Eribulin Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Breast Cancer

Initial dose: 1.4 mg/m2 intravenously over 2 to 5 minutes on days 1 and 8 of a 21-day cycle.

Renal Dose Adjustments

Mild renal dysfunction (CrCl 50 to 80 mL/min): No adjustment recommended.

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

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

Liver Dose Adjustments

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

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

Severe liver dysfunction: Data not available

Dose Adjustments

Eribulin should not be administered on day 1 or day 8 if the patient is experiencing grade 3 or 4 non-hematological toxicities, if the absolute neutrophil count (ANC) is less than 1000 cells/mm3 or if 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. If toxicities resolve or improve to less than or equal to grade 2 severity by day 15, eribulin 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 of eribulin 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 eribulin 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 of eribulin 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, eribulin should be discontinued.

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

Precautions

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 neuropathies.

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

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

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Eribulin should not be diluted in or administered through an intravenous line containing dextrose solutions or mixed with any other medicinal agents.

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

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