If you have certain cancers, your doctor might suggest Xalkori as a treatment option. It’s a prescription drug used to treat certain kinds of:

You’ll take Xalkori long term until your side effects become too bothersome, or until your cancer grows or worsens.

Xalkori comes as a capsule that you swallow. It contains the active ingredient crizotinib. (An active ingredient is what makes a drug work.)

For more information about Xalkori, including details about its uses, see this in-depth article on the drug.

Like other drugs, Xalkori can cause mild to serious side effects. Taking this drug during pregnancy is not advised due to the risk of harm. There are other medical conditions that can also increase your risk of certain side effects of Xalkori. Keep reading to learn more.

Some people may experience mild to serious side effects during Xalkori treatment. These side effects are common and can vary depending on whether the drug is used for non-small cell lung cancer (NSCLC) or anaplastic large cell lymphoma (ALCL).

These are just a few of the more common side effects reported by people who took Xalkori in studies. Other mild and serious side effects are discussed in greater detail below.

More common side effects in people taking Xalkori for NSCLC include:

More common side effects in people taking Xalkori for ALCL include:

* To learn more about this side effect, see the “Side effects explained” section below.

Like most medications, Xalkori can cause mild side effects. Most people who took Xalkori in studies had at least one mild side effect, but were usually able to continue treatment.

Examples of mild side effects that have been reported with Xalkori include:

* Rarely, changes in liver function tests can be a sign of liver damage. To learn more about Xalkori and liver damage, see “Side effect details” below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Xalkori unless your doctor recommends it.

Xalkori may cause mild side effects other than those listed above. See the Xalkori prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Xalkori, visit MedWatch.

Serious side effects with Xalkori treatment are possible. Some of these are more common than others, and some can vary depending on the condition the drug is being taken to treat.

Serious side effects that have been reported with Xalkori include:

If you develop serious side effects while taking Xalkori, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Xalkori, but it’s not clear whether this side effect occurred in studies.

Xalkori is prescribed for children and young adults (up to age 21 years) to treat a kind of cancer called anaplastic large cell lymphoma (ALCL). In studies of the drug, side effects for treating ALCL didn’t differ greatly from those for treating non-small cell lung cancer (NSCLC) in adults. But there were a few differences.

Hypotension (low blood pressure) is a unique side effect reported in children and young adults in the ALCL studies. This side effect wasn’t reported in adults who took Xalkori for treating NSCLC.

Severe stomach and digestive problems were reported in children and young adults who took Xalkori for ALCL. These included severe diarrhea, nausea, vomiting, and mouth sores.

Finally, blood clots, including pulmonary embolism (blood clot in the lungs), were more common in children and young adults taking Xalkori.

Talk with your child’s doctor if you’re interested in learning more about this drug’s side effects in children. You can also learn more about lung problems, including pulmonary embolism, in “Side effects explained” just below.

Learn more about some of the side effects Xalkori may cause.

Ocular side effects

Treatment with Xalkori can cause ocular (eye-related) side effects. Both mild and serious eye-related side effects are possible with this drug.

Mild eye-related side effects are among the most common side effects reported in Xalkori’s studies. These include:

Rarely, eye-related side effects caused by Xalkori can be severe. This can include vision loss, which may be caused by damage to your eye nerves.

Eye-related side effects are most likely to occur during your first week of taking Xalkori. But they can happen at any time during treatment.

What might help

Before you begin treatment with Xalkori, your doctor will have you complete an eye exam. This provides information about your eye health that your doctor can reference if you develop eye-related side effects from the drug. They’ll also order an eye exam for you within your first month of treatment. You’ll then continue to get eye exams at least every 3 months for as long as you take Xalkori.

Immediately contact your doctor if you notice eye-related side effects while taking Xalkori. If your symptoms are mild or moderate, your doctor may lower your dose of the drug. They may also refer you to an eye specialist.

If your symptoms are severe, your doctor will likely recommend that you stop taking Xalkori temporarily. They’ll then evaluate your symptoms to see if something else could be causing them. If they determine the drug is the probable cause of your eye problems, they’ll likely have you stop taking Xalkori permanently.

