Crizotinib (Xalkori) | Side Effects, Dosage, Uses & More
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Generic Name:

crizotinib, Oral capsule

All Brands

  • XALKORI
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Highlights for crizotinib

Oral capsule
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Crizotinib is used to treat non-small cell lung cancer caused by a defect in a gene called anaplastic lymphoma kinase. It’s also used to treat non-small cell lung cancer that’s ROS1-positive. This drug is used when cancer has spread to other parts of your body.

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This drug comes in the form of a capsule you take by mouth.

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Crizotinib is only available as the brand-name drug Xalkori. It isn’t available as a generic drug.

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The more common side effects of this drug include vision problems, diarrhea, nausea, and edema (swelling of your face, hands, feet, or ankles).

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In some cases, crizotinib can cause serious side effects. These can include liver damage, lung or heart problems, and vision loss.

IMPORTANT INFORMATION

Liver damage

This drug may cause liver injury. This can be fatal (cause death). Your doctor should do blood tests every month during treatment to check your liver. Tell your doctor right away if you have any signs of liver damage. Symptoms can include yellowing of your skin or the whites of your eyes, dark-colored urine, bleeding or bruising more easily than normal, tiredness, and loss of appetite.

Lung problems

This drug may cause inflammation (swelling) of your lungs. This may be fatal (cause death). The symptoms of this condition may be similar to those of lung cancer. Tell your doctor right away if you have any new or worse symptoms. These may include trouble breathing, shortness of breath, cough, and fever.

Vision loss

This drug may cause partial or full vision loss. This can happen in one or both eyes. Tell your doctor right away if you have any loss of vision or have trouble seeing out of one or both eyes. If this drug causes vision problems, your doctor may have you stop taking the drug and tell you to see an eye doctor.

Use contraception (birth control)

This drug can harm or even end a pregnancy. Women of childbearing age should use reliable birth control during treatment and for at least 45 days after taking their last dose of this drug. Men shouldn’t get a woman pregnant during treatment. Men with a female partner of childbearing age should use reliable birth control during treatment and for at least 90 days after taking their last dose of this drug.

What is crizotinib?

Crizotinib is a prescription drug. It’s available as an oral capsule.

Crizotinib is only available as the brand-name drug Xalkori. It isn’t available as a generic drug.

Why it's used

Crizotinib is used to treat non-small cell lung cancer caused by a defect in a gene called anaplastic lymphoma kinase. It’s also used to treat non-small cell lung cancer that’s ROS1-positive. This drug is used when cancer has spread to other parts of your body.

How it works

Crizotinib belongs to a class of drugs called kinase inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

More Details

How it works

Crizotinib belongs to a class of drugs called kinase inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Crizotinib works by blocking certain proteins called kinases. It targets kinases produced by the anaplastic lymphoma kinase gene. This action stops the cancer cells from growing and spreading. 

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crizotinib Side Effects

Oral capsule

More Common Side Effects

The more common side effects of crizotinib can include:

  • vision problems

  • diarrhea

  • nausea

  • vomiting

  • constipation

  • swelling of your face, hands, and feet

  • increase in liver enzymes that may mean you have liver problems

  • upper respiratory infection

  • loss of appetite

  • change in how foods taste

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following: 

  • Liver problems. Symptoms can include:

    • yellowing of your skin or the whites of your eyes
    • tiredness
    • dark, brown, or tea-colored urine
    • nausea or vomiting
    • decreased appetite
    • pain on the right side of your stomach
    • bleeding or bruising more easily than normal
    • itching 
  • Lung problems. Symptoms may be similar to those from lung cancer. They can include:

    • trouble breathing or shortness of breath
    • cough with or without mucous
    • fever
  • Heart problems. Symptoms can include:

    • feeling dizzy or faint
    • abnormal heartbeats
  • Vision problems. Symptoms can include:

    • loss of vision in one or both eyes
    • change in vision or trouble seeing
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Crizotinib doesn’t cause drowsiness.

This drug can cause vision problems. These usually happen within 1 week of starting treatment. Tell your doctor right away if you have any changes in your vision. Symptoms include double vision, flashes of light, blurred vision, light hurting your eyes, or new or increased floaters (spots that drift in your field of vision). 

