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osimertinib (Oral route)

oh-sim-ER-ti-nib

Commonly used brand name(s)

In the U.S.

  • Tagrisso

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Tyrosine Kinase Inhibitor

Uses For osimertinib

Osimertinib is used to treat metastatic (cancer that has already spread) non-small cell lung cancer in patients who have certain types of abnormal epidermal growth factor (EGFR) genes. It is used in patients who have already received an EGFR tyrosine kinase inhibitor and it has stopped working. Your doctor will perform a test before you take osimertinib.

Osimertinib belongs to the group of medicines called antineoplastics (cancer medicines). It works by interfering with the growth of cancer cells, which are eventually destroyed.

osimertinib is available only with your doctor's prescription.

Before Using osimertinib

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 osimertinib, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to osimertinib 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 osimertinib 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 osimertinib in the elderly.

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 taking osimertinib, 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 osimertinib 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.

  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Varicella Virus Vaccine

Using osimertinib 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.

  • Adenovirus Vaccine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Carbamazepine
  • Cholera Vaccine, Live
  • Enzalutamide
  • Fosphenytoin
  • Influenza Virus Vaccine, Live
  • Lumacaftor
  • Mitotane
  • Phenytoin
  • Poliovirus Vaccine, Live
  • Rifampin
  • Smallpox Vaccine
  • St John's Wort
  • Typhoid Vaccine
  • Yellow Fever Vaccine

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 osimertinib. Make sure you tell your doctor if you have any other medical problems, especially:

  • Electrolyte or mineral imbalance (eg, high or low sodium, potassium, or magnesium) or
  • Heart disease (eg, congestive heart failure) or
  • Heart rhythm problems (eg, congenital long QT syndrome) or
  • Lung disease or breathing problems (eg, interstitial lung disease, pneumonitis), history of—Use with caution. May make these conditions worse.

Proper Use of osimertinib

Take osimertinib exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

osimertinib should come with a patient information insert. Read and follow these instructions carefully. Ask your doctor if you have any questions.

You may take osimertinib with or without food.

If you have trouble swallowing the tablet:

  • Dissolve it in 2 ounces of water. Do not use carbonated water or other liquids.
  • Stir until the tablet is in small pieces. Do not crush or heat.
  • Drink the liquid immediately or it may be given through a nasogastric tube.
  • Add 4 to 8 ounces of water in the same container, and drink it immediately.

Dosing

The dose of osimertinib will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of osimertinib. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For lung cancer:
      • Adult—80 milligrams (mg) once a day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of osimertinib, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using osimertinib

It is very important that your doctor check your progress at regular visits to make sure osimertinib is working properly. Blood tests may be needed to check for unwanted effects. Your dose may be reduced, or the medicine withheld or stopped, if certain side effects occur.

Using osimertinib while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Female patients should use effective birth control during treatment and for at least 6 weeks after the last dose. Male patients who have female partners should use effective birth control during treatment and for at least 4 months after the last dose. If you think you or your partner becomes pregnant while using the medicine, tell your doctor right away.

If you plan to have children, talk with your doctor before using osimertinib. Some men and women using osimertinib have become infertile (unable to have children).

osimertinib may cause swelling of the lungs (pneumonitis) or interstitial lung disease. These are life-threatening conditions and require immediate medical attention. The symptoms may be similar to the symptoms from lung cancer. Check with your doctor right away if you have new or worsening cough, fever, shortness of breath, or trouble breathing.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a slow, fast, pounding, or uneven heartbeat.

osimertinib may cause heart problems. Tell your doctor right away if you have fast, pounding, or uneven heartbeat, lightheadedness, shortness of breath, or swelling of your ankles or feet.

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 (eg, St. John's wort) or vitamin supplements.

osimertinib 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 immediately if any of the following side effects occur:

More common
  • Anxiety
  • cough
  • dizziness, lightheadedness, or fainting
  • eye or vision changes
  • fast, pounding, or uneven heartbeat
  • pain in the chest, groin, or legs, especially the calves
  • pain, redness, or swelling in the arm or leg
  • shortness of breath or troubled breathing
  • slurred speech
  • sudden loss of coordination
  • sudden, severe headache
  • sudden, severe weakness or numbness in the arm or leg
Less common
  • Blurred vision
  • fever or chills
  • general feeling of discomfort or illness
  • inability to speak
  • seizures
  • sneezing
  • sore throat
  • sudden, severe weakness on one side of the body
  • temporary blindness
  • thickening of bronchial secretions

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
  • Back pain
  • changes in the fingernails or toenails, including brittleness, inflammation, pain, redness, tenderness, separation from nail bed, or shedding of nails
  • constipation
  • decreased appetite
  • diarrhea
  • headache
  • nausea
  • skin rash, dryness, or itching
  • swelling or inflammation of the mouth
  • unusual tiredness or weakness

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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