Eribulin

By Medically reviewed by hellodoktor

Generic Name: Eribulin Brand Name(s): Eribulin and Eribulin.

Uses

What is Eribulin used for?

Eribulin is commonly used to treat certain types of cancer (breast, liposarcoma). It works by slowing or stopping the growth of cancer cells.

How should I take Eribulin?

This medication is given by injection into a vein by a health care professional. It is given on a schedule as directed by your doctor. Dosage is based on your medical condition, body size, and response to treatment.

How do I store Eribulin?

Store intact vials at 25°C (77°F); excursions permitted between 15°C and 30°C (59°F and 86°F); do not freeze. Store in original carton. Undiluted solutions in a syringe and solutions diluted in normal saline for infusion are stable for up to 4 hours at room temperature or up to 24 hours refrigerated at 4°C (40°F).

If you need to store eribulin at home, talk with your doctor, nurse, or pharmacist about how to store it.

Precautions & warnings

What should I know before using Eribulin?

Before using eribulin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood/bone marrow problems (such as low red/white blood cells and platelets), kidney problems, liver problems.

Eribulin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using eribulin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using eribulin safely.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

Eribulin can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.

Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially QT prolongation.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details and to discuss reliable forms of birth control. Females should use reliable forms of birth control during and for 2 weeks after treatment with eribulin. Males and their female partner should use reliable forms of birth control during and for 14 weeks after treatment with eribulin. If you or your partner become pregnant or may be pregnant, tell your doctor right away.

It is unknown if this medication passes into breast milk. Because of possible risk to the infant, breast-feeding while using this drug and for 2 weeks after treatment is not recommended. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Eribulin during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Eribulin. Eribulin is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Eribulin?

Nausea, constipation, watering eyes, loss of appetite, dry mouth, changes in taste, trouble sleeping, muscle/joint pain, dizziness, tiredness, or weakness may occur. If any of these effects persist or worsen, tell your doctor promptly.

Temporary hair loss may occur. Normal hair growth should return after treatment has ended.

People using this medication may have serious side effects. However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk ofside effects. Careful monitoring by your doctor may decrease your risk.

Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, numbness/tingling/burning in the hands/feet, signs of anemia (such as unusual tiredness, pale skin).

This medication can lower the body’s ability to fight an infection. Tell your doctor right away if you develop any signs of an infection such as fever, chills, cough, or burning/pain when you urinate.

Get medical help right away if you have any very serious side effects, including: fainting, fast/irregular heartbeat, severe dizziness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Eribulin?

Eribulin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Eribulin?

Eribulin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Eribulin?

Eribulin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Eribulin.

What is the dose of Eribulin for an adult?

Usual Adult Dose for Breast Cancer

1.4 mg/m2 IV over 2 to 5 minutes on days 1 and 8 of a 21-day cycle

Comments:

-This drug should be administered under the supervision of a qualified physician experienced in the appropriate use of cytotoxic medicinal products.

-Patients may experience nausea or vomiting. Antiemetic prophylaxis including corticosteroids should be considered.

-Peripheral neuropathy should be assessed and complete blood cell counts should be obtained prior to each dose.

Use: For the treatment of patients with metastatic breast cancer who have previously received at least 2 chemotherapeutic regimens for the treatment of metastatic disease. Prior therapy should have included an anthracycline and a taxane in either the adjuvant or metastatic setting.

Renal Dose Adjustments

-Mild renal impairment (CrCl 50 to 80 mL/min): No adjustment recommended

-Moderate renal impairment (CrCl 30 to 50 mL/min): 1.1 mg/m2 IV over 2 to 5 minutes on days 1 and 8 of a 21-day cycle.

