ERLOTINIB HCL (Generic for TARCEVA)

Erlotinib 150mg, Oral tablet

Grapefruit juice

· Severity: Major

· Notes for Consumers: Avoid grapefruit or grapefruit juice while receiving erlotinib treatment. Side effects from erlotinib may get worse if you take grapefruit juice. Contact your health care provider if you experience rash, diarrhea, fatigue, breathing problems, nausea, vomiting, or other unusual effects.

· Notes for Professionals: Have patients avoid grapefruit or grapefruit juice during erlotinib treatment due to the increased risk of erlotinib-related adverse reactions. Erlotinib is a CYP3A4 substrate and grapefruit juice is a strong CYP3A4 inhibitor. Coadministration with another strong CYP3A4 inhibitor increased erlotinib exposure by 67%.

Erlotinib 150mg, Oral tablet

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. When used together, your medication may not work as well for you.

· Notes for Professionals: Advise patients to avoid smoking tobacco while taking erlotinib and communicate any changes in smoking status during erlotinib treatment. For patients that continue smoking or begin smoking while taking erlotinib, increase the dose of erlotinib by 50 mg increments at 2-week intervals to a maximum of 300 mg/day. Immediately reduce the dose of erlotinib to the recommended dose upon cessation of smoking. Erlotinib is partially metabolized by CYP1A2; smoking tobacco induces CYP1A2. In a single-dose pharmacokinetics trial in healthy volunteers, cigarette smoking decreased the overall exposure of erlotinib by 64% (95% CI: 46% to 76%) in current smokers compared with former/never smokers. In a separate study of patients with non-small cell lung cancer (NSCLC), steady-state trough concentrations of erlotinib were approximately 2-fold less in current smokers compared with former/never smokers.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>