Xalkori

Generic Name: crizotinib (kriz OH ti nib)
Brand Names: Xalkori

What is Xalkori?

Xalkori (crizotinib) is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Xalkori is used to treat non-small cell lung cancer.

Xalkori may also be used for purposes not listed in this medication guide.

Important information about Xalkori

Do not use Xalkori if you are pregnant. It could harm the unborn baby. Use effective birth control while you are using Xalkori and for at least 3 months after your treatment ends, whether you are a man or a woman.

Before you take Xalkori, tell your doctor if you have liver or kidney disease, a heart rhythm disorder, an electrolyte imbalance (such as low levels of potassium or magnesium in your blood), or a personal or family history of Long QT syndrome.

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Do not stop taking this medication without first talking to your doctor. There are many other drugs that can interact with Xalkori. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Before taking Xalkori

You should not use Xalkori if you are allergic to it crizotinib.

To make sure you can safely use Xalkori, tell your doctor if you have any of these other conditions:

• liver or kidney disease;

• a heart rhythm disorder;

• a personal or family history of Long QT syndrome; or

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

FDA pregnancy category D. Do not use Xalkori if you are pregnant. It could harm the unborn baby. Use effective birth control while you are using this medication and for at least 3 months after your treatment ends. If a man fathers a child while using Xalkori, the baby may have birth defects. Use a condom to prevent pregnancy while you are using this medication and for at least 3 months after your treatment ends. It is not known whether crizotinib passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using Xalkori.

See also: Xalkori pregnancy and breastfeeding warnings (in more detail)

How should I take Xalkori?

Take Xalkori exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Before you start treatment, your doctor may perform tests to make sure Xalkori is the best treatment for your type of lung cancer.

Xalkori is usually taken twice per day. Follow your doctor's instructions.

You may take Xalkori with or without food.

Do not crush, chew, dissolve, or open a Xalkori capsule. Swallow it whole. To be sure this medicine is helping your condition and is not causing harmful effects, your blood cells and liver function may need to be tested often. Your heart function may need to be tested with an electrocardiogram (ECG or EKG). Your cancer treatments may be delayed based on the results of these tests. Do not miss any follow-up visits to your doctor. Do not stop taking Xalkori without first talking to your doctor.

Store Xalkori in the original container at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if your next dose is less than 6 hours away. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Xalkori?

Grapefruit and grapefruit juice may interact with Xalkori and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Xalkori may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Xalkori side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Xalkori: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Xalkori and call your doctor at once if you have a serious side effect such as:

• severe dizziness, fainting, fast or pounding heartbeats;

• vision problems such as blurred vision, increased sensitivity of your eyes to light, or seeing flashes of light or "floaters";

• chest pain, dry cough or cough with mucus, wheezing, feeling short of breath;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

• fever, chills, body aches, flu symptoms, sores in your mouth and throat; or

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious Xalkori side effects may include:

• mild dizziness;

• tired feeling;

• nausea, vomiting, stomach pain, loss of appetite;

• diarrhea, constipation;

• mild rash or itching;

• cold symptoms such as stuffy nose, sneezing, sore throat;

• numbness or tingling; or

• swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Xalkori side effects (in more detail)

What other drugs will affect Xalkori?

Many drugs can interact with Xalkori. Below is just a partial list. Tell your doctor if you are using:

• a blood thinner such as warfarin (Coumadin, Jantoven);

• cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune) or tacrolimus (Prograf);

• dexamethasone (Cortastat, Dexasone, Solurex, DexPak);

• digoxin (digitalis, Lanoxin, Lanoxicaps);

• isoniazid (for treating tuberculosis);

• nicardipine (Cardene);

• pimozide (Orap);

• St. John's wort;

• theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl);

• an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), rifapentine (Priftin), or telithromycin (Ketek);

• an antidepressant such as citalopram (Celexa), desipramine (Norpramin), doxepin (Sinequan, Silenor), escitalopram (Lexapro), mirtazapine (Remeron), nefazodone, sertraline (Zoloft), trazodone (Desyrel, Oleptro), trimipramine (Surmontil), or venlafaxine (Effexor);

• antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

• a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);

• ergot medicine such as ergotamine (Ergomar, Cafergot) or dihydroergotamine (D.H.E. 45, Migranal Nasal Spray);

• a heart rhythm medication such as disopyramide (Norpace), procainamide (Procan, Pronestyl), or quinidine (Quin-G);

• HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), etravirine (Intelence), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, Kaletra), or saquinavir (Invirase); or

• seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), divalproex (Depakote), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), primidone (Mysoline), or valproic acid (Depakene, Stavzor).

This list is not complete and there are many other drugs that can interact with Xalkori. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about Xalkori.