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Cetuximab (IMC-C225, Erbitux)  

 

Warning: There have been very severe, sometimes fatal infusion reactions to Cetuximab. You should seek medical attention immediately if you have difficulty breathing, itching or hoarseness of voice. 

 

There have been some deaths reported in people that have head and neck cancer that have been treated with this medication and radiation. These occurrences have been rare and usually happen a few days up to a few months after an infusion. If you have heart disease (arrhythmias, congestive heart failure, and coronary artery disease) you should inform your doctor before using this medication or any radiation. Your blood levels should also be checked for certain minerals often. 

Indications:  Cetuximab has been used alone or with other medications (with Irinotecan for instance) for the treatment of colorectal cancer and other malignant tumors such as head and neck cancer that has spread to other parts of the body.

Many patients that have been prescribed this medication have been proven to be non-responsive to other drugs for the treatment of their cancer. The drug works by slowing down the growth of the cancer cells. The cells will stop growing once the drug attaches itself to a protein (epidermal growth factor receptor) on the cancer cells. This drug is a man-made protein.  

Dosage:  Cetuximab is most often given to patients once a week through their veins by a medical professional. The larger dose (loading dose) is given first and will usually take two hours to inject. The injections that follow are smaller and given depending on the patient’s medical condition and the reaction to the drug.

The medical professional should supervise the patient for an hour after the last infusion to insure no infusion reactions occur. During the treatment and even after, patients should to drink plenty of water and other fluids to avoid damage to their kidneys, stomach and liver.  

Contraindications: Before taking this or any medication tell your doctor all of the allergies you have. There are sometimes rare occurrences of allergic reactions to the ingredients in this drug. Tell your doctor all of your medical history including lung disease, heart disease, or radiation therapy.

This medication may make some people very drowsy. Do not take Cetuximab before operating machinery, driving or any activity that requires alertness. Limit your alcohol intake. Sunlight may make any skin reaction that you have while on this medication worse. Take precautions in the sun. This medication may also harm an unborn baby, it is highly recommended to use two forms of birth control. Breast feeding is not recommended on this medication.

In general, Cetuximab is contraindicated or should be used with precaution in the following conditions:  

 

  • very elderly  
  • pregnancy/breastfeeding   
  • liver failure  
  • kidney failure  
  • allergy to Cetuximab or any of its ingredients   
  • cardio-respiratory disorders   
  • Severe alteration of general condition.    

Interactions: Your healthcare professionals should already be aware of the possible interactions that may occur. Do not start, stop or change the dosage of your medications without consulting a professional.  You should always notify your doctor and your pharmacist of all of the medications you are taking, as well as keeping a list with you.

Tell your health care provider if you are taking or planing to take vitamins, nutritional supplements, st john worth or the following medications:

  • Ganciclovir, an antiviral drug 
  • Azathioprine, an immune system inhibitor  
  • Barbiturates,  depressant drug that causes relaxation and sleepiness 
  • Cimetidine , a drug used to inhibit the production of acid in the stomach 
  • Colchicines , a medication used to treat pain of gouty arthritis 
  • Live vaccines: BCG vaccine, yellow fever vaccine, etc.   
  • Cyclophosphamide  (Cytoxan), a medication of the alkylating agent family used to treat a variety of cancers 
  • Cyclophosphamide  (Cytoxan, Cytoxan, Neosar, Procytox, Revimmune), a drug used to treat several types of cancers 
  • Celecoxib, a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, painful menstruation, colon and rectum polyps, etc. 
  • Etc.  

Side effects:  Cetuximab can cause adverse effects in some patients:

  • sneezing
  • hoarseness
  • diarrhea
  • fatigue
  • heartburn
  • decreased appetite
  • weight loss
  • light Sensitivity (Photophobia)
  • hair loss
  • dry mouth
  • dry skin
  • chapped lips
  • mouth sores
  • headache
  • tiredness
  • weakness
  • Insomnia
  • depression
  • nausea and vomiting
  • constipation
  • Stomach pain 

See your health care provider immediately if you experience any of these symptoms: 

  • renal failure
  • blood clots in the lungs
  • unconsciousness
  • heart attack or irregular heart beat
  • coughing up blood or dry cough
  • shaking of the hands that you cannot control
  • severe clincal depression
  • sudden tightening of the hands or feet
  • Hypotension
  • Breathing difficulty
  • sore throat or difficulty swallowing
  • Pain or burning sensation in eye(s)
  • Infections (which can be indicated by sore throat, fever, chills).  

    

 

 

 

 

References: 

 

1 - pharmacyescrow.com 

2 - Cetuximab .com, Cetuximab   

3 - nlm.nih.gov.