Why is this medication prescribed?

Ceritinib is a medication primarily prescribed for the treatment of a specific type of non-small cell lung cancer (NSCLC) known as anaplastic lymphoma kinase (ALK)-positive metastatic NSCLC. It is used when the cancer has progressed or when other treatments have not been effective.

Prescription of Ceritinib:

• Indication: It is prescribed for ALK-positive metastatic NSCLC, which means the cancer cells have a specific genetic mutation called ALK-positive.
• Treatment Stage: Ceritinib is typically used in patients who have already undergone other treatments that did not work well or for those who cannot tolerate other treatments.

How should this medicine be used?

Usage of Ceritinib:

• Dosage: The dosage of Ceritinib is usually determined by a healthcare provider based on the patient’s overall health, other medications they are taking, and specific characteristics of their cancer.
• Administration: Ceritinib is taken orally in capsule form.
• Timing: It is usually taken once daily, at around the same time each day, with or without food.
• Follow-up: It’s crucial to follow the prescribed dosage schedule exactly as instructed by the healthcare provider to ensure the medication works effectively.
• Monitoring: Patients taking Ceritinib may require regular monitoring of their blood tests and overall health to manage any potential side effects and to assess the response to treatment.
• Side Effects: Ceritinib can cause various side effects, ranging from mild to severe. Common side effects include nausea, diarrhea, vomiting, fatigue, and changes in liver function tests. Patients should report any unusual symptoms promptly to their healthcare provider.
• Interaction: It’s essential to inform the healthcare provider about all other medications, supplements, and vitamins being taken, as Ceritinib may interact with certain drugs.
• Compliance: Taking Ceritinib consistently and as prescribed is crucial for its effectiveness in managing ALK-positive NSCLC.

Always consult with a healthcare professional for specific guidance on the use of Ceritinib, as individual circumstances may vary.

Other uses for this medicine

Ceritinib is primarily used for the treatment of ALK-positive metastatic non-small cell lung cancer (NSCLC). It is not typically prescribed for other conditions or types of cancer unless specifically recommended by a healthcare provider for off-label use. The efficacy and safety of Ceritinib in other cancer types or conditions have not been extensively studied.

What special precautions should I follow?

Special Precautions for Ceritinib:

• Liver Function Monitoring: Ceritinib can affect liver function, so regular monitoring of liver enzymes (AST, ALT) is essential. If liver enzyme levels become elevated, dosage adjustments or temporary cessation of treatment may be necessary.
• Pulmonary Effects: Serious pulmonary adverse reactions, including interstitial lung disease/pneumonitis and respiratory failure, have been reported with Ceritinib. Patients should be monitored for new or worsening respiratory symptoms, such as dyspnea, cough, or fever.
• Cardiac Effects: Ceritinib may prolong the QT interval on electrocardiograms (ECGs), which can lead to serious cardiac arrhythmias. ECG monitoring should be conducted prior to starting treatment and periodically during treatment, especially in patients with a history of or risk factors for QT prolongation.
• Gastrointestinal Toxicity: Diarrhea, nausea, vomiting, and abdominal pain are common side effects of Ceritinib. Prophylactic use of anti-diarrheal medications and supportive care may be necessary to manage gastrointestinal toxicity.
• Hyperglycemia: Ceritinib can cause hyperglycemia (high blood sugar levels), especially in patients with pre-existing diabetes or glucose intolerance. Blood glucose levels should be monitored regularly during treatment.
• Vision Disorders: Visual disturbances, including blurred vision and photophobia, have been reported with Ceritinib. Patients experiencing visual symptoms should undergo ophthalmologic evaluation.
• Fertility and Pregnancy: Ceritinib may cause fetal harm if used during pregnancy. Effective contraception should be used by both males and females during treatment and for some time after discontinuation of Ceritinib. It is advised not to breastfeed while taking Ceritinib.
• Drug Interactions: Ceritinib is metabolized by CYP3A enzymes and may interact with drugs that inhibit or induce these enzymes. Caution should be exercised when co-administering Ceritinib with strong CYP3A inhibitors or inducers.
• Hepatic Impairment: Ceritinib exposure may be increased in patients with moderate to severe hepatic impairment. Close monitoring for adverse effects is recommended in these patients.

Always follow the specific instructions provided by your healthcare provider regarding the use of Ceritinib, including dosage, monitoring, and management of side effects.

What special dietary instructions should I follow?

