Larotrectinib (Vitrakvi®)

Printable PDF Version

About This Drug

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

Possible Side Effects

  • Nausea and vomiting (throwing up)
  • Constipation (not able to move bowels)
  • Diarrhea (loose bowel movements)
  • Tiredness
  • Changes in your liver function
  • Dizziness
  • Cough

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

Warnings and Precautions

  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, have hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • Severe changes in your liver function

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

  • This drug may impair your ability to drive or use machinery. Use caution and tell your nurse or doctor if you feel dizzy or have any other central nervous symptoms.

How to Take Your Medication

  • Capsules: Swallow the medicine whole with or without food. Do not crush or chew capsules.
  • Oral solution: Please refer to the package insert for administration instruction.
  • Equal doses of the oral solution and capsules can be substituted for each other.
  • Missed dose: If you miss a dose, and it is less than 6 hours until your next dose, then skip the missed dose and go back to your normal schedule. If you miss a dose, and it is more than 6 hours until your next dose, take the missed dose. Do not take 2 doses at the same time or extra doses. Do not replace a vomited dose. If you vomit a dose or miss a dose, contact your doctor.
  • 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: Capsules: Store capsules in the original container at room temperature.
  • Storage: Oral solution: Store oral solution in the original bottle in the refrigerator, between 36°F to 46°F (2°C to 8°C). Do not freeze. Opened bottles should be used within 90 days. 
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • 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.
  • If you throw up or have diarrhea, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you have 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 doctor or nurse about medicines that are available to help stop or lessen constipation, diarrhea.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • If you are dizzy, get up slowly after sitting or lying.

Food and Drug Interactions

  • Avoid grapefruit or grapefruit juice while taking this medicine as it may raise the levels of larotrectinib in your body which could make side effects worse.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with larotrectinib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort while taking larotrectinib as this may lower the levels of the drug in your body, which can make it less effective.

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
  • Tiredness that interferes with your daily activities
  • Agitation or confusion
  • Seizures
  • Hallucinations
  • Trouble understanding or speaking
  • Loss of control of bowels or bladder
  • Blurry vision or changes in your eyesight
  • Feeling dizzy or lightheaded
  • Numbness or lack of strength to your arms, legs, face, or body
  • Have a seizure or coma
  • Coughing 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
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • No bowel movement in 3 days or when you feel uncomfortable
  • 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
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 1 week after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 1 week after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breast feed during treatment and for 1 week after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In women, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on egg banking.

New December 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.