Why is this medication prescribed?

Nerlynx (neratinib) is a prescription medication used for the treatment of certain types of breast cancer. It is specifically indicated for the extended adjuvant treatment of early-stage, HER2-positive breast cancer following prior treatment with another HER2-targeted therapy, such as trastuzumab (Herceptin).

HER2-positive breast cancer is a subtype of breast cancer where the cancer cells have an overexpression or increased production of a protein called human epidermal growth factor receptor 2 (HER2). This protein promotes the growth of cancer cells. Nerlynx is a tyrosine kinase inhibitor that works by blocking specific proteins, including HER2, to inhibit their signaling pathways and help slow down or stop the growth of cancer cells.

Nerlynx is typically prescribed as an oral medication to be taken once daily for a year following completion of a standard course of HER2-targeted therapy. It is aimed at reducing the risk of recurrence of HER2-positive breast cancer in patients who have undergone prior treatment.

How should this medicine be used?

Nerlynx (neratinib) is an oral medication that should be taken exactly as prescribed by a healthcare professional. The recommended dosage and duration of treatment may vary depending on individual factors, so it’s important to follow the specific instructions provided by your doctor. Here are some general guidelines for using Nerlynx:

• Timing: Take Nerlynx at approximately the same time each day, with or without food. It’s important to maintain a consistent dosing schedule.
• Swallowing: Swallow the tablets whole with a glass of water. Do not crush, chew, or split the tablets unless advised by your doctor or pharmacist.
• Duration: The usual treatment duration with Nerlynx is one year (12 months) unless otherwise directed by your healthcare professional.
• Adjuvant treatment: Nerlynx is typically prescribed as extended adjuvant treatment, meaning it is given after completion of a standard course of HER2-targeted therapy (e.g., trastuzumab). It is important to follow your doctor’s instructions regarding the timing and sequencing of treatments.
• Missed Dose: If you miss a dose of Nerlynx, take it as soon as you remember on the same day. If it is already close to the time for your next 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.
• Precautions: Inform your doctor about any other medications, supplements, or herbal products you are taking, as some may interact with Nerlynx. Additionally, discuss any underlying health conditions you have, as certain conditions may affect the use of Nerlynx or require dose adjustments.

Always consult with your healthcare professional for personalized instructions and guidance on how to use Nerlynx appropriately and effectively for your specific condition.

Other uses for this medicine

Nerlynx (neratinib) is primarily used for the extended adjuvant treatment of early-stage, HER2-positive breast cancer. However, it’s important to note that medications can sometimes be prescribed off-label, meaning they may be used for conditions or purposes other than the FDA-approved indications. There are no widely recognized or established off-label uses for Nerlynx. The decision to use Nerlynx for any other purpose would be based on the clinical judgment of the prescribing healthcare professional.

What special precautions should I follow?

Regarding special precautions, here are some important considerations to keep in mind when using Nerlynx:

• Pregnancy and breastfeeding: Nerlynx may cause harm to a developing fetus, so it should not be used during pregnancy unless the potential benefits outweigh the risks. Similarly, it is not recommended while breastfeeding, as it may pass into breast milk and harm the nursing infant. Discuss with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding.
• Liver problems: Nerlynx can cause liver damage. Your doctor may monitor your liver function with blood tests before starting treatment and periodically during treatment. Inform your doctor if you have a history of liver problems or if you experience symptoms such as yellowing of the skin or eyes, dark urine, or persistent nausea and vomiting.
• Diarrhea: Diarrhea is a common side effect of Nerlynx. Your doctor may prescribe medications to help manage diarrhea, and it’s important to follow their instructions. Severe or persistent diarrhea can lead to dehydration and electrolyte imbalances, which may require medical intervention.
• Drug interactions: Inform your doctor about all the medications, supplements, and herbal products you are taking, as certain medications may interact with Nerlynx and affect its effectiveness or increase the risk of side effects. Examples of medications that may interact with Nerlynx include strong CYP3A4 inhibitors and inducers, as well as medications that affect the heart’s electrical activity (QT prolongation).
• Pre-existing medical conditions: Inform your doctor about any pre-existing medical conditions, including a history of heart problems, lung problems, or gastrointestinal disorders, as Nerlynx may worsen these conditions or interact with medications used to manage them.

