Crizotinib is a medicine used to treat a certain type of lung cancer (non-small cell lung cancer) that has spread to other parts of the body which is caused by a defect in a gene called ALK (anaplastic lymphoma kinase) or ROS1.
This medicine reduces the size of the tumour by stopping cancer cells from growing.
Take Crizotinib exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Swallow the capsule whole. Do not crush, dissolve or open the capsule.
If you vomit after taking this medicine, do not repeat the dose. Take the next dose at the normal scheduled time.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the dosage and treatment time frame depending on your condition and response to the medication.
Crizotinib must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is less than 6 hours before the next dose is due, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have an inherited heart rhythm disorder as Crizotinib may not be suitable for you.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with this medicine, alert your doctor immediately. Crizotinib may cause harm to your unborn child.
Do not breastfeed while you are being treated with this medicine and for 45 days after stopping the treatment.
Inform your doctor if you have the following conditions:
- any other lung problems
- heart disease e.g. heart failure, heart rhythm disorder
- stomach or intestine problems e.g. cancer that has spread to the stomach or intestines
- liver disease
- kidney disease
- eye problems
It is important that you do not get pregnant or father a child while you are being treated with Crizotinib. You and your partner must use proven birth control methods during the treatment and for at least 90 days after stopping the treatment. You may wish to discuss birth control methods with your doctor or pharmacist.
If you are going for an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking Crizotinib.
To know if this medicine is suited for you, your doctor may need to check if you are a carrier of ALK gene by performing genetic test before treatment initiation.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Your blood pressure and heart rate must be checked regularly as it may rise to unsafe levels.
- Certain tests such as ECG (a recording of electrical activity of the heart) and electrolyte level monitoring may be done specifically to those who have heart problems, electrolyte abnormalities, or those who are taking medicines for heart rhythm disorder.
- Your doctor may also need to do blood tests, eye examination, liver and kidney function tests. Your doctor will advise you about how often you need to have these tests.
Crizotinib may cause drowsiness, dizziness or some problems with your eyesight. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects may include any of the following: diarrhoea, nausea, vomiting, stomach pain, constipation, indigestion, decreased appetite, altered taste, mouth sore, nose or throat irritation, headache, weakness or lack of energy, joint pain, swelling of the hands, feet or legs, skin rash, gain or loss in weight.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- irregular heartbeat
- light-headedness, fainting, chest pain or discomfort
- eye problems e.g. blurred vision, seeing flashes of light or floaters, sensitivity to light
- unusual or persistent bruising or bleeding
- signs of liver problems e.g. light coloured stools, dark coloured urine, yellowing of the eyes or skin, severe stomach pain, tiredness
- signs of lung problems e.g. shortness of breath or any breathing difficulties, cough
- signs of infection e.g. fever
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat fungal infections e.g. itraconazole, ketoconazole, voriconazole
- certain antibiotics e.g. clarithromycin, erythromycin, telithromycin, troleandomycin
- medicine to treat TB (infection known as tuberculosis) e.g. rifampicin
- medicines for fits or seizures e.g. phenytoin, carbamazepine, phenobarbital
- medicines for HIV infection e.g. atazanavir, indinavir, nelfinavir, saquinavir, ritonavir
- medicines to treat depression e.g. nefazodone
- medicines to treat heart disorder e.g. quinidine
- medicines used in organ transplant or certain immune disorders e.g. ciclosporin, sirolimus, tacrolimus
- medicines for migraine e.g. ergotamine, dihydroergotamine
- medicines for pain e.g. alfentanil, fentanyl
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Crizotinib.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid consumption of grapefruit juice.
Store in a cool, dry place away from the reach of children.
The medicine must not be used past the expiry date.
As this is a cancer medicine, always return any unused or expired capsules to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.