-Severe renal impairment (CrCl less than 30 mL/min): Data not available

Liver Dose Adjustments

-Mild liver impairment (Child-Pugh A): 1.1 mg/m2 intravenously over 2 to 5 minutes on days 1 and 8 of a 21-day cycle

-Moderate liver impairment (Child-Pugh B): 0.7 mg/m2 intravenously over 2 to 5 minutes on days 1 and 8 of a 21-day cycle

-Severe liver impairment (Child-Pugh C): Data not available

Dose Adjustments

PLEASE NOTE:

-In the EU the recommended dose refers to the base of the active substance (eribulin). Calculation of the individual dose to be administered to a patient should be based on the strength of the ready to use solution that contains 0.44 mg/mL eribulin.

-In some other regions (e.g., the US and other countries), the recommended dose is based on the salt form (eribulin mesylate).

This drug should not be administered on day 1 or day 8 if:

-The patient is experiencing grade 3 or 4 non-hematological toxicities

-The absolute neutrophil count (ANC) is less than 1000 cells/mm3

-Platelets are less than 75,000/mm3.

The day 8 dose may be delayed for a maximum of 1 week if:

-Toxicities do not resolve or improve to less than or equal to grade 2 by day 15, the dose should be omitted

-Toxicities resolve or improve to less than or equal to grade 2 severity by day 15, this drug should be administered at a reduced dose and the next cycle should be initiated at least 2 weeks later

The 1.4 mg/m2 dose should be permanently reduced to 1.1 mg/m2 for any of the following:

-Absolute neutrophil count (ANC) less than 500 cells/mm3 for more than 7 days

-ANC less than 1000 cells/mm3 with fever or infection

-Platelets less than 25,000/mm3

-Platelets less than 50,000/mm3 requiring transfusion

-Non-hematologic grade 3 or 4 toxicities

-Omission or delay of day 8 dose in previous cycle for toxicity

-The occurrence of any adverse event requiring permanent dose reduction while receiving the 1.1 mg/m2 dose, the dose should be further reduced to 0.7 mg/m2.

-The occurrence of any adverse event requiring permanent dose reduction while receiving the 0.7 mg/m2 dose, this drug should be discontinued.

The dose of this drug should not be re-escalated after it has been reduced.

Other Comments

Storage requirements:

-The manufacturer product information should be consulted for recommended storage requirements.

Reconstitution/preparation techniques:

-The dose should be diluted in up to 100 mL of sodium chloride 0.9% solution for injection. It should not be diluted in glucose 5% infusion solution.

IV compatibility:

-This drug should not be diluted in or administered through an IV line containing dextrose solutions or mixed with any other medicinal agents.

General:

-Good peripheral venous access or a patent central line should be obtained prior to administration.

-If extravasation occurs, treatment should be symptomatic.

Monitoring:

-A complete blood count is recommended prior to each dose and increased monitoring is recommended in patients who develop grade 3 or 4 cytopenias.

-Patients should be closely monitored for the development of neuropathies.

-Electrocardiogram (ECG) monitoring is recommended in patients at risk of developing QT interval prolongation. Use should be avoided in patients with congenital long QT syndrome.

-Electrolyte abnormalities should be corrected prior to initiation of the dose and periodic monitoring of electrolytes is recommended during therapy.

Patient advice:

-This drug can cause a decrease in white blood cell count (neutropenia). This can make you more likely to get serious infections that could lead to death. You may need treatment in the hospital with antibiotic medicines.

-Call your healthcare provider right away if you develop any of these symptoms of infection while you are receiving this drug: Fever (temperature above 100.5F), chills, cough, burning or pain when you urinate.

-This drug can cause numbness, tingling, or burning in your hands and feet (neuropathy). Tell your healthcare provider if you have any of these symptoms.

-Tell your healthcare provider if you have liver or kidney problems, heart problems, including a problem called “congenital long QT syndrome”, are pregnant or plan to become pregnant, are breastfeeding or planning to breastfeed.

-The most common side effects of this drug are: Weakness or tiredness, hair loss, nausea, and constipation.

What is the dose of Eribulin for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Eribulin available?

Eribulin is available in the following dosage forms and strengths:

  • Solution for Injection

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Eribulin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 26, 2018 | Last Modified: September 12, 2019

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