natgillin/translations-raw huggingface dataset:
In Study A2301, 44 patients with measurable brain metastasis at baseline and at least one post-baseline brain radiological assessment (22 patients in the ceritinib arm and 22 patients in the chemotherapy arm) were assessed for intracranial response by BIRC neuro-radiologist per modified RECIST 1.1 (i.e. 
U ispitivanju A2301, u 44 bolesnika s mjerljivim metastazama na mozgu na početku i najmanje jednom radiološkom pretragom mozga nakon početka ispitivanja (22 bolesnika u ceritinib skupini i 22 bolesnika u kemoterapijskoj skupini) BIRC-ov neuroradiolog ocijenio je intrakranijalni odgovor prema modificiranim kriterijima RECIST 1.1 (tj. do 5 lezija na mozgu).
Tumour responses (based on BIRC) Objective response rate (95% CI) Duration of response Number of responders Median, months d 
Tumorski odgovori (prema BIRC-u) Stopa objektivnog odgovora (95% CI) Trajanje odgovora Broj bolesnika s odgovorom Medijan, mjeseci d
Zykadia should be permanently discontinued in patients who develop QTc >500 msec or >60 msec change from baseline and torsade de pointes or polymorphic ventricular tachycardia or signs/symptoms of serious arrhythmia. 
Primjena Zykadie mora se trajno prekinuti u bolesnika u kojih dođe do QTc-a >500 msek ili do promjene >60 msek u odnosu na početnu vrijednosti te torsade de pointes ili polimorfne ventrikularne tahikardije ili znakova/simptoma ozbiljne aritmije.
Hazard Ratio = 0.73 95% CI (0.50, 1.08) 
Omjer hazarda = 0,73 95% CI (0,50; 1,08)
Severe, life-threatening or fatal ILD/pneumonitis have been observed in patients treated with ceritinib in clinical studies. 
Teški, po život opasni ili smrtonosni IBP/pneumonitis uočeni su u bolesnika liječenih ceritinibom u kliničkim ispitivanjima.
Therefore, no dose adjustment is necessary in patients with mild to moderate renal impairment. 
Stoga nije potrebno prilagođavanje doze u bolesnika s blagim do umjerenim oštećenjem bubrega.
Hyperglycaemia (all grades) was reported in 9.4% of patients treated with ceritinib across the seven clinical studies; grade 3 or 4 events were reported in 5.4% of patients. 
Hiperglikemija (svih stupnjeva) bila je prijavljena u 9,4% bolesnika liječenih ceritinibom u sedam kliničkih ispitivanja; događaji stupnja 3 ili 4 bili su prijavljeni u 5,4% bolesnika.
Co-administration of a single 750 mg fasted ceritinib dose with a proton pump inhibitor (esomeprazole) 40 mg daily for 6 days in healthy, fasting subjects decreased ceritinib AUC by 76% and Cmax by 79%. 
Istodobna primjena jednokratne doze ceritiniba od 750 mg natašte s inhibitorom protonske pumpe (esomeprazolom) u dozi od 40 mg dnevno natašte tijekom 6 dana u zdravih ispitanika smanjila je AUC ceritiniba za 76% i Cmax za 79%.
The median age was 51 years (range: 29-80 years); 87.1% of patients were younger than 65 years and 50.0% were female. 
Medijan dobi bio je 51 godina (raspon: 29-80 godina); 87,1% bolesnika bilo je mlađe od 65 godina, a 50,0% bolesnika bilo je ženskog spola.
16.7 (14.8, NE) 
16,7 (14,8; NP)
Agents whose plasma concentration may be altered by ceritinib 
Tvari čiju koncentraciju u plazmi ceritinib može promijeniti
In the dose optimisation study A2112 (ASCEND-8) in both previously treated and untreated patients with ALK-positive advanced NSCLC at the recommended dose of ceritinib 450 mg taken with food (N=89), adverse events of diarrhoea, nausea and vomiting were mainly grade 1 (49.4%). 
