Erlotinib Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Non-Small Cell Lung Cancer

150 mg orally once a day

Duration of therapy: Treatment should continue until disease progression or unacceptable toxicity occurs.

Comments:
-Erlotinib should be taken at least one hour before or two hours after ingestion of food.
-Erlotinib is not recommended for use in combination with platinum-based chemotherapy
-Safety and efficacy of erlotinib have not been evaluated as first-line treatment in patients with metastatic NSCLC whose tumors have EGFR mutations other than exon 19 deletions or exon 21 (L858R) substitution.

Usual Adult Dose for Pancreatic Cancer

100 mg orally once a day

Duration of therapy: Treatment should continue until disease progression or unacceptable toxicity occurs.

Comments: Erlotinib should be taken at least one hour before or two hours after ingestion of food.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Because erlotinib is eliminated by hepatic metabolism and biliary excretion, caution is recommended when administering erlotinib to patients with hepatic dysfunction. Dose reductions or interruption should be considered if severe adverse reactions occur.

Dose Adjustments

Discontinue erlotinib therapy for:
-Interstitial Lung Disease (ILD)
-Severe hepatic toxicity that does not improve or resolve within 3 weeks
-GI perforation
-Severe bullous, blistering or exfoliating skin conditions
-Corneal perforation of severe ulceration

Withhold erlotinib therapy for:
-Diagnostic evaluation of possible ILD
-Severe (grade 3 to 4) renal toxicity and consider discontinuation
-Without preexisting hepatic impairment: Total bilirubin levels greater than 3 times the upper limit of normal (ULN) or transaminases greater than 5 times ULN, and consider discontinuation
-With preexisting hepatic impairment or biliary obstruction: Doubling of bilirubin or tripling of transaminase values over baseline and consider discontinuation
-Persistent, severe diarrhea not responsive to medical management
-Severe rash not responsive to medical management
-Keratitis of grade 3 to 4, or for grade 2 lasting greater than 2 weeks
-For acute/worsening ocular disorders such as eye pain, and consider discontinuation

Reduce erlotinib dose in 50 mg decrements:
-If severe reactions occur with concomitant use of strong CYP450 3A4 inhibitors or when using concomitantly with an inhibitor of both CYP450 3A4 and CYP450 1A2. Avoid concomitant use if possible.
-When restarting therapy following withholding treatment for a dose-limiting toxicity that has resolved to baseline or grade 1 or less.

Increase erlotinib dose in 50 mg increments as tolerated for:
-Concomitant use with CYP450 3A4 inducers. Increase dose by 50 mg increments at 2 week intervals to a maximum of 450 mg. Avoid concomitant use, if possible.
-Concurrent cigarette smoking. Increase by 50 mg increments at 2 week intervals to a maximum of 300 mg. Immediately reduce the dose of erlotinib to the recommended dose (150 mg or 100 mg daily) upon cessation of smoking.

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Data not available

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