Gefitinib (Iressa ®)
Gefitinib (Iressa ®) is a drug that can be used to treat non-small cell lung cancer (NSCLC).
Gefitinib is a type of drug called a tyrosine kinase inhibitor (TKI), also known as a cancer growth inhibitor. Kinases are proteins in the body that regulate how the cells grow and divide. Gefitinib blocks (inhibits) the protein from sending signals to the cancer cells that make them grow and divide.
When gefitinib is given
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Gefitinib is used to treat some people with non-small cell lung cancer (NSCLC). It only works for cancers that have an abnormal form of a protein called epidermal growth factor receptor (EGFR). Tests are done on the cancer cells from a lung biopsy or previous surgery to check the level of EGFR. This tells your doctor whether gefitinib is likely to be of benefit to you.
The National Institute for Health and Care Excellence (NICE) gives advice on which new drugs should be available on the NHS in England and Wales. It recommends gefitinib as a possible first treatment for people with NSCLC that is EGFR positive and has spread to surrounding tissues or other parts of the body (advanced or metastatic cancer).
The Scottish Medicines Consortium (SMC) makes recommendations on the use of new drugs within the NHS in Scotland. The SMC doesn’t currently recommend the use of gefitinib. If you live in Northern Ireland, your cancer doctor can tell you if gefitinib is recommended in your situation. Some people may be given gefitinib as part of a clinical trial.
Gefitinib is taken as a tablet once a day, about the same time each day. Take the tablet with a glass of water, with or without food.
If you have trouble swallowing tablets put the tablet in a glass of water and leave it to dissolve. It may take 20 minutes to completely dissolve. Once it’s dissolved, drink it straight away then refill the glass with water and drink it to make sure you’ve taken all of the gefitinib.
Always take your tablets exactly as your nurse or pharmacist explained. This is important to make sure they work as well as possible for you.
There are some important things to remember when taking your tablets:
If you are sick just after taking the tablets, tell your doctor as you may need to take another dose. Don't take another dose without telling your doctor first.
If you forget to take a tablet, take it as soon as you realise. But if there’s less than 12 hours until your next dose, don’t take it, just take your next dose at the usual time. Never take a double dose.
Don’t take antacids two hours before or one hour after taking gefitinib. They can affect how it works.
Keep tablets in the original package and at room temperature, away from heat and direct sunlight.
Keep them safe and out of the reach of children.
Get a new prescription before you run out of tablets and make sure you have plenty for holidays.
Return any unused tablets to the pharmacist if your treatment is stopped.
Possible side effects of gefitinib
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Each person’s reaction to their treatment is different. Some people have very few side effects, while others may have more. The side effects described here won't affect everyone having this treatment.
We have listed the most common side effects but haven’t included all those that are rare as they are unlikely to affect you. If you notice any effects that aren’t listed here, discuss them with your doctor or nurse.
The most common side effect of gefitinib is an acne-like rash that mainly affects the head, chest and back. This usually begins during the first 2–3 weeks of treatment and goes away once treatment ends.
Your skin may also become dry and itchy, or feel tender and peel.
There are some things that you can do to help with skin changes, although they can’t prevent them altogether:
Use tepid water and mild, non-scented soap for bathing and washing.
Avoid skincare products containing alcohol.
Don’t use anti-acne products as they can dry your skin and make your symptoms worse.
Moisturise your skin regularly, including after a bath or shower. Your doctor or specialist nurse can tell you which moisturisers are best.
Wear rubber gloves when washing dishes to protect your hands from the detergent.
Protect your skin in the sun, as sunlight can make skin symptoms worse. During treatment with gefitinib, and for several months afterwards, you will be more sensitive to the sun, and your skin may burn more easily than normal. You can still go out in the sun, but you should wear a suncream with a high sun protection factor (SPF), and cover up with clothing and a hat. If you’re having radiotherapy, don't apply suncream to any skin in the area being treated.
Let your doctor know as soon as possible if you develop skin changes. They can prescribe treatment to help.
In people who have more severe side effects, treatment with gefitinib can be stopped for a few days to allow their skin to recover.
Gefitinib can cause diarrhoea. This can usually be easily controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea, around 2 litres (4 pints) per day.
Loss of appetite
You may lose your appetite while taking gefitinib. Try to eat small meals regularly. If your appetite doesn’t improve after a few days, let your doctor or nurse know. They can arrange for you to see a dietitian who can give you advice. You may be given food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.
Feeling sick or being sick
If you feel sick, this can be controlled by taking anti-sickness (anti-emetic) drugs that your doctor can prescribe for you. Tell your doctor if the sickness doesn’t improve so they can prescribe other anti-sickness drugs which may work better for you.
Dry or sore mouth
Your mouth may become dry, sore or red. This can make you more likely to get an infection in your mouth. Gently clean your teeth and/or dentures morning and night and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might ask you to rinse your mouth regularly or use mouthwashes. It’s important to follow any advice you are given and to drink plenty of fluids.
Tell your nurse or doctor if you have any problems with your mouth. They can prescribe medicines to prevent or treat mouth infections and reduce any soreness.
Feeling tired is a common side effect of cancer treatment. It‘s important to try to pace yourself and get as much rest as you need. Try to balance this with taking some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
Hair and nail changes
You may notice that your head and body hair becomes finer, curlier or more brittle. Some people have hair thinning or hair loss. These changes are usually temporary and gradually improve once treatment is over.
The nails on your hands or feet may become red, sore and brittle. Let your nurse or doctor know if this happens. Wearing gloves when using detergents or washing dishes can help protect your nails.
Your eyes may become dry and feel sore, or get red and inflamed. Your doctor can prescribe eye drops to help with these problems. If you get pain in your eyes or have changes in your vision, let your doctor know immediately.
Some people find that their eyelashes grow longer and more curly than usual but this isn’t common.
Your bladder may feel irritated during your treatment. You may notice a burning feeling when you pass urine, or you may need to go more often or more urgently. Tell your nurse or doctor if you have these symptoms. Drink plenty of fluids, around 2 litres (4 pints) per day. Rarely, you may pass blood in your urine. Tell your doctor straight away if you notice this.
Treatment with gefitinib may cause changes in the way that your liver works, although it will return to normal when the treatment finishes. Your doctor will take regular blood samples to check your liver is working properly.
Less common side effects
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This is an uncommon side effect that may affect about 1 in 100 people taking gefitinib.
If you become breathless, your breathing worsens or you have a cough or fever, tell your doctor straight away. It may mean you have an inflammation of the lungs, which can be serious.
Let your doctor know if you have any unusual bleeding, for example, nosebleeds, bleeding gums or blood in your urine while taking gefitinib.
Severe tummy pain
Very rarely, gefitinib can cause a hole (perforation) in the small bowel or an inflamed pancreas. Contact your doctor immediately if you have severe pain in the tummy and sickness and vomiting. It’s also very important to let them know if you have bleeding from the back passage, black stools, vomiting up blood or vomit that looks like coffee grounds.
It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned above.
Some medicines, including those you can buy in a shop or chemist, can be harmful to take while you are taking gefitinib. Tell your doctor about any medicines you are taking, including ones you can buy for yourself, complementary therapies and herbal drugs.
Doctors don’t yet know how gefitinib may affect the fertility of both men and women. If you are worried about this, talk to your doctor before treatment starts.
Your doctor will advise you not to become pregnant during treatment. We don’t know effects of gefitinib on a developing baby. You can talk to your doctor or nurse about this.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is any trace of the drug in their breast milk.
Medical or dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are taking gefitinib. Tell them the name of your cancer doctor so they can ask for advice.
Always tell your dentist you are taking gefitinib.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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