U ispitivanju optimizacije doze A2112 (ASCEND-8) u prethodno liječenih i neliječenih bolesnika s ALK-pozitivnim uznapredovalim NSCLC-om pri preporučenoj dozi ceritiniba od 450 mg uzetoj uz hranu (N=89), štetni događaji proljeva, mučnine i povraćanja bili su većinom stupnja 1 (49,4%).
What Zykadia is 
Što je Zykadia
QTc prolongation has been observed in patients treated with ceritinib. 
Produljenje QTc-a uočeno je u bolesnika liječenih ceritinibom.
If the concomitant medicinal product can be adjusted or discontinued, Zykadia should be reinitiated with dose reduced by 150 mg on recovery to asymptomatic bradycardia or to a heart rate of 60 bpm or above, with frequent monitoring (see sections 4.2 and 4.8). 
Ako se primjena istodobno primijenjenog lijeka može prilagoditi ili prekinuti, treba ponovo započeti primjenu Zykadie dozom smanjenom za 150 mg nakon oporavka do asimptomatske bradikardije ili do srčane frekvencije od 60 otkucaja u minuti ili više, uz učestalo praćenje (vidjeti dijelove 4.2 i 4.8).
Hepatotoxicity i 
Hepatotoksičnost i
chest pain or discomfort, changes in your heartbeat (fast or slow), light-headedness, fainting, dizziness, blue discoloration of your lips, shortness of breath, swelling of your lower limbs or skin. 
To mogu biti simptomi problema s plućima. bol ili nelagoda u prsnom košu, promjene u otkucajima srca (ubrzani ili usporeni), ošamućenost, nesvjestica, omaglica, plave usnice, nedostatak zraka, oticanje donjih udova ili kože.
Withhold Zykadia until recovery to baseline or to a QTc ≤480 msec, check and if necessary correct electrolytes, then reinitiate with dose reduced by 150 mg. 
Privremeno prekinuti primjenu Zykadie do oporavka na početnu vrijednost ili do QTc-a ≤480 msec, provjeriti te po potrebi korigirati elektrolite, zatim ponovno započeti primjenu dozom smanjenom za 150 mg.
Particular caution should be exercised when treating patients with severe hepatic impairment, and the dose should be adjusted (see section 4.2). 
Potreban je poseban oprez kod liječenja bolesnika s teškim oštećenjem jetre te prilagodba doze (vidjeti dio 4.2).
Co-administration of a single dose of midazolam (a sensitive CYP3A substrate) following 3 weeks of ceritinib dosing in patients (750 mg daily fasted) increased the midazolam AUCinf (90% CI) by 5.4-fold (4.6, 6.3) compared to midazolam alone. 
Istodobna primjena jednokratne doze midazolama (osjetljivog CYP3A supstrata) nakon 3 tjedna primjene ceritiniba u bolesnika (750 mg dnevno natašte) povećala je AUCinf (90% CI) midazolama za 5,4-puta (4,6; 6,3) u usporedbi sa samim midazolamom.
Patients should be monitored for fasting plasma glucose prior to the start of Zykadia treatment and periodically thereafter as clinically indicated. 
U bolesnika je potrebno pratiti glukozu u plazmi natašte prije početka liječenja Zykadiom te periodički nakon toga prema kliničkim indikacijama.
Zykadia 150 mg hard capsules 
Zykadia 150 mg tvrde kapsule
In a dose optimisation study A2112 (ASCEND-8) in patients comparing Zykadia 450 mg or 600 mg daily with food (approximately 100 to 500 kcalories and 1.5 to 15 grams of fat) to 750 mg daily under fasted conditions (dose and food condition of administration initially authorised), there was no clinically meaningful difference in the systemic steady-state exposure of ceritinib for the 450 mg with food arm (N=36) compared to the 750 mg fasted arm (N=31), with only small increases in steady-state AUC (90% CI) by 4% (-13%, 24%) and Cmax (90% CI) by 3% (-14%, 22%). 
