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Care During Chemotherapy and Beyond

Xalkori capsules



(zal-KOR-ee)

Generic name: Crizotinib

Xalkori capsules is the trade name for the generic chemotherapy drug Crizotinib. In some cases, health care professionals may use the trade name Xalkori when referring to the generic drug name Crizotinib.

Drug type:  Xalkori capsules is a targeted therapy. It is an oral receptor tyrosine kinase inhibitor - (For more detail, see "How this drug works," below).

What this drug is used for:

For the treatment of non-small cell lung cancer that is caused by a defect in a gene called ALK (anaplastic lymphoma kinase). The cancer must be (ALK)-positive as indicated by an FDA-approved test.

Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How this drug is given:

  • Xalkori capsules are a pill, taken by mouth.  It can be taken with or without food.
  • Take Xalkori capsules exactly as prescribed.
  • Swallow Xalkori capsules whole. Do not crush, dissolve or open capsules.
  • Do not change your dose or stop Xalkori capsules unless your health care provider tells you to.
  • If you miss a dose, take it as soon as you remember. If it is too close to your next dose (within 6 hours), just take your next dose at your regular time.
  • Do not take more than 1 dose of Xalkori capsules at one time. Call your health care provider right away if you take too much.
  • The amount of Xalkori capsules that you will receive depends on many factors, your general health or other health problems, and the type of cancer or condition being treated.  Current recommendation is for one tablet twice daily, higher doses do not give a better response and may cause increased toxicity.  Your doctor will determine your dose and schedule.

Side effects:
Important things to remember about the side effects of Xalkori capsules:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking Xalkori capsules:

These side effects are less common side effects (occurring in about 10-29%) of patients receiving Xalkori capsules:

A serious, but very uncommon side effect of Xalkori capsules is pneumonitis (swelling of the lungs). When this side effect occurred, it was often accompanied by breathing difficulty with cough or a low-grade fever requiring hospitalization.  Symptoms may be similar to those symptoms from lung cancer. Contact your health care provider right away if you have any new or worsening symptoms.

Another serious but very uncommon side effect of Xalkori capsules is EKG changes.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms: 

  • Fever of 100.4° F (38° or higher, chills)
  • Sudden onset of shortness of breath, accompanied by cough and/or fever

The following symptoms require medical attention, but are not an emergency.  Contact your health care provider within 24 hours of noticing any of the following:

  • Diarrhea (4-6 episodes in a 24-hour period).
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
  • Eye irritation
  • Skin or the whites of your eyes turn yellow
  • Urine turns dark or brown (tea color)
  • Decreased appetite
  • Pain on the right side of your stomach
  • Bleed or bruise more easily than normal
  • Itching
  • Cough with or without mucus

Precautions:

  • Before starting Xalkori capsule treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking Xalkori capsules .
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Xalkori capsules may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.) 
  • For both men and women: Do not conceive a child (get pregnant) while taking Xalkori capsules. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.
  • You should not drink grapefruit juice or eat grapefruit during your treatment with Xalkori capsules. It may make the amount of Xalkori capsules in your blood increase to a harmful level.

Self-care tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • If you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals.  Sucking on lozenges and chewing gum may also help.
  • Avoid sun exposure.  Wear SPF 15 (or higher) sun block and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
  • Get plenty of rest. 
  • Maintain good nutrition.
  • Xalkori capsules can cause visual changes, dizziness and tiredness. If you have any of these symptoms, use caution when driving a car, using machinery, or anything that requires you to be alert.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

You will be checked regularly by your health care professional while you are taking Xalkori capsules, to monitor side effects and check your response to therapy.

How this drug works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells.  To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly.  Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects. 

Targeted therapy is about identifying other features of cancer cells.  Scientists look for specific differences in the cancer cells and the normal cells.  This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects.  Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells. 

There are different types of targeted therapies, defined in three broad categories.  Some targeted therapies focus on the internal components and function of the cancer cell.  The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die.  There are several types of targeted therapy that focus on the inner parts of the cells.   Other targeted therapies target receptors that are on the outside of the cell.   Therapies that target receptors are also known as monoclonal antibodies.  Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Xalkori capsules is a targeted therapy that targets and binds to the tyrosine kinase receptors and inhibits ALK, Hepatocyte Growth Factor Receptor (HGFR, c-Met) and Recepteur d’Origine Nantais (RON) on the surface of the cell.  By binding to these receptors Xalkori capsules blocks an important pathway that promotes cell division.

Research continues to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer. 

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.