Care During Chemotherapy and Beyond
Trade name: Xalkori capsules®
Crizotinib is the generic for the trade chemotherapy drug Xalkori. In some
cases, health care professionals may use the trade name Xalkori when referring
to the generic drug name crizotinib.
Drug type: Crizotinib is a targeted therapy. It is an oral receptor
tyrosine kinase inhibitor - (For more detail, see "How this drug works," below.)
What Crizotinib 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 Crizotinib Is Given:
- Crizotinib is a pill, taken by mouth. It can be taken with or without food.
- Take Crizotinib exactly as prescribed.
- Swallow Crizotinib capsules whole. Do not crush, dissolve or open capsules.
- Do not change your dose or stop Crizotinib unless your health care provider tells
- 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 Crizotinib at one time. Call your health care provider
right away if you take too much.
- The amount of Crizotinib 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.
Important things to remember about the side effects of Crizotinib:
- 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
These side effects are less common side effects (occurring in about 10-29%) of patients
A serious, but very uncommon side effect of Crizotinib 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 Crizotinib 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
- 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
- Cough with or without mucus
Always inform your health care provider if you experience any unusual symptoms.
- Before starting Crizotinib 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 Crizotinib.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (Crizotinib 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 Crizotinib.
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
Crizotinib. It may make the amount of Crizotinib in your blood increase to a harmful
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- 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.
- Crizotinib 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
Crizotinib, to monitor side effects and check your response to therapy.
How Crizotinib 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.
Crizotinib 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 Crizotinib 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.
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