U ispitivanju optimizacije doze A2112 (ASCEND-8) u bolesnika koje je uspoređivalo Zykadiu 450 mg ili 600 mg dnevno uz hranu (približno 100 do 500 kilokalorija i 1,5 do 15 grama masti) s 750 mg dnevno natašte (doza i uvjeti primjene s hranom prema inicijalnom odobrenju), nije bilo klinički značajne razlike u sistemskoj izloženosti ceritinibu u stanju dinamičke ravnoteže za skupinu koja je primala 450 mg uz hranu (N=36) u usporedbi sa skupinom koja je primala 750 mg natašte (N=31), sa samo malim porastima AUC-a u stanju dinamičke ravnoteže (90% CI) za 4% (-13%, 24%) i Cmax-a (90% CI) za 3% (-14%, 22%).
OS rate at 24 months d, % (95% CI) 
Stopa OS-a nakon 24 mjeseca d, % (95%
The incidence and severity of gastrointestinal adverse drug reactions were reduced for patients treated with Zykadia 450 mg with food (diarrhoea 56%, nausea 45%, vomiting 35%; 1.1% reported a grade 3/4 event) compared to 750 mg fasted (diarrhoea 76%, nausea 50%, vomiting 56%; 12% reported a grade 3/4 event). 
Incidencija i težina gastrointestinalnih nuspojava bila je smanjena u bolesnika liječenih Zykadiom 450 mg uz hranu (proljev 56%, mučnina 45%, povraćanje 35%; 1,1% prijavljenih događaja stupnja 3/4) u usporedbi s 750 mg natašte (proljev 76%, mučnina 50%, povraćanje 56%; 12% prijavljenih događaja stupnja 3/4).
The geometric mean AUCinf (unbound AUCinf) of ceritinib was increased by 18% (35%) and 2% (22%) in subjects with mild and moderate hepatic impairment, respectively, compared to subjects with normal hepatic function. 
Geometrijska srednja vrijednost AUCinf (nevezani AUCinf) ceritiniba bila je povećana za 18% (35%) u ispitanika s blagim, odnosno 2% (22%) u ispitanika s umjerenim oštećenjem jetre, u usporedbi s ispitanicima s normalnom jetrenom funkcijom.
Zykadia as monotherapy is indicated for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously treated with crizotinib. 
Zykadia je kao monoterapija indicirana za liječenje odraslih bolesnika s uznapredovalim rakom pluća nemalih stanica (engl. non-small cell lung cancer, NSCLC) pozitivnim na kinazu anaplastičnog limfoma (engl. anaplastic lymphoma kinase, ALK) koji su prethodno liječeni krizotinibom.
How to take Zykadia 
Kako uzimati Zykadiu
A dedicated pharmacokinetic study in patients with renal impairment has not been conducted. 
Posebno farmakokinetičko ispitivanje u bolesnika s oštećenjem bubrega nije provedeno.
What Zykadia looks like and contents of the pack Zykadia hard capsules have a white opaque body and blue opaque cap, with “LDK 150MG” imprinted on the cap and “NVR” on the body. 
Zykadia tvrde kapsule imaju bijelo neprozirno tijelo i plavu neprozirnu kapicu, s oznakom „LDK 150MG“ otisnutom na kapici i „NVR“ na tijelu.
The incidence and severity of gastrointestinal adverse drug reactions were higher for patients treated with Zykadia 750 mg fasted (diarrhoea 76%, nausea 50%, vomiting 56%; 12% reported a grade 3/4 event) compared to 450 mg with food (diarrhoea 56%, nausea 45%, vomiting 35%; 1.1% reported a grade 3/4 event). 
Incidencija i težina gastrointestinalnih nuspojava bila je viša u bolesnika liječenih Zykadiom 750 mg natašte (proljev 76%, mučnina 50%, povraćanje 56%; 12% prijavljenih događaja stupnja 3/4) u usporedbi s 450 mg uz hranu (proljev 56%, mučnina 45%, povraćanje 35%; 1,1% prijavljenih događaja stupnja 3/4).
