatment and for 1 month after the final dose, and should tell their doctor right away if they are or may be pregnant.

Breastfeeding is not advised during treatment and for 2 weeks after the final dose.

Erlotinib Brands in India

Tarceva, Zyceva, Erlonat and Erlotero are among the erlotinib brands sold in India. Other brands are also available, so this is not a complete list. Availability can vary by pharmacy, so confirm with your pharmacist or doctor.

Erlotinib Price in India

Prices below are approximate and are based on online pharmacy listings. Branded Tarceva costs far more than Indian generic brands, so each is listed separately.

Prices vary by brand, strength, pack size, pharmacy, city or location, and discounts. Always check the current price with your pharmacy. Some patient support or assistance programmes may be available for certain brands, so ask your doctor.

How HealthPil Can Help

Medicines should be started, adjusted, or stopped only under the guidance of a qualified healthcare professional. If you have questions about erlotinib, its side effects, or your treatment plan, you can consult an oncologist through HealthPil.

You can consult a doctor online with HealthPil before starting, stopping or changing this medicine.