Erlotinib (patient information)

# About your treatment
Your doctor has ordered erlotinib to help treat your illness. Erlotinib comes as a tablet to take by mouth. It is usually taken once a day on an empty stomach. Take erlotinib at least 1 hour before or 2 hours after you eat a meal or snack. To help you remember to take erlotinib, take it at around the same time every day.
Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain anything you do not understand. Take erlotinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Do not stop taking erlotinib without talking to your doctor.
This medication is used to treat non-small cell lung cancer (a type of cancer that begins in the lungs) in patients who have already been treated with at least one other chemotherapy medication and have not gotten better.
Erlotinib is in a class of drugs known as Human Epidermal Growth Factor Receptor Type 1/Epidermal Growth Factor Receptor (HER1/EGFR) tyrosine kinase inhibitors. It slows the growth of cancer cells. The length of your treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have. Be sure to tell your doctor how you are feeling during your treatment.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Precautions
Before taking erlotinib:
- tell your doctor and pharmacist if you are allergic to erlotinib or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); anticoagulants ('blood thinners') such as warfarin (Coumadin); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); aspirin and other non-steroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); carbamazepine (Tegretol); cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); danazol (Danocrine); delavirdine (Rescriptor); dexamethasone (Decadron); diltiazem (Cardizem, Dilacor, Tiazac); erythromycin (E.E.S., E-Mycin, Erythrocin); ethosuximide (Zarontin); fluvoxamine (Luvox); HIV protease inhibitors such as atazanavir (Reyataz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Fortovase, Invirase); isoniazid (INH, Nydrazid); metronidazole (Flagyl); nefazodone; oral contraceptives (birth control pills); other chemotherapy drugs, especially carboplatin (Paraplatin), cisplatin (Platinol-AQ), gemcitabine (Gemzar), and paclitaxel (Onxol, Taxol); phenobarbital (Luminal, Solfoton); phenytoin (Dilantin); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane); telithromycin (Ketek); troglitazone (Rezulin); troleandomycin (TAO);; voriconazole (Vfend); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor what herbal products you are taking, especially St. John's wort.
- tell your doctor if you have ever been treated with radiation therapy (treatment for cancer that uses waves of high energy particles to kill cancer cells) and if you have or have ever had any medical condition, especially any type of lung disease other than lung cancer, cancer that began in another part of your body but has spread to your lungs, and liver or kidney disease.
- tell your doctor if you are pregnant. You should not plan to have children while receiving chemotherapy or for a while after treatments. Use a reliable method of birth control to prevent pregnancy during your treatment and for at least 2 weeks after you stop taking erlotinib. Talk to your doctor for further details. Erlotinib may harm the fetus.
- tell your doctor if you are breastfeeding. You should not breastfeed while you are taking erlotinib.
- tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.

# Side effects

## Minor side effects
Erlotinib may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- diarrhea
- nausea
- vomiting
- stomach pain
- loss of appetite
- mouth sores
- itching
- dry skin
- tiredness

## Severe side effects
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- rash
- new or worsening shortness of breath, cough, or fever
- sore throat, chills and other signs of infection
- unusual bruising or bleeding
- black and tarry stools
- red blood in stools
- bloody vomit
- vomiting material that looks like coffee grounds
- dry, red, or irritated eyes
- sunken eyes
- dry mouth
- decreased urination
- lack of energy
Erlotinib may cause other side effects. Call your doctor if you have any unusual problems while taking this drug.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions
Keep erlotinib in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- diarrhea
- rash

# Special instructions
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to erlotinib.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Tarceva