All About Tarceva

What is Tarceva?

If you have a certain kind of lung cancer or pancreatic cancer, your doctor may recommend Tarceva to treat your condition. Tarceva is a prescription medication that’s used in adults to treat:

• non-small cell lung cancer that:
  • is metastatic (has spread to other parts of your body), and
  • has certain mutations (abnormal changes)
• pancreatic cancer* that is any of the following:
  • locally advanced (spread into nearby tissues)
  • not removable with surgery
  • metastatic

Tarceva is used to treat these types of cancer in certain situations. It also has some limitations of use. To learn more about how Tarceva is used, see the “What is Tarceva used for?” section below.

* For this use, you’ll take Tarceva with the chemotherapy drug gemcitabine.

Tarceva basics

Tarceva contains the active drug erlotinib, which belongs to a group of drugs called kinase inhibitors. It comes as a tablet that you swallow. You’ll take a dose once per day.

Tarceva is a targeted therapy for cancer. Targeted therapies aim to kill cancer cells without affecting healthy cells.

What is Tarceva’s dosage?

Your doctor will recommend the dosage of Tarceva that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths (25 mg, 100 mg, 150 mg)

Tarceva comes as a tablet that you take by mouth. It’s available in three strengths:

• 25 milligrams (mg)
• 100 mg
• 150 mg

Recommended dosages

The recommended dosing schedule for Tarceva for each of its uses is described below.

Dosage for non-small cell lung cancer

For non-small cell lung cancer, you’ll typically take 150 mg of Tarceva once daily.

Dosage for pancreatic cancer

For pancreatic cancer, you’ll typically take 100 mg of Tarceva once per day.

To learn more about Tarceva’s dosage and administration, see this article.

Questions about Tarceva’s dosing

Below are some common questions about Tarceva’s dosing.

• What if I miss a dose of Tarceva? If you miss a dose of Tarceva, take the missed dose as soon as possible. But if it’s almost time for your next dose, skip the missed dose and take your next dose at its usual time. You should not take two doses at once to make up for a missed dose. Doing so could raise your risk of side effects.
• How long can you take Tarceva? You can usually take Tarceva for as long as the drug continues to work for your cancer. But if you have bothersome side effects, your doctor may recommend stopping your treatment.
• How long does Tarceva take to work? Tarceva starts working soon after you take your first dose. But it’s not likely that you’ll feel the drug working in your body. Your doctor will likely monitor how the drug is working for you with scans or other tests. If you have questions about what to expect from your Tarceva treatment, talk with your doctor.

What are Tarceva’s side effects?

Like most drugs, Tarceva may cause mild or serious side effects. The lists below describe some of the more common side effects that Tarceva may cause. These lists don’t include all possible side effects.

Keep in mind that the side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Tarceva. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Tarceva can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Tarceva’s prescribing information.

Mild side effects of Tarceva that have been reported include:

• mild skin rash
• dry or itchy skin
• pain in your back, joints, or muscles
• chest pain
• diarrhea
• reduced appetite
• fatigue (low energy)
• general weakness
• shortness of breath
• cough
• nausea and vomiting
• infection
• sores in your mouth
• increased hair growth on the face and body
• unusually long eyelashes
• brittle or loose nails
• mild allergic reaction*

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Tarceva can occur, but they aren’t common. If you have serious side effects from Tarceva, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Tarceva that have been reported include:

• severe blistering or peeling skin rashes
• interstitial lung disease (scarring in the lungs)
• severe diarrhea
• liver problems, such as raised liver enzymes or liver failure
• kidney failure
• tear in the lining of the stomach or intestine
• extremely dry eyes, which may lead to severe eye side effects, such as inflammation or ulcers in the cornea (the clear layer over the front of the eye)
• stroke
• breakdown of red blood cells that leads to low red blood cell count
• low level of platelets (cells that help with blood clotting)
• severe allergic reaction*

* To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

While allergic reaction wasn’t reported in studies of Tarceva, it can still happen.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Tarceva. But if you think you’re having a medical emergency, call 911 or your local emergency number.

What are some frequently asked questions about Tarceva?

Find answers to some commonly asked questions about Tarceva.

Is Tarceva a kind of insulin?

Tarceva is not insulin, and it’s not used to treat diabetes. Instead, Tarceva is used to treat certain kinds of lung cancer and pancreatic cancer.

In rare cases, people with pancreatic cancer may develop diabetes. This can happen if the cancer damages the insulin-producing cells in your pancreas. If that occurs, you may be prescribed insulin.

One kind of insulin you might be prescribed is called Tresiba. Some people may confuse Tresiba with Tarceva because the two drug names sound similar.

How long does Tarceva extend life?

Exactly how long Tarceva may extend your life depends on several factors. These include the type and stage of your cancer, other treatments you’ve had, and how your body responds to Tarceva.

To learn about the possible results you may have with Tarceva, talk with your doctor.

What should I know about alternatives to Tarceva, such as Tagrisso or Iressa?