These are just a few of the precautions associated with Nerlynx. It’s important to consult with your healthcare professional for a comprehensive understanding of the precautions, potential side effects, and specific considerations related to your individual health situation.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Nerlynx. However, it is generally recommended to maintain a balanced and healthy diet while undergoing cancer treatment. It’s important to follow your healthcare provider’s advice regarding nutrition and any specific dietary considerations based on your individual health needs.

What should I do if I forget a dose?

Regarding missed doses of Nerlynx:

• Timing: If you forget to take a dose of Nerlynx, take it as soon as you remember on the same day. However, if it is already close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
• Double dose caution: Do not take a double dose to make up for a missed one. Taking more than the prescribed dose can increase the risk of side effects without providing additional benefits.

What side effects can this medication cause?

Nerlynx (neratinib) can cause several side effects. It’s important to note that not all individuals will experience these side effects, and the severity can vary from person to person. It’s also worth mentioning that some side effects may require immediate medical attention. Here are some of the common and notable side effects associated with Nerlynx:

• Diarrhea: Diarrhea is the most common side effect of Nerlynx. It can range from mild to severe. Your healthcare provider may recommend anti-diarrheal medications and provide guidelines for managing diarrhea. Severe or persistent diarrhea can lead to dehydration and electrolyte imbalances.
• Nausea and vomiting: Nausea and vomiting are common side effects. Your doctor may prescribe medications to help manage these symptoms. Taking Nerlynx with food or dividing the dose throughout the day may help reduce these side effects.
• Fatigue: Feeling tired or experiencing fatigue is another common side effect reported by individuals taking Nerlynx. It’s important to listen to your body and get adequate rest. If fatigue becomes severe or affects your daily activities, consult your healthcare provider.
• Abdominal pain: Some individuals may experience abdominal pain or discomfort while taking Nerlynx. Inform your doctor if you experience persistent or worsening pain.
• Loss of appetite: Nerlynx may cause a decrease in appetite. It’s important to maintain proper nutrition during treatment. If loss of appetite persists or leads to significant weight loss, consult your healthcare provider for appropriate guidance.
• Skin and nail problems: Nerlynx can cause skin and nail-related side effects, including rash, dry skin, redness, itching, and changes in the nails. Inform your doctor if you notice any skin or nail abnormalities.
• Muscle spasms: Some individuals may experience muscle spasms or muscle cramps while taking Nerlynx. Inform your doctor if you experience these symptoms.
• Cardiac effects: Nerlynx may have cardiac side effects such as heart palpitations, decreased left ventricular ejection fraction (LVEF), and QT prolongation. Regular monitoring of cardiac function may be required during treatment.

It’s important to report any side effects you experience to your healthcare provider. They can provide guidance, support, and determine the best course of action to manage any side effects that arise during Nerlynx treatment.

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

• Storage: Keep Nerlynx tablets in their original container at room temperature, away from excessive heat, moisture, and direct light. Follow any specific storage instructions provided by your pharmacist or healthcare provider.
• Childproofing: Store Nerlynx out of the reach of children and pets. The medication should not be handled by anyone other than the individual for whom it was prescribed.
• Disposal: Dispose of unused or expired Nerlynx tablets properly. Do not flush them down the toilet or throw them in the regular trash. Contact your local pharmacy or healthcare facility to inquire about safe medication disposal programs or guidelines in your area.

In case of emergency/overdose

• Overdose: If you suspect an overdose of Nerlynx, seek immediate medical attention or contact a poison control center. Overdose symptoms may include severe diarrhea, severe nausea, vomiting, dizziness, or fainting.
• Emergency: In case of any other medical emergency, contact emergency services or go to the nearest emergency room.

What other information should I know?

• Follow-up appointments: Attend all scheduled follow-up appointments with your healthcare provider. Regular monitoring and check-ups are important to assess the effectiveness of treatment, manage side effects, and ensure your overall well-being.
• Compliance: Take Nerlynx exactly as prescribed by your healthcare provider. Do not alter the dosage or stop taking it without consulting your doctor.
• Drug interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking. Certain medications may interact with Nerlynx and affect its efficacy or increase the risk of side effects.
• Laboratory tests: Your doctor may order periodic blood tests and cardiac assessments to monitor your response to Nerlynx and check for any potential complications.
• Supportive care: Discuss with your healthcare provider any side effects or concerns you may have during Nerlynx treatment. They can provide guidance on managing side effects and offer supportive care options to help enhance your overall well-being.

Remember to consult your healthcare provider or pharmacist for specific instructions, guidance, and any additional information related to the storage, disposal, and emergency procedures associated with Nerlynx.