Why is this medication prescribed?

Crizotinib is prescribed primarily for the treatment of certain types of cancers, particularly:

• Non-small cell lung cancer (NSCLC): Crizotinib is effective in treating NSCLC that is positive for a specific genetic alteration called anaplastic lymphoma kinase (ALK) rearrangement. This mutation causes the ALK gene to fuse with another gene, leading to uncontrolled cell growth and cancer.
• Metastatic ALK-positive NSCLC: It is specifically used in patients with metastatic NSCLC whose cancer has progressed despite treatment with other therapies.

Crizotinib works by inhibiting the activity of the ALK protein, which helps to slow down or stop the growth of cancer cells that rely on this protein for their growth and survival. It is typically used when other treatments have not been effective or when the ALK mutation is present and targeted therapy is deemed appropriate by the healthcare provider.

How should this medicine be used?

Crizotinib is typically taken orally in the form of capsules. Here are the general guidelines on how Crizotinib should be used:

• Dosage: The dosage of Crizotinib can vary based on the specific cancer being treated and individual patient factors. It is important to follow the dosage prescribed by your healthcare provider.
• Administration: Crizotinib is usually taken with food to help increase its absorption and reduce the likelihood of stomach upset. It is important to swallow the capsules whole with water and not crush, chew, or open them.
• Schedule: Crizotinib is usually taken twice daily, approximately 12 hours apart. This helps to maintain a consistent level of the medication in the body.
• Duration: Treatment with Crizotinib is often continued as long as it is providing benefit and tolerated well by the patient. Your doctor will monitor your response to the medication and may adjust the dosage or schedule if needed.
• Follow-up: Regular follow-up appointments with your healthcare provider are important while taking Crizotinib. These visits allow your doctor to monitor your condition, check for any side effects, and adjust your treatment plan as necessary.
• Missed Dose: If you miss a dose of Crizotinib, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.
• Special Instructions: Your doctor may give you specific instructions based on your individual health status and other medications you may be taking. Always follow these instructions carefully.

It’s crucial to adhere to your prescribed regimen and communicate any concerns or side effects promptly to your healthcare provider.

Other uses for this medicine

Some other potential uses of Crizotinib that are under investigation include:

• Inflammatory Myofibroblastic Tumors (IMTs): Crizotinib has shown some effectiveness in treating IMTs that harbor ALK gene rearrangements.
• Neuroblastoma: Preclinical studies suggest that Crizotinib may have activity against neuroblastoma with ALK gene alterations.
• Other ALK-positive Cancers: Research is ongoing to explore the efficacy of Crizotinib in other cancers that have ALK gene rearrangements, such as anaplastic large cell lymphoma.

What special precautions should I follow?

When taking Crizotinib, it’s important to follow specific precautions to ensure safe and effective use:

• Liver Function Monitoring: Regular monitoring of liver function tests is recommended during treatment with Crizotinib, as it can cause liver enzyme abnormalities.
• Heart Monitoring: Crizotinib may affect the electrical activity of the heart (prolongation of QT interval), so cardiac monitoring may be necessary, especially in patients with pre-existing heart conditions or those taking other medications that affect heart rhythm.
• Interstitial Lung Disease (ILD): Cases of ILD, including fatalities, have been reported with Crizotinib. Patients should be monitored for symptoms such as difficulty breathing, cough, or fever, and treatment should be discontinued if ILD is suspected.
• Pregnancy and Breastfeeding: Crizotinib can harm an unborn baby, so it should not be used during pregnancy unless the potential benefits outweigh the risks. It is also not recommended during breastfeeding.
• Drug Interactions: Crizotinib can interact with other medications, so it’s important to inform your healthcare provider about all medications (prescription, over-the-counter, herbal supplements) you are taking before starting Crizotinib.
• Driving and Operating Machinery: Crizotinib may cause dizziness or blurred vision, which can impair your ability to drive or operate machinery. Use caution until you know how Crizotinib affects you.
• Allergic Reactions: Inform your healthcare provider if you have a history of allergic reactions to Crizotinib or any of its components.