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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crizotinib May Interact with Other Medications

Oral capsule

Crizotinib can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Food interactions

You shouldn’t drink grapefruit juice or eat grapefruit during your treatment with this medication. It may increase the amount of this drug in your body to a harmful level. This may cause more side effects.

Medications that might interact with this drug

Interactions that increase your risk of side effects
  • Side effects from crizotinib: Taking crizotinib with certain medications may raise your risk of side effects from crizotinib. This is because the amount of that drug in your body is increased. Examples of these drugs include:
    • Atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, troleandomycin, and voriconazole. Taking these drugs with crizotinib may cause severe stomach upset, vision problems, and liver or lung issues. 
  • Side effects from other drugs: Taking crizotinib with certain medications raises your risk of side effects from those drugs. Examples of those drugs include:
    • Alfentanil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimiozide, quinidine, sirolimus, and tacrolimus. In general, you shouldn’t take these drugs with crizotinib. However, if you must use one of these drugs, your doctor may reduce your dose of crizotinib.

Interactions that can make your drugs less effective
  • When crizotinib is less effective: When crizotinib is used with certain drugs, it may not work as well to treat your condition. This is because the amount of crizotinib in your body may be decreased. Examples of these drugs include:
    • Carbamazepine, phenobarbital, phenytoin, rifabutin, rifampin, and St. John’s wort 

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Crizotinib warnings
People with kidney problems
People with kidney problems

If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of crizotinib in your body and cause more side effects. Your doctor may adjust your dose to reduce your risk of side effects. 

People with heart problems
People with heart problems

This drug can cause slow heart rate, abnormal heart rate, dizziness, and lightheadedness. Tell your doctor if you have any heart problems or are on any blood pressure medications before taking this drug. You may have a higher risk of side effects.  

Pregnant women
Pregnant women

The Food and Drug Administration (FDA) hasn’t assigned a pregnancy category to crizotinib.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug can harm your baby. Women of childbearing age should use reliable birth control during treatment with this drug and for at least 45 days after taking their last dose.

Men taking this drug shouldn’t get a woman pregnant during treatment. Men with a female partner of childbearing age should use reliable birth control during treatment with this drug and for at least 90 days after taking their last dose. 

Women who are breast-feeding
Women who are breast-feeding

It isn’t known if crizotinib passes into breast milk. If it does, it may cause side effects in a child who is breastfed. You shouldn’t breastfeed your child during treatment with crizotinib and for 45 days after taking your last dose.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication. 

For children
For children

This drug hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

When to call the doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

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How to Take crizotinib (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Non-small cell lung cancer (NSCLC)

Brand: Xalkori

Form: Oral capsule
Strengths: 200 mg, 250 mg
Adult dosage (ages 18 years and older)
  • Typical dose: Take 250 mg twice per day. You’ll take this drug until your cancer gets worse or until you can no longer tolerate it.
  • Dose changes: If you have severe side effects, your doctor will slowly reduce your dose. If you still cannot tolerate this drug, your doctor may have you stop taking it. 
Child dosage (ages 0–17 years)

This drug hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Special considerations

Kidney disease: If you have severe kidney disease but don’t need dialysis, your dose will be 250 mg taken once per day.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Crizotinib comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your cancer may progress or get worse.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body.

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember within 6 hours of your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You may not be able to tell if this drug is working. However, your doctor will do a physical exam and scans to check how your cancer is responding to treatment. Your doctor will tell you if the drug is working to treat your cancer.

Crizotinib is used for long-term treatment.

You’ll take this drug until your cancer gets worse or until you can no longer tolerate it.

Important considerations for taking crizotinib
take crizotinib with or without food
You may take crizotinib with or without food
timing
Take this drug at the time(s) recommended by your doctor
storage
Store this drug carefully
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medication is refillable
A prescription for this medication is refillable
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Travel
Travel
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Clinical monitoring
Clinical monitoring
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not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
prior authorization
Insurance
See Details

Store this drug carefully

  • Store crizotinib at room temperature. Keep it between 68°F and 77°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Kidney function. Your doctor will do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, your doctor may lower your dose of this drug.
  • Liver function. Your doctor should do blood tests at least every month while you’re taking this drug to check your liver.
  • Heart function. Your doctor will measure your heart rate and rhythm to see if you’re having side effects from this drug.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does crizotinib Cost?

Oral capsule

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These prices represent the lowest priced national pharmacies for crizotinib on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on April 16, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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