Drug Action
Alectinib is a tyrosine kinase inhibitor.
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Drug reference
Alectinib is a tyrosine kinase inhibitor.
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Anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (specialist use only) ▶BY MOUTH ▶Adult: 600 mg twice daily, for dose adjustments due to side-effects—consult product literature
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NICE decisions Immune system and malignant disease ▶Alectinib for untreated ALK-positive advanced non-small-cell lung cancer (August 2018) NICE TA536 Alectinib (Alecensa ®) is recommended, within its marketing authorisation, as an option for untreated anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer in adults. It is recommended only if the manufacturer provides alectinib according to the commercial arrangement. www.nice.org.uk/guidance/ta536 Scottish Medicines Consortium (SMC) decisions SMC No. SMC2012 The Scottish Medicines Consortium has advised (August 2018) that alectinib (Alecensa ®) is accepted for use within NHS Scotland as monotherapy for the first-line treatment of adults with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower.
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RISKS OF INCORRECT DOSING OF ORAL ANTI-CANCER MEDICINES See Cytotoxic drugs p. 938.
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→Appendix 1: alectinib
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▶Common or very common Anaemia. arrhythmias. constipation. diarrhoea. eye disorders. eye inflammation. hyperbilirubinaemia. musculoskeletal pain. myalgia. nausea. oedema. photosensitivity reaction. skin reactions . vision disorders. vomiting ▶Uncommon Drug-induced liver injury. respiratory disorders
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Manufacturer advises women of child-bearing potential should use effective contraception during and for at least 3 months after stopping treatment.
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Manufacturer advises avoid—toxicity in animal studies. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Manufacturer advises avoid—no information available.
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Dose adjustments Manufacturer advises reduce dose to 450 mg twice daily in severe impairment.
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▶Manufacturer advises monitor creatine phosphokinase every 2 weeks for the first month and as clinically indicated thereafter in patients reporting symptoms of myalgia. ▶Manufacturer advises monitor heart rate and blood pressure as clinically indicated. ▶Manufacturer advises monitor liver function at baseline then every 2 weeks during the first 3 months of treatment and periodically thereafter as clinically indicated; more frequent monitoring should be performed in patients who develop aminotransferase and bilirubin elevations. ▶Manufacturer advises monitor for symptoms of interstitial lung disease and pneumonitis.
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There can be variation in the licensing of different medicines containing the same drug. Capsule CAUTIONARY AND ADVISORY LABELS 11, 21 ELECTROLYTES: May contain Sodium ▶Alecensa (Roche Products Ltd) A Alectinib (as Alectinib hydrochloride) 150 mg Alecensa 150mg capsules | 224 capsule P £5,032.00
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Photosensitivity Manufacturer advises patients should use a broad spectrum sunscreen and lip balm and be advised to avoid prolonged sun exposure during treatment, and for 7 days after discontinuation. Myalgia Manufacturer advises patients should advised to report any unexplained muscle pain, tenderness or weakness. Vomiting Manufacturer advises if vomiting occurs after taking tablets, no additional dose should be taken on that day and the next dose should be taken at the usual time. Missed doses Manufacturer advises if a dose is more than 6 hours late, the missed dose should not be taken and the next dose should be taken at the normal time. Driving and skilled tasks Manufacturer advises patients and carers should be counselled on the effects on driving and performance of skilled tasks—increased risk of symptomatic bradycardia and vision disorders.
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600 mg twice daily, for dose adjustments due to
First-line fragment. Read the complete Indications and Dose section above.
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