In the event of life-threatening bradycardia Zykadia should be permanently discontinued if no contributing concomitant medicinal product is identified; however, if associated with a concomitant medicinal product known to cause bradycardia or hypotension, Zykadia should be withheld until recovery to asymptomatic bradycardia or to a heart rate of 60 bpm or above. 
U slučaju bradikardije opasne po život, potrebno je trajno prekinuti primjenu Zykadie ako se ne identificira nijedan istodobno primijenjeni lijek koji doprinosi bradikardiji: međutim, ako je povezana s istodobno primijenjenim lijekom za koji je poznato da uzrokuje bradikardiju ili hipotenziju, primjenu Zykadie treba privremeno prekinuti do oporavka do asimptomatske bradikardije ili do srčane frekvencije od 60 otkucaja u minuti ili više.
The median age was 54 years (range: 22 to 81 years); 78.5% of patients were younger than 65 years. 
Medijan dobi bio je 54 godine (raspon: 22 do 81 godina); 78,5% bolesnika bilo je mlađe od 65 godina.
Zykadia as monotherapy is indicated for the first-line treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC). 
Zykadia je kao monoterapija indicirana za prvu liniju liječenja odraslih bolesnika s uznapredovalim rakom pluća nemalih stanica (engl. non-small cell lung cancer, NSCLC) pozitivnim na kinazu anaplastičnog limfoma (engl. anaplastic lymphoma kinase, ALK).
Progression-free survival (based on BIRC) Number of events, n (%) Median, months d 
Preživljenje bez progresije (prema BIRC-u) Broj događaja, n (%)
Tumour response (based on BIRC) Overall response rate (95% CI) Duration of response (based on BIRC) Number of responders Median, months d 
Tumorski odgovor (prema BIRC-u) Stopa ukupnog odgovora (95% CI) Trajanje odgovora (prema BIRC-u) Broj bolesnika s odgovorom Medijan, mjeseci d
If unavoidable, dose reduction for co-administered medicinal products that are CYP2C9 substrates with narrow therapeutic indices should be considered. 
Ako nije moguće, potrebno je razmotriti smanjenje doze istodobno primjenjenih lijekova koji su CYP2C9 supstrati s uskim terapijskim indeksom.
- If your next dose is in less than 12 hours, skip the missed capsules. 
Ako sljedeću dozu morate uzeti za manje od 12 sati, preskočite propuštene kapsule.
Zykadia 150 mg hard capsules ceritinib 
Zykadia 150 mg tvrde kapsule ceritinib
Time-dependent inhibition of CYP3A was also observed. 
Bila je uočena i inhibicija CYP3A ovisna o vremenu.
Interstitial lung disease/Pneumonitis 
Intersticijska bolest pluća/Pneumonitis
Table 3 ASCEND-4 (Study A2301) - Efficacy results in patients with previously untreated ALK-positive advanced NSCLC 
Tablica 3 ASCEND-4 (ispitivanje A2301) - Rezultati za djelotvornost u bolesnika s prethodno neliječenim ALK-pozitivnim uznapredovalim NSCLC-om
Agents that may increase ceritinib plasma concentrations 
Tvari koje mogu povećati koncentracije ceritiniba u plazmi
Hepatobiliary disorders Abnormal liver function tests h 
Poremećaji jetre i žuči Poremećeni testovi jetrene funkcije h
In healthy subjects, co-administration of a single 450 mg fasted ceritinib dose with ketoconazole (200 mg twice daily for 14 days), a strong CYP3A/P-gp inhibitor, resulted in 2.9-fold and 1.2-fold increase in ceritinib AUCinf and Cmax, respectively, compared to when ceritinib was given alone. 
