eribulin (Intravenous route)

er-i-BUE-lin MES-i-late

Commonly used brand name(s)

In the U.S.

  • Halaven

Available Dosage Forms:

  • Solution

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Eribulin

Uses For eribulin

Eribulin belongs to the group of medicines called antineoplastics (cancer medicines). It is used to treat metastatic (cancer that has already spread) breast cancer. eribulin is used in patients who have already received at least two types of cancer medicines.

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Eribulin interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by eribulin, other side effects may occur. Some of these may be serious and must be reported to your doctor right away. Some unwanted effects may not be serious but may cause concern. Some of the unwanted effects do not occur until months or years after the medicine is used.

Before you begin treatment with eribulin, you and your doctor should talk about the benefits of eribulin as well as the risks.

eribulin is to be administered only by or under the immediate supervision of your doctor.

Before Using eribulin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For eribulin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to eribulin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of eribulin injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of eribulin injection in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving eribulin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using eribulin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Piperaquine

Using eribulin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Clarithromycin
  • Crizotinib
  • Dabrafenib
  • Delamanid
  • Escitalopram
  • Fluoxetine
  • Ivabradine
  • Ketoconazole
  • Ondansetron
  • Pazopanib
  • Quetiapine
  • Sevoflurane
  • Vandetanib
  • Vemurafenib
  • Vinflunine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of eribulin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood or bone marrow problems (e.g., cytopenia, neutropenia) or
  • Congestive heart failure or
  • Heart rhythm problems (e.g., arrhythmias, QT prolongation) or
  • Mineral imbalance (e.g., low magnesium or potassium in the blood) or
  • Nerve problems (e.g., peripheral neuropathy)—Use with caution. May make these conditions worse. or
  • Heart rhythm problem (e.g., congenital long QT syndrome)—Eribulin injection should not be given in patients with this condition.
  • Kidney disease or
  • Liver disease—Use with caution. You may require a lower dose of eribulin. Talk with your doctor if you have concerns about this.

Proper Use of eribulin

A nurse or other trained health professional will give you eribulin in a hospital or cancer treatment center. eribulin is given through a needle placed in one of your veins.

eribulin is usually given on Day 1 and Day 8 of a 21-day cycle of treatment. This 2-day treatment is given again every 21 days until your body responds to the medicine or you and your doctor decide to stop the treatment. Each treatment usually takes about 2 to 5 minutes.

eribulin comes with a patient information leaflet. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Precautions While Using eribulin

It is very important that your doctor check your progress closely to make sure that eribulin is working properly. Blood tests may be needed to check for unwanted effects.

Using eribulin while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Eribulin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Check with your doctor right away if you are having burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet. These could be symptoms of a condition called peripheral neuropathy.

eribulin can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

eribulin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Black, tarry stools
  • bladder pain
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • bloody or cloudy urine
  • body aches or pain
  • burning, numbness, tingling, or painful sensations
  • chills
  • convulsions
  • cough
  • decreased urine
  • decreased weight
  • difficult or labored breathing
  • difficult, burning, or painful urination
  • dry mouth
  • ear congestion
  • fever
  • frequent urge to urinate
  • headache
  • increased thirst
  • irregular heartbeat
  • loss of appetite
  • loss of voice
  • lower back or side pain
  • mood changes
  • muscle pain or cramps
  • nasal congestion
  • nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • pale skin
  • rapid weight gain
  • runny nose
  • shortness of breath
  • sneezing
  • sore throat
  • tightness in the chest
  • troubled breathing with exertion
  • ulcers, sores, or white spots in the mouth
  • unsteadiness or awkwardness
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss
  • weakness in the arms, hands, legs, or feet
  • wheezing
Incidence not known
  • Fainting
  • irregular heartbeat, recurrent

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Acid or sour stomach
  • back pain
  • belching
  • bone pain
  • change in taste
  • cracked lips
  • depression
  • diarrhea
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • difficulty with swallowing
  • dizziness
  • hair loss or thinning of the hair
  • heartburn
  • indigestion
  • lack or loss of strength
  • loss of taste
  • muscle spasm or weakness
  • muscle stiffness
  • pain in the arms or legs
  • pain in the joints
  • rash
  • sleeplessness
  • sores, ulcers, or white spots on the lips, tongue, or inside the mouth
  • stomach discomfort, upset, or pain
  • swelling or inflammation of the mouth
  • trouble sleeping
  • unable to sleep
  • watering of the eyes
  • weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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