The drugs osimertinib (Tagrisso) and gefitinib (Iressa) are alternatives to Tarceva for treating non-small cell lung cancer. But neither drug is used for pancreatic cancer (which Tarceva is used to treat).

Tarceva, Tagrisso, and Iressa are very similar treatments. They’re all taken by mouth once per day. They have some similar side effects and others that vary.

For example, Tarceva and Iressa can both cause tears in your digestive system. Tagrisso doesn’t have this side effect, but it can sometimes cause heart side effects. So, Tagrisso might be a good option if you have certain digestive problems. But if you have a heart problem, Tarceva or Iressa might be better for you.

Your doctor can tell you more about alternatives to Tarceva for treating your cancer. And they can help determine which treatment may be best for you.

Does Tarceva cause acne?

No, Tarceva doesn’t cause acne. But the drug commonly causes a rash that looks like acne. With this kind of rash, you may have pus-filled spots on areas typically affected by acne, such as your face, neck, chest, or back. Unlike acne, this rash can be itchy.

Acne-like rashes usually develop within a few days of starting Tarceva. They tend to get better after a few weeks as you continue to take the drug. The rash is typically mild, but in some cases, it can be more severe.

There’s some evidence that if you develop this kind of rash with Tarceva, the drug is likely working well for your cancer.

If you have an acne-like rash that’s bothersome to you, talk with your doctor. They may prescribe a steroid or antibiotic cream to treat the rash. They may also temporarily lower your dosage of Tarceva.

Is hair loss a side effect of Tarceva?

No, Tarceva should not cause hair loss. In studies, this wasn’t reported as a side effect in people who took Tarceva. On the other hand, some people have experienced hirsutism (increased hair growth on the face and body) with Tarceva.

If you take Tarceva for pancreatic cancer, you’ll take Tarceva with the chemotherapy drug gemcitabine. As with other chemotherapy drugs, gemcitabine can cause hair loss.

If you’re concerned about changes to your hair while taking Tarceva, talk with your doctor.

What is Tarceva’s price?

The costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

Tarceva is available as the generic drug erlotinib. Generics usually cost less than brand-name drugs. Talk with your doctor if you’d like to learn about taking generic erlotinib.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. In addition, Medicine Assistance Tool lists programs that may help lower the cost of Tarceva. For more information and to find out if you’re eligible for support, visit the organization’s website.

You can also check out this article to learn more about saving money on prescriptions.

What is Tarceva used for?

Tarceva is used to treat certain kinds of lung cancer and pancreatic cancer. Tarceva may also be used off-label for other conditions. (With off-label use, a drug that’s approved for certain conditions is used for another use.) Talk with your doctor for more information.

Tarceva for non-small cell lung cancer

Tarceva is used in adults to treat non-small cell lung cancer that:

• is metastatic (has spread to other parts of your body), and
• has certain epidermal growth factor receptor (EGFR) mutations (abnormal changes in the EGFR gene)

Specifically, Tarceva treats EGFR mutations called exon 19 deletions and exon 21 substitutions. Your doctor will use a test to check if your cancer has these mutations.

Tarceva may be used in the following ways for this type of lung cancer:

• as a first treatment
• as a maintenance (long-term) treatment
• as a treatment after you’ve tried at least one other chemotherapy treatment but your cancer has gotten worse

Tarceva for pancreatic cancer

Tarceva is used in adults to treat pancreatic cancer that’s any of the following:

• locally advanced (spread into nearby tissues, such as lymph nodes)
• not removable with surgery
• metastatic

Tarceva is a first-line treatment for pancreatic cancer. (This means it’s typically prescribed if you haven’t tried any other treatments for your cancer.) To treat pancreatic cancer, Tarceva is used with gemcitabine, a chemotherapy drug.

Limitations of use

It’s not known if Tarceva is safe or effective for treating non-small cell lung cancer with EGFR mutations other than exon 19 deletions and exon 21 substitutions.

Tarceva isn’t recommended for use with platinum-based chemotherapy drugs, such as cisplatin or carboplatin.

To learn whether you can take Tarceva for your condition, talk with your doctor.

What should be considered before taking Tarceva?

Several factors can affect whether Tarceva is a good option for you. Some important things to consider include your health history, other conditions you have, and other medications you take. Read on to find out how Tarceva may interact with these factors.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Tarceva, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Tarceva.

For information about drug-condition interactions, see the “Warnings” section below.

Interactions with drugs or supplements

Tarceva can interact with several types of drugs. These drugs include:

• certain antifungal drugs, such as ketoconazole, itraconazole (Sporanox), and voriconazole (Vfend)
• certain antibiotics, such as clarithromycin, ciprofloxacin (Cipro), rifampin (Rifadin, Rimactane), rifapentine (Priftin), and rifabutin (Mycobutin)
• certain HIV drugs, such as atazanavir (Reyataz), nelfinavir (Viracept), and ritonavir (Norvir)
• certain seizure medications, such as phenytoin (Dilantin, Phenytek), carbamazepine (Tegretol, Carbatrol, others)
• drugs to reduce stomach acid, such as esomeprazole (Nexium), famotidine (Pepcid), and calcium carbonate (Tums)
• the antidepressant drug nefazodone
• the blood thinner warfarin (Jantoven)
• the multiple sclerosis drug teriflunomide (Aubagio)
• the herbal supplement St. John’s wort

This list does not contain all types of drugs that may interact with Tarceva. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Tarceva.