U zdravih ispitanika, istodobna primjena jednokratne doze ceritiniba od 450 mg natašte s ketokonazolom (200 mg dvaput na dan tijekom 14 dana), snažnim CYP3A/P-gp inhibitorom, rezultirala je povećanjem od 2,9 puta u AUCinf te od 1,2 puta u Cmax ceritiniba, u usporedbi s primjenom samog ceritiniba.
Nausea e 
Mučnina e
Zykadia 150 mg tablets ceritinib 
Zykadia 150 mg tablete ceritinib
Kaplan-Meier medians (95% CI) (Months) Ceritinib 750 mg: 5.4 (4.1;6.9) Chemotherapy: 1.6 (1.4;2.8) 
Kaplan-Meierovi medijani (95% CI) (mjeseci) Ceritinib 750 mg: 5,4 (4,1;6,9) Kemoterapija: 1,6 (1,4;2,8)
Co-administration of ceritinib with substrates primarily metabolised by CYP3A or CYP3A substrates known to have narrow therapeutic indices (e.g. alfuzosin, amiodarone, cisapride, ciclosporin, dihydroergotamine, ergotamine, fentanyl, pimozide, quetiapine, quinidine, lovastatin, simvastatin, sildenafil, midazolam, triazolam, tacrolimus, alfentanil and sirolimus) should be avoided and alternative medicinal products that are less sensitive to CYP3A4 inhibition should be used if possible. 
Istodobnu primjenu ceritiniba sa supstratima koji se primarno metaboliziraju putem CYP3A ili CYP3A supstratima za koje je poznato da imaju uski terapijski indeks (npr. alfuzosin, amiodaron, cisaprid, ciklosporin, dihidroergotamin, ergotamin, fentanil, pimozid, kvetiapin, kinidin, lovastatin, simvastatin, sildenafil, midazolam, triazolam, takrolimus, alfentanil i sirolimus) treba izbjegavati i ako je moguće, treba primjenjivati druge lijekove koji su manje osjetljivi na CYP3A4 inhibiciju.
Withhold Zykadia until lipase or amylase returns to grade ≤1, then reinitiate with dose reduced by 150 mg. 
Privremeno prekinuti primjenu Zykadie do povratka lipaze ili amilaze na stupanj ≤1, zatim ponovno započeti primjenu Zykadie dozom smanjenom za 150 mg.
Administration of anti-hyperglycaemic medicinal products should be initiated or optimised as indicated (see sections 4.2 and 4.4). 
Primjenu antidijabetika treba započeti ili optimizirati prema indikacijama (vidjeti dijelove 4.2 i 4.4).
No efficacy data are available in patients over 85 years of age. 
Nema dostupnih podataka o djelotvornosti u bolesnika starijih od 85 godina.
In the dose optimisation study A2112 (ASCEND-8) in both previously treated and untreated patients with ALK-positive advanced NSCLC, the overall safety profile of Zykadia at the recommended dose of 450 mg with food (N=89) was consistent with Zykadia 750 mg fasted (N=90), except for a reduction in gastrointestinal adverse drug reactions, while achieving comparable steady-state exposure (see section 5.1 and subsection ‘Gastrointestinal adverse reactions' below). 
U ispitivanju optimizacije doze A2112 (ASCEND-8) u prethodno liječenih i neliječenih bolesnika s ALK-pozitivnim uznapredovalim NSCLC-om, ukupni sigurnosni profil Zykadie pri preporučenoj dozi od 450 mg uz hranu (N=89) bio je u skladu sa Zykadiom od 750 mg natašte (N=90), osim za smanjenje u gastrointestinalnim nuspojavama, za vrijeme postizanja usporedive izloženosti u stanju dinamičke ravnoteže (vidjeti dio 5.1 i pododjeljak „Gastrointestinalne nuspojave“ ispod).
Co-administration of a single dose of warfarin (a CYP2C9 substrate) following 3 weeks of ceritinib dosing in patients (750 mg daily fasted) increased the S-warfarin AUCinf (90% CI) by 54% (36%, 75%) compared to warfarin alone. 
