Lapatinib (Tyverb ®)
Lapatinib (Tyverb ®) is a targeted therapy drug. It is used to treat women with HER2 positive breast cancer that has spread to other parts of the body (secondary cancer). It may be used to treat other types of cancer as part of a research trial.
It’s best to read this information with our general information about secondary breast cancer or the type of cancer you have. You'll see your doctor regularly while you have this treatment so they can monitor its effects. This information should help you discuss any questions about your treatment and its side effects with your doctor or specialist nurse.
What is lapatinib and how does it work?
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Lapatinib is a targeted therapy drug. These drugs work by ‘targeting’ specific proteins (receptors) that make cancer cells grow. Lapatinib works by blocking the action of two proteins:
epidermal growth factor receptor (EGFR)
human epidermal growth factor receptor 2 (HER2).
This can cause the cells to die or to grow more slowly. You may have tests to measure levels of EGFR or HER2 in the cancer cells. This is to find out if lapatinib is a helpful treatment for you.
We have more information on HER2 breast cancer, including HER2 testing.
When is lapatinib used?
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Lapatinib is used to treat women with HER2 positive breast cancer that has spread to other parts of the body (secondary or metastatic breast cancer).
It is given with a chemotherapy tablet called capecitabine, or in combination with hormonal therapy. It can also be given with another targeted therapy drug called trastuzumab (Herceptin ®). We have further information on these drugs.
The National Institute for Health and Care Excellence (NICE) currently gives advice on which new drugs or treatments should be available on the NHS in England and Wales. The Scottish Medicines Consortium (SMC) makes recommendations on the use of new drugs in the NHS in Scotland. Neither NICE nor the SMC recommend the use of lapatinib. This means that lapatinib may not be available on the NHS, but it may be given as part of a clinical trial.
We have more information on what you can do if a treatment isn’t available.
Taking lapatinib tablets
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Lapatinib is given as tablets, which you take once a day. Take the tablets with a glass of water, either an hour before or after food, and at the same time each day. For example, you could always take your tablets one hour before breakfast. Don’t take lapatinib with food or with grapefruit juice.
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 forget to take your tablets, take them as soon as you remember. This is unless it’s nearly time for your next dose - don’t take a double dose.
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.
If you're sick just after taking the tablets, let your doctor know. You may need to take another dose. Don't take another dose without telling your doctor, nurse or pharmacist first.
Possible side effects of lapatinib
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Each person’s reaction to cancer treatment is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone being treated with lapatinib.
We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any side effects that aren't listed here, discuss them with your doctor or specialist nurse.
Because lapatinib is given with other cancer treatments, some side effects may be linked with, or increased because of other treatments.
Common side effects
This is the most common side effect of lapatinib. It usually develops within the first week after treatment. Tell your cancer doctor or nurse straight away if you have diarrhoea. It’s important to get it treated quickly.
Your doctor can prescribe anti-diarrhoea drugs to control it. It’s important to take them exactly as your nurse or pharmacist explains. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea. If the anti-diarrhoea drugs don’t work quickly, or you still have diarrhoea after 24 hours, contact the hospital straight away on the numbers your nurse gave you.
You may develop an acne-like rash and your skin may also become dry and itchy, or feel tender and peel.
The palms of your hands and the soles of your feet may become red and sore, especially if you are having lapatinib with capecitabine. Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
It may help to do the following:
Wash with tepid water using mild, unperfumed, soap-free cleansers.
Moisturise your skin regularly with unperfumed moisturisers – ask your doctor or nurse what’s best.
Do not use anti-acne products or any products containing alcohol on your skin.
Wear sunscreen with a sun protection factor (SPF) of at least 30 when you’re in the sun.
Feeling very tired is a common side effect. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery.
Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to help prevent, or control sickness. If it isn't controlled, or if it continues, tell your doctor. They can prescribe other anti-sickness drugs that may be more effective.
Indigestion and heartburn
This is a common side effect, which can usually be relieved by taking an antacid. You should take the antacid at least an hour before or after taking lapatinib. Let your doctor or nurse know if you have any indigestion that isn’t relieved.
Stomach cramps and bloating
Let your doctor know if you get any stomach cramps or bloating. They can prescribe medicines that will help relieve this.
Loss of appetite
Some people lose their appetite. This can be mild and may only last a few days. If your appetite doesn’t improve, you can ask to see a dietitian or specialist nurse at your hospital. They can give you advice on improving your appetite and keeping to a healthy weight.
Sore mouth and ulcers
Your mouth may become sore or dry, or you may get small mouth ulcers. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Tell your nurse or doctor if you have any mouth problems. They can prescribe mouthwashes and medicine to prevent or clear mouth infections.
You may get constipated. This can usually be helped by drinking plenty of fluids, eating more fibre in your diet and doing some gentle exercise. You may need to take medicine (laxatives) to help. Your doctor can prescribe these or you can buy them at a pharmacy.
Muscle and joint pains
You may have joint or muscle pains, especially in your back. Let your doctor know if you develop these as they can prescribe painkillers.
Some people find that lapatinib causes headaches. Let your doctor or nurse know if you get headaches. They can give you painkillers to relieve this.
Some people find they have trouble sleeping while taking lapatinib. Using relaxation techniques or CDs may help. If you experience this, talk to your doctor.
Cough, shortness of breath
Let your doctor or nurse know if you have a cough or notice that you get breathless.
Less common side effects
Your liver may be temporarily affected
Rarely, lapatinib may cause temporary changes to the way your liver works. The changes are unlikely to cause you any harm, but your doctor will monitor this carefully.
Changes in the way the heart works
Lapatinib can affect the way the heart works. You may have tests to see how well your heart is working before and during treatment. If you have pain or tightness in your chest, feel breathless or notice changes to your heartbeat at any time during or after treatment, tell a doctor straight away. These symptoms can be caused by other conditions but it’s important to get them checked by a doctor.
Effects on the lungs
Lapatinib can cause changes to the lungs. Always tell your doctor if you develop wheezing, a cough, a fever or feel breathless. You should also let them know if any existing breathing problems get worse. If necessary, they can arrange for you to have tests to check your lungs.
Other information about lapatinib
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Some medicines, including those that you can buy in a shop or chemist, can be harmful to take when you’re taking lapatinib. Lapatinib can interact with a number of different drugs.
Tell your doctor about any medicines you’re taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Your ability to become pregnant or father a child may be affected by taking this drug. It's important to discuss fertility with your doctor before starting treatment.
It's not advisable to become pregnant while taking lapatinib, as it may harm the developing baby. It’s important to use effective contraception while taking this drug, and for at least a few months afterwards.
Lapatinib may be present in breast milk. Women are advised not to breastfeed while taking it, or for a few months afterwards.
It’s good to know who you should contact if you have any problems or troublesome side effects when you’re at home. During office hours, you can contact the clinic or ward where you had your treatment. Your specialist nurse or doctor will tell you who to contact during the evening or at weekends.
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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