Advanced NSCLC where chemotherapy has not helped to stop disease progression; the disease has not worsened after 4 cycles of 1st line chemotherapy; or activating mutation of the Epidermal Growth Factor Receptor tyrosine kinase (EGFR-TK) is confirmed.
Should be taken on an empty stomach: Take at least 1 hr before or 2 hr after meals. If taken w/ medication that reduces stomach acid production: 2 hr before morning dose of medication & 10 hr after evening dose of medication. Swallow w/ a glass of plain water.
Confirm activating mutation of EGFR-TK prior to starting therapy. Reports of liver failure & GI perforation. Patients w/ GI ulcers or diverticular disease; lung disease; liver or kidney problems; sugar intolerance; cataracts, previous cataract surgery, patients wearing contact lenses; patients who smoke tobacco. Women of childbearing potential must use adequate contraception during treatment & for at least 2 wk after taking the last tab. Avoid pregnancy while on treatment. Avoid breastfeeding while on treatment & for at least 2 wk after the final dose.
Rash, diarrhea. Tiredness, loss of appetite, difficulty in breathing, cough, infection, nausea, vomiting, mouth irritation, stomach pain, itching, dry skin, eye irritation. Stomach or intestinal bleeding, abnormal blood tests for liver function; headache, dizziness; hair & nail changes; acne or other red or pink little bumps at hair follicles.
Drug Interactions
Potential interaction w/ antifungals (eg, ketoconazole, fluconazole); Ca channel blockers (eg, diltiazem, verapamil); macrolide antibiotics (eg, erythromycin, clarithromycin); fluoroquinolone antibiotics (eg, ciprofloxacin, norfloxacin); other antibiotics eg, rifampin; some antivirals (eg, ritonavir, indinavir); grapefruit juice; St. John's Wort; anticonvulsants eg, carbamazepine, phenytoin; blood thinners eg, warfarin; medications which reduce acid in the stomach eg, omeprazole, ranitidine; statins.
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