Istodobna primjena jednokratne doze varfarina (CYP2C9 supstrata) nakon 3 tjedna primjene ceritiniba u bolesnika (750 mg dnevno natašte) povećala je AUCinf (90% CI) S-varfarina za 54% (36%, 75%) u usporedbi sa samim varfarinom.
Table 4 ASCEND-5 (Study A2303) - Efficacy results in patients with previously treated ALK-positive metastatic/advanced NSCLC 
Tablica 4 ASCEND-5 (Ispitivanje A2303) - Rezultati za djelotvornost u bolesnika s prethodno liječenim ALK-pozitivnim metastatskim/uznapredovalim NSCLC-om
If these side effects become severe, please tell your doctor or pharmacist. 
Ako te nuspojave postanu teške, obratite se svom liječniku ili ljekarniku.
However, the risk for a clinically relevant decrease in bioavailability of ceritinib is possibly lower with concomitant use of H2 blockers if they are administered 10 hours before or 2 hours after the ceritinib dose, and with antacids if they are administered 2 hours before or 2 hours after the ceritinib dose. 
H2-receptora ako se primijene 10 sati prije ili 2 sata nakon doze ceritiniba, te kod antacida ako se primijene 2 sata prije ili 2 sata nakon doze ceritiniba.
Ceritinib AUCinf values were approximately 58% and 73% higher (Cmax approximately 43% and 41% higher) in healthy subjects when a single 500 mg ceritinib dose was administered with a low fat meal (containing approximately 330 kcalories and 9 grams of fat) and a high fat meal (containing approximately 1000 kcalories and 58 grams of fat), respectively, as compared with the fasted state. 
Vrijednosti AUCinf ceritiniba bile su otprilike 58% odnosno 73% više (Cmax otprilike 43% odnosno 41% viši) u zdravih ispitanika kada je jednokratna doza ceritiniba od 500 mg primijenjena uz obrok s malim udjelom masti (koji sadrži približno 330 kilokalorija i 9 grama masti), odnosno uz obrok s visokim udjelom masti (koji sadrži približno 1000 kilokalorija i 58 grama masti), u usporedbi s primjenom natašte.
Patients should be monitored for pulmonary symptoms indicative of ILD/pneumonitis. 
U bolesnika treba pratiti plućne simptome koji ukazuju na IBP/pneumonitis.
Patients with pulmonary symptoms indicative of ILD/pneumonitis should be monitored. 
Bolesnike s plućnim simptomima koji ukazuju na IBP/pneumonitis potrebno je pratiti.
Previously untreated ALK-positive advanced NSCLC - randomised phase 3 Study A2301 (ASCEND-4) The efficacy and safety of Zykadia for the treatment of advanced ALK-positive NSCLC patients who have not received previous systemic treatment anti-cancer therapy (including ALK inhibitor) with the exception of neo-adjuvant or adjuvant therapy, was demonstrated in a global multicentre, randomised, open-label phase 3 Study A2301. 
Djelotvornost i sigurnost Zykadie za liječenje bolesnika s uznapredovalim ALK-pozitivnim NSCLC-om koji nisu prethodno primali sistemsku terapiju protiv raka (uključujući ALK inhibitor) uz iznimku neoadjuvantne ili adjuvantne terapije, dokazane su u globalnom multicentričnom, randomiziranom, otvorenom ispitivanju faze 3, A2301.
Patients should not alternate between fasted and fed dosing. 
Bolesnici ne smiju izmjenjivati režim doziranja uz hranu ili bez nje.
Table 1 Zykadia dose adjustment and management recommendations for ADRs 
Tablica 1 Preporuke za prilagođavanja doze Zykadie i zbrinjavanje nuspojava
Temporary dose interruption and/or dose reduction of Zykadia may be required based on individual safety and tolerability. 
Ovisno o sigurnosti i podnošljivosti lijeka za pojedinog bolesnika, može biti potrebno privremeno prekinuti primjenu i/ili smanjiti dozu Zykadie.
