Care During Chemotherapy and Beyond
Generic Name: Eribulin
(er i BUE lin)
Trade Name(s): Halaven ®
Eribulin is the generic name for the trade name drug Halaven. In some cases, health
care professionals may use the trade name Halaven when referring to the generic
drug name eribulin.
Halaven is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This
medication is classified as a "non-taxane microtubule inhibitor". (For
more detail, see “How Halaven Works” below)
What Halaven Is Used For:
Halaven is used for the treatment of patients with metastatic breast cancer.
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 Halaven Is Given:
- Halaven is given through a vein as an intravenous push or as intravenous
infusion over 2 to 5 minutes.
The amount of Halaven that you will receive depends on many factors, including your
height and weight, your general health or other health problems, and the type of
cancer or condition you have. Your doctor will determine your exact dosage and schedule.
Important things to remember about the side effects of Halaven:
- Most people will not experience all of the Halaven side effects
- Halaven side effects are often predictable in terms of their
onset, duration, and severity.
- Halaven side effects will improve after therapy is complete.
- Halaven side effects may be quite manageable. There are many options
to minimize or prevent the side effects of Halaven.
The following side effects are common (occurring in greater than 30%) for
patients taking Halaven:
blood counts. Your white and red blood cells may temporarily decrease. This
can put you at increased risk for infection and/or anemia.
(approximately 13 days; recovery approximately 8 days)
These are less common (occurring in 10-29%) side effects for patients receiving
Not all side effects are listed above. Side effects that are rare -- occurring in
less than about 10 percent of patients -- are not listed here. But 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° C) or higher, chills (possible signs of
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:
- Nausea (interferes with ability to eat and unrelieved with prescribed
- Vomiting (vomiting more than 4-5 times in a 24 hour period)
- Diarrhea (4-6 episodes in a 24-hour period)
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools
- Blood in the urine
- Pain or burning with urination
- Extreme fatigue (unable to carry on self-care activities)
- Mouth sores (painful redness, swelling or ulcers)
Always inform your health care provider if you experience any unusual symptoms.
- Before starting Halaven 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, 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 Halaven. .
- Inform your health care professional if you are pregnant or may
be pregnant prior to starting this treatment. Pregnancy category D (Eribulin 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: Use contraceptives, and do not conceive
a child (get pregnant) while taking Halaven. Barrier methods of contraception, such
as condoms, are recommended.
- Do not breast feed while taking Halaven.
- Drink at least two to three quarts of fluid every 24 hours, unless
you are instructed otherwise.
- You may be at risk of infection so try to avoid crowds or people
with colds, and report fever or any other signs of infection immediately to your
health care provider.
- Wash your hands often.
- To help treat/prevent mouth sores, use a soft toothbrush, and
rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
- Keep your bowels moving. Your health care provider may prescribe
a stool softener to help prevent constipation that may be caused by Erubulin.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by
your doctor, and eat small, frequent meals.
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective
- 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.
- Remain active as you are able. Gentle exercise is encouraged
such as a daily walk.
- 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 doctor while you are taking Halaven, to monitor
side effects and check your response to therapy. Periodic blood work will be obtained
to monitor your complete blood count (CBC) as well as the function of other organs
(such as your kidneys and liver) will also be ordered by your doctor. You
may be asked to get ECG to monitor your heart’s rhythm if you have history of heart
failure or very slow heart rate. You will be assessed for peripheral
How Halaven Works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cells no longer have the normal checks and
balances in place that control and limit cell division. The process of cell
division, whether normal or cancerous cells, is through the cell cycle. The
cell cycle goes from the resting phase, through active growing phases, and then
to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells
the cell how to copy itself in division. If the cells are unable to divide,
they die. The faster the cells are dividing, the more likely it is that chemotherapy
will kill the cells, causing the tumor to shrink. They also induce cell suicide
(self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the
type of cells, rate at which they divide, and the time at which a given drug is
likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.
Unfortunately, chemotherapy does not know the difference between the cancerous cells
and the normal cells. The "normal" cells will grow back and be healthy but in the
meantime, side effects occur. The "normal" cells most commonly affected by
chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and
the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea,
and/or hair loss. Different drugs may affect different parts of the body.
Antimicrotubule agents (such as Halaven), attack cells during a certain phase of
division and so are considered cell-cycle specific. Halaven interferes with
the microtubule structures within the cell. Microtubules are part of the cell's
apparatus for dividing and reproducing itself. Inhibition of these microtubule
structures ultimately results in cell death.
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.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org