Lung problems

Lung problems are possible with Xalkori treatment and may be severe. But these weren’t common in the drug’s studies. Lung problems that were reported include:

* These conditions are most common in the first 3 months of taking Xalkori, but can happen at any point during treatment.

In rare cases, lung problems caused by Xalkori can be severe or life threatening.

Symptoms of lung problems caused by this drug can be similar to those caused by lung cancer. This includes the kind of non-small cell lung cancer Xalkori is used to treat. These symptoms include:

What might help

Call your doctor immediately if you notice new or worsening symptoms of lung problems while taking Xalkori. They’ll likely want to see you to evaluate your symptoms. Depending on your doctor’s findings, they may have you stop taking Xalkori permanently. And depending on how severe your symptoms are, you may need to have them treated in a hospital. Your doctor will help you determine the best lung cancer treatment going forward.

Abnormal heart rhythm

Abnormal heart rhythm is a serious side effect Xalkori may cause.

There were two specific kinds of abnormal heart rhythm reported in the drug’s studies:

These heart rhythm problems often don’t cause symptoms. But it’s possible you may notice some, such as:

What might help

Due to the risk of abnormal heart rhythm, doctors may not prescribe Xalkori based on certain conditions. These include if you:

* The QT interval is the time it takes your heart to contract and relax.

If you have any of the above conditions and your doctor prescribes Xalkori for you, they’ll monitor your heart health closely during treatment. This will include checking your heart rate and blood pressure regularly.

If you notice symptoms of an abnormal heart rhythm while taking Xalkori, contact your doctor right away. They’ll likely ask you to come in so they can evaluate your symptoms in person. Depending on their findings, they may:

  • lower your Xalkori dose to see if your symptoms go away
  • temporarily or permanently stop your Xalkori treatment
  • prescribe a treatment for the abnormal heart rhythm

Liver damage

While rare, it’s possible to have liver damage as a side effect of Xalkori. This can be severe or life threatening in rare cases.

Changes in liver function tests, which can be a sign of liver damage, are most common during the first 2 months of treatment. But liver-related side effects can occur at any time while you’re taking Xalkori.

Changes in liver function tests don’t usually cause symptoms. (See “What might help” below to learn more about how your doctor will monitor these results.) But in the rare case that you have liver damage from Xalkori, you may notice symptoms such as:

What might help

Your doctor will order blood tests to check your liver function while you’re taking Xalkori. Specifically, you’ll have these tests every 2 weeks for your first 2 months of treatment. Then your doctor will order them once each month and any other time as needed.

Depending on the results of your liver function tests, your doctor may have you:

  • temporarily pause treatment with Xalkori until your liver function levels become healthy
  • permanently stop taking Xalkori

Contact your doctor right away if you notice symptoms of liver damage. They’ll likely want to examine you in person and order liver function tests. If they confirm you have liver damage, they’ll likely have you stop taking Xalkori permanently.

Allergic reaction

Like most drugs, Xalkori can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine)
  • a topical product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Xalkori, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Xalkori, they may have you switch to a different treatment.

Keeping track of side effects

During Xalkori treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Xalkori affects you. They can then use this information to adjust your treatment plan if needed.

Get answers to some frequently asked questions about Xalkori’s side effects.

What should I know about side effects of Xalkori compared with Alecensa?

Alecensa and Xalkori are both prescribed to treat certain kinds of non-small cell lung cancer (NSCLC) in adults. They can cause many similar side effects, including:

To learn more about how these drugs compare, check out this article. You can also talk with your doctor or pharmacist.

Does Xalkori cause hair loss?

No, hair loss wasn’t reported in the drug’s studies and isn’t a side effect expected with Xalkori.

Hair loss is a common side effect caused by chemotherapy drugs (traditional drugs used to treat cancer). Chemotherapy drugs are prescribed to treat many cancers, including lung cancer and lymphoma. Chemotherapy is sometimes prescribed along with Xalkori. There are also reports of hair loss with targeted therapies such as alectinib, which is a drug similar to Xalkori. This medication is also prescribed to treat a certain kind of non-small cell lung cancer (NSCLC).

But there haven’t been any reports of hair loss with Xalkori alone since the drug was approved for use.

