Erlotinib (Tarceva®)

About This Drug

Erlotinib is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Loose bowel movements (diarrhea)
  • Nausea and throwing up (vomiting)
  • Decreased appetite (decreased hunger)
  • Tiredness
  • Cough
  • Trouble breathing
  • Rash
  • Changes in your liver function

Note: Each of the side effects above was reported in 20% or greater of patients treated with erlotinib. Not all possible side effects are included above.

Warnings and Precautions

  • Inflammation (swelling) of the lungs, which can be life-threatening. You may have a dry cough or trouble breathing.
  • Changes in your kidney function which can cause kidney failure and be life-threatening
  • Severe changes in your liver function which can cause liver failure and be life-threatening
  • Perforation- a hole in your stomach, small and/or large intestine which can be life-threatening
  • Severe skin reactions. You may get a rash with fluid-filled bumps/blisters and/or a red skin rash which sometimes can be weeping (peeling off).
  • Breakdown of your red blood cells which is very rare and can cause anemia (decreased red blood cells)
  • Increased risk of a stroke in patients with pancreatic cancer. Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Eye irritation, increased tears, sensitivity to light and other changes in eyesight.
  • Erlotinib may interact with blood thinning medicine such as warfarin, which may increase your risk of bleeding. symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • Talk to your doctor and/or nurse if you smoke or have any changes in your smoking habit while taking erlotinib as this may lower the levels of the drug in your body, which can make it less effective. It is highly recommended to quit smoking while taking erlotinib.

How to Take Your Medication

  • Take this drug by mouth without food, at least 1 hour before you eat or 2 hours after you eat.
  • If you take an antacid such as Pepcid®, Tagamet®, and Zantac®, take erlotinib at least 2 hours before or 10 hours after you take the antacid. Antacids such as Maalox® and Mylanta® should be taken before or after erlotinib by several hours. Contact your physician for specific instructions.
  • Missed dose: If you vomit or miss a dose, contact your physician for further instructions. Do not take 2 doses at the same time and do not double up on the next dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • To help with decreased appetite, eat small, frequent meals.
  • Eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.

Food and Drug Interactions

  • Do not eat grapefruit or drink grapefruit juice while taking this medicine. Grapefruit and grapefruit juice may raise the levels of erlotinib in your body. This could make side effects worse.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with erlotinib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort and cigarette smoking while taking erlotinib as this may lower the levels of the drug in your body, which can make it less effective
  • Drugs that treat heartburn and stomach upset such Maalox®, Mylanta®, Protonix®, Nexium®, Prilosec®, Pepcid®, Tagamet®, and Zantac® may lower the effect of your cancer treatment if taken with erlotinib. Call your doctor to find out what drug you may take with erlotinib to help with heartburn or stomach upset.
  • There are known interactions of erlotinib with blood thinning medicine such as warfarin. Ask your doctor what precautions you should take.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Blurred vision or other changes in eyesight
  • Red or painful eye
  • Sensitivity to light
  • Pain in your chest
  • Dry cough or coughing up yellow, green, or bloody mucus
  • Wheezing or trouble breathing
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Severe Abdominal pain that does not go away
  • Easy bleeding or bruising
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Coughing up blood
  • Decreased urine, or very dark urine
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for 1 month after treatment. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: Women should not breastfeed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.Ask for information on sperm or egg banking.

Revised February 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.