Neratinib is used to treat cancer of the breast.
This medicine is used in patients with early-stage breast cancer who has previously been treated with another medicine called trastuzumab.
It may also be used together with capecitabine to treat breast cancer that has spread to other parts of the body.
Take Neratinib 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.
Take it together with food or immediately after a meal. Try to take it at the same time each day.
Swallow it whole with a glass of water. Do not divide, chew or crush the tablet.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to this medication.
Neratinib 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.
If you miss a dose, 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 severe liver disease as Neratinib may not be suitable for you.
Do not breastfeed while you are being treated with this medicine and for at least 1 month after stopping the treatment.
Do not take Neratinib with medicines known as strong CYP3A/P-gp inducers or gastric medicines known as H2-receptor antagonists. Please see the section “Can I take this with other medicines?” below for more information.
Inform your doctor if you have the following conditions:
- long-term stomach or bowel disease with diarrhoea as a major symptom
- conditions that increase the risk of cardiac problems
- skin disease
- kidney disease
Let your doctor know if you are pregnant.
You must use proven birth control methods during Neratinib therapy and for at least 1 month after stopping the treatment. Birth control medicines containing hormones may not be effective. You may wish to discuss other reliable methods of birth control with your doctor. Avoid fathering a child during treatment and for 3 months after completion of treatment.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if this medicine is suited for you to take.
- Routine tests (e.g. liver and heart function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for the occurrence of diarrhoea may also be needed.
Neratinib may cause dizziness, temporary loss of consciousness or tiredness. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: nausea, vomiting, stomach pain, indigestion, dry mouth, headache, decreased appetite, decreased weight, excessive water loss from the body, muscle spasm, nosebleeds, rash, dry skin and nail problems.
Neratinib can cause diarrhoea early during treatment. You may be given anti-diarrhoea medicine so that your diarrhoea does not become severe, and to prevent excessive fluid loss during treatment with this medicine. If you have severe diarrhoea, alert your doctor immediately.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Neratinib if you are taking any of these medicines:
- rifampicin (medicine to treat lung infection known as TB)
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine
- gastric medicines called proton pump inhibitors e.g. lansoprazole, omeprazole
- St. John’s wort (herbal medicine)
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat fungal infection e.g. ketoconazole, itraconazole, fluconazole, voriconazole
- ciclosporin (medicines used in organ transplant or certain immune disorders)
- medicines for HIV infection e.g. ritonavir, saquinavir, atazanavir, indinavir, efavirenz, cobicistat
- certain antibiotics e.g. ciprofloxacin, clarithromycin, erythromycin, troleandomycin
- other medicines for epilepsy (fits or seizures) e.g. phenobarbital, primidone
- medicines for high blood pressure and chest pain e.g. diltiazem, verapamil
- digoxin (medicine to treat heart failure)
- dabigatran (blood-thinning medicine)
This medicine should not be taken with antacids or gastric medicines known as H
2-receptor antagonists as these agents could reduce the effectiveness of Neratinib. If you must take antacid, take it at least 3 hours after you have taken this medicine. If H
2-receptor antagonists are used, take Neratinib at least 2 hours before or 10 hours after the intake of the H
2-receptor antagonist.
This list does not include all medicines that may interact with Neratinib.
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 alcohol.
Avoid excessive consumption of grapefruit or pomegranate juice.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
As this is a cancer medicine, always return any unused or expired tablets to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.
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