Always discuss any concerns or questions about Crizotinib with your healthcare provider, as they can provide personalized advice based on your medical history and current health status.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Crizotinib. However, it is generally recommended to take Crizotinib with food to help improve its absorption and reduce the likelihood of stomach upset. Follow your healthcare provider’s instructions regarding meals and Crizotinib administration.

What should I do if I forget a dose?

If you miss a dose of Crizotinib, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take double doses to make up for a missed dose.

What side effects can this medication cause?

Crizotinib, like any medication, can cause side effects. It’s important to be aware of these potential side effects and to discuss them with your healthcare provider. Common side effects of Crizotinib include:

• Gastrointestinal Effects: Nausea, vomiting, diarrhea, constipation, abdominal pain, and loss of appetite.
• Visual Disturbances: Blurred vision, visual impairment, and photophobia (sensitivity to light).
• Liver Function Abnormalities: Elevated liver enzymes (AST, ALT), which can indicate liver damage.
• Fatigue: Feeling tired or weak.
• Peripheral Edema: Swelling of the hands or feet due to fluid retention.
• QT Prolongation: Lengthening of the QT interval on an electrocardiogram, which can predispose to arrhythmias.
• Interstitial Lung Disease (ILD): Rare but serious, characterized by symptoms such as cough, difficulty breathing, or fever.
• Bradycardia: Abnormally slow heart rate.
• Rash: Skin reactions such as rash or itching.
• Musculoskeletal Effects: Muscle pain, joint pain, or back pain.
• Renal Toxicity: Changes in kidney function, although less common.
• Neurological Effects: Headache or dizziness.
• Changes in Blood Counts: Decrease in white blood cell count (neutropenia) or platelet count (thrombocytopenia).
• Endocrine Effects: Changes in thyroid function tests.

It’s important to promptly report any unusual symptoms or side effects to your healthcare provider while taking Crizotinib. They can help manage these side effects and adjust treatment if necessary. Some side effects may require close monitoring or discontinuation of Crizotinib, depending on their severity and impact on your health.

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

Storage and Disposal of Crizotinib:

• Storage:
  • Store Crizotinib capsules or tablets at room temperature, away from moisture and heat.
  • Keep the medication in its original container with the lid tightly closed.
  • Store out of reach of children and pets.
• Disposal:
  • Dispose of unused or expired Crizotinib safely to prevent accidental ingestion by children, pets, or others.
  • Follow any specific disposal instructions provided by your healthcare provider or pharmacist.
  • Do not flush medications down the toilet unless instructed to do so.

In case of emergency/overdose

• Seek Immediate Medical Attention: Call emergency services (911) or your local poison control center (1-800-222-1222) immediately.
• Symptoms of Overdose: Symptoms may include severe nausea, vomiting, diarrhea, dizziness, or blurred vision. Be prepared to provide information about the amount of Crizotinib taken and any symptoms experienced.

What other information should I know?

• Regular Follow-up: Attend all scheduled appointments with your healthcare provider for monitoring of your condition and response to Crizotinib treatment.
• Medication Interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as Crizotinib can interact with other drugs.
• Pregnancy and Breastfeeding: Crizotinib can harm an unborn baby and should not be used during pregnancy unless clearly necessary. It is not recommended during breastfeeding.
• Driving and Activities: Be cautious when driving or operating machinery, as Crizotinib may cause dizziness or blurred vision.
• Blood Tests: Your healthcare provider may perform blood tests (liver function tests, electrolytes, etc.) periodically to monitor for side effects and effectiveness of Crizotinib.
• Patient Assistance Programs: Some pharmaceutical companies offer patient assistance programs to help with the cost of medications like Crizotinib. Ask your healthcare provider or pharmacist for more information.

Always follow your healthcare provider’s instructions carefully regarding Crizotinib and contact them with any questions or concerns you may have during your treatment.