Talk with your doctor if you’re concerned about hair loss and your cancer treatment.

Are older adults at higher risk of side effects with Xalkori?

Older adults (ages 65 years and over) aren’t expected to have a higher risk of side effects with Xalkori. In studies of people taking Xalkori for NSCLC, there were no differences in side effects between older and younger adults.

But certain factors may increase your risk of side effects if you’re an older adult. For example, as we age, we’re more likely to have problems with certain organ functions. For instance, having liver or kidney issues can increase your risk of side effects from Xalkori.

Older adults also often take more medications compared with younger adults. It’s possible that drugs you take may interact with Xalkori. This can increase your risk of side effects from Xalkori or the other medications.

If you’re an older adult, talk with your doctor about health conditions you have and medications you take that could increase your risk of side effects with Xalkori.

Xalkori may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Xalkori. Below are a few factors to consider.

Liver or kidney problems. If you have liver or kidney problems, your doctor will likely prescribe a lower dose of Xalkori for you. This is because your body uses these organs to get rid of Xalkori after you take a dose. And liver or kidney problems can affect your body’s ability to clear Xalkori from your system. This can raise the level of Xalkori in your body and possibly increase your risk of side effects, including nausea and diarrhea.

Lung problems. Xalkori can cause lung problems, including interstitial lung disease (inflammation and scarring in your lungs). While rare, these side effects can be severe or even deadly in extreme cases. Your doctor can determine whether Xalkori is safe for you to take if you have a condition affecting your lungs.

Heart problems, including long QT syndrome. While rare, treatment with Xalkori can cause heart problems, such as an abnormal heart rhythm. This includes a condition called long QT syndrome. Due to this risk, doctors usually won’t prescribe Xalkori if you were born with a long QT interval. (The QT interval is the time it takes your heart to contract and relax.) If you have other heart problems and your doctor prescribes Xalkori, they’ll monitor your heart health closely during treatment.

Eye or vision problems. Rarely, Xalkori can cause ocular (eye-related) side effects. This can include vision loss in extreme cases. If you already have eye or vision problems, you may be at an increased risk of eye-related side effects from Xalkori. This can include existing problems getting worse. Your doctor can determine whether Xalkori is safe for you to take.

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

Alcohol and Xalkori

There are no known interactions between taking Xalkori and consuming alcohol. But alcohol could increase your risk of certain Xalkori side effects, such as diarrhea, nausea, vomiting, and liver problems.

If you consume alcohol, talk with your doctor about how much, if any, is safe for you to drink while taking Xalkori.

Pregnancy and breastfeeding while taking Xalkori

Taking Xalkori during pregnancy is not recommended. If you can become pregnant, your doctor will order a pregnancy test to ensure you’re not pregnant before you begin treatment. They’ll also recommend using birth control during treatment and for at least 45 days after your last dose.

Breastfeeding while taking Xalkori is also not recommended. And you should avoid breastfeeding for at least 45 days after your last dose of the drug. Talk with your doctor about safe feeding options for your child while you’re taking Xalkori.

Xalkori can cause mild to severe side effects. Most people who took Xalkori in studies had at least one mild side effect. Severe side effects are much rarer.

Before starting Xalkori, talk with your doctor. Ask questions that help you feel comfortable about the drug and your risk of side effects. Some examples to get you started include:

  • Can any of my medications increase my risk of side effects from taking Xalkori?
  • If I have bothersome side effects while taking Xalkori, is there a lower dose I can try?
  • Will my risk of side effects increase the longer I take this drug?

Q:

Are there any foods I should avoid while taking Xalkori?

Anonymous

A:

You should avoid drinking grapefruit juice or eating grapefruit while you’re taking Xalkori.

Grapefruit and grapefruit juice can affect how your body breaks down Xalkori after you take a dose. They can cause the Xalkori level in your body to become too high, increasing your risk of side effects. This is especially true of mild side effects, including:

They can also increase your risk of serious side effects, such as an abnormal heart rhythm.

Due to these risks, it’s important to avoid the following while taking Xalkori:

  • eating grapefruit
  • drinking grapefruit juice
  • taking supplements that include grapefruit extract
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Was this helpful?

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 another 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.