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Gefitinib (Iressa ®)

Warning:   Although rare (about 1%.), cases of interstitial lung disease (or diffuse parenchymal lung disease) have been observed in cancer patients treated with Gefitinib. Common lungs problems include pneumonia, pneumonitis and alveolitis which may be associated with cough or low-grade fever, often becoming severe within a short time and requiring hospitalization.

Gefitinib is not recommended in pregnant women as it may cause fetal harm. Cautious is highly recommended patients having liver disease or hepatotoxicity.

 

Indications: Gefitinib is a lung cancer fighting medication that is only recommended to be taken by people that have used other treatments for cancer whose cancer has not improved or has unfortunately gotten worse.  It is not advised to start this medication unless you have already benefited from its use. 

There are other cancer drugs that can promote a longer life that are suggested for use.  Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor. This drug blocks a substance that cancer cells use to multiply.

 

Dosage:  Gefitinib comes in a pill form that is only to be taken orally.  If you have trouble swallowing, you place one tablet in a half a glass of water and completely dissolve the tablet for about ten minutes.  Make sure to crush up any large pieces, and to drink immediately.  Some patients take Gefitinib with food, other’s do not, it is pure preference.  Taking this medication about the same time every day is advised.  Never take more or less than prescribed.  Do not miss a dose, because you are feeling better. If a dose is missed, take it as soon as you can.  But, if the next dose is due, omit the missed dose.  Never take a double dose.

Gefitinib is only available through a select mail order distribution program for patients that have used the medication in the past.  Consent is generally required for delivery of this medication to begin.  It is very important to always ask your doctor any questions that you may have regarding this medication.

 

This medication should be stored in the container it was delivered in.  All medications should be kept away from children and out their reach.  Storing at room temperature is advised and to avoid excess moisture. Contact your doctor about the proper disposal of any medications that are no longer needed or have expired.

  

Storage: store Gefitinib at room temperature (15-25 ° C), away from heat, light and moisture. Keep your medications out of the reach of children . Gefitinib and all drugs should not be used beyond the expiration date printed on the container.    

Overdose: chemotherapy drugs, even when taken at normal dose, can damage the bone marrow, and cause serious decrease in the number of blood cells in your body. Gefitinib overdose may be dangerous, mainly in fragile patients, or if taken for long term. Contact your doctor or the poison control center nearest you if you experience the following symptoms:  

  • skin rash
  • confusion 
  • fast heartbeat 
  • shortness of breath
  • diarrhea  
  • Signs of infection: fever, sore throat, chills, cough, etc.  

Missing dose: take Gefitinib as indicated your doctor or pharmacist. In case you forget to take a dose, take the missed one as soon as you remember it. If, however, it is almost time for your next dose, do not double it to recover the missed one; it can be dangerous. Contact your doctor or wait to go back to your regular schedule. This applies not only to Gefitinib but also any other drug.    

Contraindications: Gefitinib is contraindicated in patients who suffer from:  

  • allergy to Gefitinib or any of its ingredients 
  • EGFR-negative tumors- EGFR stands for epidermal growth factor receptor 

Tell your doctor if you are pregnant/breast-feeding, or have:  

  • skin rash
  • confusion 
  • pulmonary fibrosis (scarring of the lungs)
  • liver problems
  • kidney disease.

Mechanism of action (MOA): Gefitinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor; i t reduces tumor proliferation by inhibiting tyrosine kinases, enzymes highly involved in intracellular transmission of signals inducing cell proliferation. 

Interactions:  It is strongly advised to alert your health care professional if you eat grapefruit or drink grapefruit juice.

Tell your doctor about all the medications you are taking; many other medications may interact with Gefitinib. Talk to your doctor before taking aspirin, vitamins, nutritional supplements or St. John's wort. Tell your doctor and pharmacist if you are taking any of these medications:

  • rifampicin
  • rifampin
  • vinorelbine
  • warfarin
  • carbamazepine
  • protease inhibitors: atazanavir, nelfinavir, ritonavir
  • azole antifungals: itraconazole, ketoconazole,
  • macrolide antibiotics: clarithromycin, erythromycin
  • barbiturates: mephobarbital, pentobarbital, secobarbital
  • histamine H2-receptor antagonists : cimetidine, ranitidine
  • Proton pump inhibitors (PPIs): esomeprazole, lansoprazole, pantoprazole 

Side effects: Gefitinib not only attack cancer cells but also normal (healthy) cells, which often leads to, in certain patients, the following side effects:

  • dry skin 
  • itching
  • rash
  • acne
  • mouth sores
  • weight loss
  • weakness
  • hair loss
  • decreased appetite
  • trouble sleeping
  • mild nausea and vomiting.

Contact your doctor immediately if you experience any of these symptoms:  

  • anxiety
  • severe depression symptoms
  • black, tarry stools
  • severe low or high blood pressure
  • nose bleeding
  • abdominal pain
  • purple, blue, or black discoloration of the skin
  • dehydration symptoms (muscle cramps, decreased blood pressure, dizziness, fainting)
  • vision changes
  • persistent diarrhea
  • itchy or red eye
  • ulcer on the surface of the eye
  • fast or irregular heart beat
  • shortness of breath
  • severe headaches
  • lip or Skin reactions: ulcers, blisters, pain, redness, scaling, etc 

 

 

 

References:

http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=60249#nlm34071-1