• Hydration: Drink plenty of fluids to prevent dehydration, especially if experiencing diarrhea or vomiting.
• Diet: Eat small, frequent meals and avoid spicy, greasy, or acidic foods that may exacerbate nausea or stomach upset.
• Fiber: Consider incorporating high-fiber foods to help manage diarrhea, unless otherwise advised by your healthcare provider.

What should I do if I forget a dose?

• If you miss a dose of Ceritinib, take it as soon as you remember on the same day.
• If it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
• Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Ceritinib (Zykadia) can cause a range of side effects, varying from mild to severe. It’s important to note that not all people will experience these side effects, and their severity can differ among individuals. Here are some common and potentially serious side effects associated with Ceritinib:

Common Side Effects:

• Gastrointestinal Disturbances: Diarrhea, nausea, vomiting, abdominal pain, constipation.
• Fatigue: Feeling tired or weak.
• Liver Function Changes: Elevated liver enzymes (AST, ALT).
• Edema: Swelling, typically in the ankles and feet.
• Increased Blood Sugar Levels: Hyperglycemia.
• Vision Disturbances: Blurred vision, photophobia (sensitivity to light).
• Muscle Pain: Myalgia.
• Decreased Appetite.
• Rash or Skin Reactions.

Less Common but Serious Side Effects:

• Interstitial Lung Disease/Pneumonitis: Symptoms may include difficulty breathing, cough, or fever.
• Cardiac Effects: QT prolongation (visible on ECG), which can lead to serious heart rhythm disturbances.
• Liver Toxicity: Severe liver injury or failure.
• Pancreatitis: Inflammation of the pancreas, characterized by severe abdominal pain.
• Renal Failure: Impaired kidney function.
• Hyperglycemic Hyperosmolar Syndrome: Severe hyperglycemia leading to dehydration and altered mental status.
• Eye Disorders: Severe vision problems or loss of vision.
• Severe Skin Reactions: Stevens-Johnson syndrome or toxic epidermal necrolysis (rare but serious skin conditions).

It’s important to promptly report any unusual or severe symptoms to your healthcare provider while taking Ceritinib. They can help manage these side effects and adjust treatment as needed to minimize discomfort and ensure your safety. Regular monitoring of blood tests and other parameters may be required to monitor for potential side effects.

What should I know about storage and disposal of this medication?

Storage of Ceritinib:

• Room Temperature: Store Ceritinib capsules at room temperature, between 20°C to 25°C (68°F to 77°F).
• Protection from Light: Keep the capsules in the original container to protect them from light.
• Dry Place: Store Ceritinib in a dry place away from moisture and humidity.
• Childproof: Keep Ceritinib out of reach of children and pets, as it should not be used by anyone other than the prescribed patient.

Disposal of Ceritinib:

• Unused Medication: Dispose of any unused or expired Ceritinib capsules properly.
• Guidelines: Follow local regulations and guidelines for medication disposal. You can ask your pharmacist for specific instructions on how to dispose of Ceritinib safely.

In case of emergency/overdose

• Symptoms: In case of overdose or accidental ingestion of too much Ceritinib, symptoms may include severe nausea, vomiting, diarrhea, and potential exacerbation of other known side effects.
• Seek Medical Help: If you suspect an overdose, contact your healthcare provider, emergency services (911 in the US), or poison control center immediately.

What other information should I know?

• Monitoring: Your healthcare provider will monitor you closely while you are taking Ceritinib to check for any side effects or changes in your condition.
• Regular Appointments: Attend all scheduled appointments with your healthcare provider for blood tests and other evaluations as recommended.
• Contraception: Ceritinib can cause harm to an unborn baby, so effective contraception should be used during treatment and for some time after stopping the medication. Discuss contraception options with your healthcare provider.
• Interactions: Inform your healthcare provider about all medications (prescription, over-the-counter, herbal supplements) you are taking, as Ceritinib can interact with other drugs.
• Travel: If you plan to travel, ensure you have enough Ceritinib for the duration of your trip. Keep it in its original container with a copy of your prescription.
• Support: Consider joining a support group for cancer patients or discussing your experiences with Ceritinib with others who are undergoing similar treatment.

Always follow your healthcare provider’s instructions carefully regarding the use of Ceritinib to ensure safe and effective treatment. If you have any concerns or questions about Ceritinib or its usage, do not hesitate to consult your healthcare provider or pharmacist for clarification and guidance.