In patients who develop transaminase elevations, more frequent monitoring of liver transaminases and total bilirubin should be carried out as clinically indicated (see sections 4.2 and 
U bolesnika u kojih dođe do povišenja transaminaza potrebno je provoditi učestalije praćenje jetrenih transaminaza i ukupnog bilirubina prema kliničkim indikacijama (vidjeti dijelove 4.2 i 4.8).
These events required dose reduction or interruption in 0.2% of patients. 
Ti su događaji zahtijevali smanjenje doze ili prekid doziranja u 0,2% bolesnika.
The steady-state AUC of ceritinib at reduced doses after co-administration with ketoconazole 200 mg twice daily for 14 days was predicted by simulations to be similar to the steady-state AUC of ceritinib alone. 
Simulacijama je predviđeno da će AUC ceritiniba u stanju dinamičke ravnoteže pri smanjenim dozama nakon istodobne primjene ketokonazola od 200 mg dvaput na dan tijekom 14 dana biti sličan AUC-u samog ceritiniba u stanju dinamičke ravnoteže.
NE (29.3, NE) 
NP (29,3, NP)
A dedicated pharmacokinetic study under steady-state in patients with hepatic impairment has not been conducted. 
Posebno farmakokinetičko ispitivanje u stanju dinamičke ravnoteže u bolesnika s oštećenjem jetre nije provedeno.
Agents that may decrease ceritinib plasma concentrations 
Tvari koje mogu smanjiti koncentracije ceritiniba u plazmi
Anti-hyperglycaemic medicinal products should be initiated or optimised as indicated (see sections 4.2 and 4.8). 
Antidijabetike treba uvesti ili optimizirati prema indikacijama (vidjeti dijelove 4.2 i 4.8).
If unavoidable, dose reduction for co-administered medicinal products that are CYP3A substrates with narrow therapeutic indices should be considered. 
Ako nije moguće, potrebno je razmotriti smanjenje doze istodobno primjenjenih lijekova koji su CYP3A supstrati s uskim terapijskim indeksom.
Capsule contents: silica, colloidal anhydrous; hydroxypropylcellulose, low-substituted; sodium starch glycolate (type A); magnesium stearate; cellulose, microcrystalline. 
Sadržaj kapsule: silicijev dioksid, koloidni, bezvodni; hidroksipropilceluloza, nisko supstituirana; natrijev škroboglikolat (vrsta A); magnezijev stearat; celuloza, mikrokristalična.
The OIRR in patients with measurable disease in the brain at baseline and at least one post-baseline assessment was higher in the ceritinib arm (35.3%, 95% CI: 14.2, 61.7) compared to the chemotherapy arm (5.0%, 95% CI: 0.1, 24.9). 
OIRR u bolesnika s mjerljivom bolešću u mozgu na početku ispitivanja i najmanje jednom ocjenom nakon početka bio je viši u ceritinib skupini (35,3%, 95% CI: 14,2; 61,7) u usporedbi s kemoterapijskom skupinom (5,0%, 95% CI: 0,1; 24,9).
Oesophageal disorder g 
Poremećaj jednjaka g
In cases of symptomatic bradycardia that is not life-threatening, Zykadia should be withheld until recovery to asymptomatic bradycardia or to a heart rate of 60 bpm or above, the use of concomitant medicinal products should be evaluated and the Zykadia dose adjusted if necessary. 
U slučajevima simptomatske bradikardije koja nije opasna po život, potrebno je privremeno prekinuti primjenu Zykadie do oporavka do asimptomatske bradikardije ili do srčane frekvencije od 60 otkucaja u minuti ili više, ocijeniti primjenu istodobno primijenjenih lijekova te prilagoditi dozu Zykadie ako je potrebno.
- If your next dose is in less than 12 hours, skip the missed tablets. 
Ako sljedeću dozu morate uzeti za manje od 12 sati, preskočite propuštene tablete.