Other interactions

You should avoid eating grapefruit and drinking grapefruit juice while taking Tarceva. Grapefruit causes your body to break down Tarceva more slowly than usual. This could cause the drug to build up in your body, which may raise your risk of side effects.

Warnings

Tarceva can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Tarceva is a good treatment option for you.

Talk with your doctor about your health history before you take Tarceva. Factors to consider include those described below.

Smoking. Smoking tobacco lowers the amount of Tarceva in your body, which can make the drug less effective. If you smoke, your doctor may prescribe a dosage of Tarceva that’s higher than usual. Your doctor will likely also recommend that you quit smoking.

If you stop smoking during treatment, it’s important to tell your doctor right away. They’ll lower your dosage of Tarceva. This is because continuing to take a higher dose of Tarceva after you’ve quit smoking can raise your risk of serious side effects.

Liver or kidney problems. Tarceva can cause liver or kidney problems. It could also worsen any liver or kidney problems you already have. If you have liver or kidney problems, your doctor may prescribe a lower dosage of Tarceva for you. They will also regularly check your liver and kidney function during your treatment. If liver or kidney problems occur, your doctor may have you pause or stop taking Tarceva.

Dehydration. Tarceva can cause nausea, vomiting, and diarrhea. In some cases, these side effects could lead to dehydration. This can raise your risk of kidney failure with Tarceva.

If you’re losing lots of fluids through vomiting or diarrhea or can’t drink fluids due to nausea, talk with your doctor right away. They can suggest a treatment option for your dehydration. And in some cases, they may have you temporarily stop taking Tarceva.

Peptic ulcer or diverticulitis. In rare cases, Tarceva may cause tears in the lining of your stomach or intestines. If you’ve had a peptic ulcer or diverticulitis before, you may have a higher risk of this side effect. Talk with your doctor about whether Tarceva is safe for you.

Allergic reaction. If you’ve had an allergic reaction to Tarceva or any of its ingredients, your doctor will likely not prescribe Tarceva. Ask them what other medications are better options for you.

Tarceva and alcohol

Tarceva isn’t known to interact with alcohol. But drinking alcohol while you’re taking this drug may raise your risk of certain side effects, such as nausea and diarrhea. Drinking excessive amounts of alcohol may also raise your risk of liver or kidney problems.

If you drink alcohol, talk with your doctor about how much is safe to drink while you’re taking Tarceva.

Pregnancy and breastfeeding

Tarceva is not safe to take during pregnancy. It could cause harm to a fetus. If you’re pregnant or planning to become pregnant, talk with your doctor about possible treatment options for your condition.

If you could become pregnant, you should use birth control while taking Tarceva and for 1 month after your last dose.

You should not take Tarceva while breastfeeding. It’s not known whether Tarceva passes into breast milk. But if it does, it could cause serious side effects in a child who’s breastfed. If you’re breastfeeding, talk with your doctor about your options.

How is Tarceva taken?

Your doctor will explain how you should take Tarceva. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Tarceva

Tarceva comes as a tablet that you swallow. You’ll take a dose once per day on an empty stomach. (This means at least 1 hour before or 2 hours after eating.)

Accessible medication containers and labels

If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:

• have large print
• use braille
• contain a code you can scan with a smartphone to change the text into audio

Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.

Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Tarceva in an easy-open container. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.

Taking Tarceva with other drugs

If you take Tarceva for pancreatic cancer, you’ll take it with a chemotherapy drug called gemcitabine (Infugem). You’ll receive gemcitabine as an intravenous (IV) infusion (an injection into a vein over a period of time). Your doctor will explain how often you’ll receive gemcitabine.

Questions about taking Tarceva

Below are some common questions about taking Tarceva.

• Can Tarceva be chewed, crushed, or split? No, Tarceva should be swallowed whole. If you have trouble swallowing the tablets, talk with your doctor or pharmacist.
• Should I take Tarceva with food? No, you should take Tarceva on an empty stomach. This means you should take the drug at least 1 hour before or 2 hours after eating.
• Is there a best time of day to take Tarceva? No. You can take Tarceva at any time of day. But you should try to take it at the same time each day. This helps keep a steady level of the drug in your body, which helps it work effectively.

Questions for your doctor

You may have questions about Tarceva and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

• Before your appointment, write down questions such as:
  • How will Tarceva affect my body, mood, or lifestyle?
• Bring someone with you to your appointment if doing so will help you feel more comfortable.
• If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

What should be done in case of overdose?

Do not take more Tarceva than your doctor prescribes. Taking more than this can lead to serious side effects.

What to do in case you take too much Tarceva

Call your doctor if you think you’ve taken too much Tarceva. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.