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How do you take Nerlynx?

Medically reviewed by Judith Stewart, BPharm. Last updated on April 13, 2023.

Official answer


Nerlynx is an oral treatment for HER2-positive breast cancer. It is taken as a dose of six 40 mg tablets (total of 240 mg) once a day, with food. For the first two months of treatment, patients should also take a medicine called loperamide to manage diarrhea, which is a common, and potentially severe side effect of Nerlynx. Nerlynx is usually taken for one year.

Nerlynx is an oral tyrosine kinase inhibitor:

  • used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treated with trastuzumab-based therapy.
    • Extended Adjuvant Treatment of Early Stage Breast Cancer: 240 mg (6 tablets) given orally once daily, with food, continuously until disease recurrence for up to one year.
  • used with a medicine called capecitabine to treat adults with HER2-positive breast cancer that has spread to other parts of the body (metastatic) and who have received two or more anti-HER2 therapy medicines for metastatic breast cancer.
    • Advanced or metastatic breast cancer: 240 mg (6 tablets) given orally once daily with food on Days 1-21 of a 21-day cycle plus capecitabine (750 mg/m2 given orally twice daily) on Days 1-14 of a 21-day cycle until disease progression or unacceptable toxicities.

Patients should start treatment with the anti-diarrhea medicine loperamide with the first dose of Nerlynx and continue for two months (56 days). After two months, loperamide can be used as needed to maintain bowel movement frequency to one or two per day.

  • Nerlynx is available as 40 mg tablets. Six 40 mg tablets are required to be taken for a 240 mg daily dose.
  • Your health care provider may change your dose if needed.
  • Nerlynx tablets should be taken with food, at the same time each day.
  • The tablets should be swallowed whole. Do not chew, crush, or split the tablets.
  • If you take an antacid medicine, take your Nerlynx dose three hours after the antacid medicine.
  • If you take an acid reducer (H2 receptor blocker), take your Nerlynx dose at least 2 hours before or 10 hours after you take the acid reducer.
  • If you miss a dose of Nerlynx, skip that dose and take your next dose at your regular scheduled time.
  • If you take too much Nerlynx, call your health care provider right away or go to the nearest hospital emergency room.
  • You should avoid eating products that contain grapefruit during treatment with Nerlynx.

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