Afatinib (Giotrif ®)
Afatinib (Giotrif ®) is a targeted therapy drug. It is used to treat non-small cell lung cancer (NSCLC) that has spread.
It is best to read this information with our general information about lung cancer.
Afatinib may also be used to treat other types of cancer as part of a clinical trial.
During treatment, you will see a cancer doctor or nurse. This is who we mean when we mention a doctor or nurse in this information.
Afatinib 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.
Afatinib blocks the proteins from sending signals to the cancer to grow. Blocking the signals causes the cells to die. This may help to stop or slow down the cancer.
Afatinib may be given if you have non-small cell lung cancer (NSCLC) that has spread to surrounding tissues (locally advanced). It may also be given if you have NSCLC that has spread to other parts of the body (advanced or metastatic).
Afatinib works for cancers that have an abnormal form of a protein called epidermal growth factor receptor (EGFR). Tests are usually done on the cancer cells from a biopsy or previous surgery to check the level of EGFR. This tells your doctor whether afatinib is likely to work for you. If you have a type of lung cancer called squamous cell lung cancer, you may be given afatinib without having an EGFR test.
Taking afatinib tabletsBack to top
You take afatinib as a tablet once a day. Take the tablets with a glass of water. Take them three hours after food and don’t eat for an hour after taking them. Afatinib is less effective if taken at the same time as food.
If you have trouble swallowing tablets, you can put the afatinib tablet in a glass of water and leave it to dissolve. It may take 15 minutes to completely dissolve. Once the tablet is dissolved, drink it straight away. Then refill the glass with water and drink that, to make sure you’ve taken all of the afatinib.
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.
Do not stop taking any of your tablets unless your doctor tells you to. Here are some important things to remember:
- 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 is less than eight hours until your next regular dose, don’t take the missed dose. Instead, just take your next dose at the usual time. Never 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. Make sure you have plenty for holidays.
- Return any unused tablets to the pharmacist if your treatment is stopped.
You usually take afatinib for as long as it controls the cancer.
Possible side effects of afatinibBack to top
We have included the most common likely side effects of afatinib here. We have also included some less common and rarer side effects. You may get some of the side effects we mention, but you will not get them all.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist has explained. Your nurse will give you advice about managing side effects. Always tell your doctor or nurse about the side effects you have.
Serious and life-threatening side effects
Sometimes cancer drugs can result in very serious side effects, which rarely may be life-threatening. Your cancer doctor and nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your mobile phone or keep them somewhere safe.
More information about this drug
We’re not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information, you can visit the electronic Medicines Compendium (eMC).
This is the most common side effect. It usually starts in the first two weeks of treatment. It can sometimes be severe. Your doctor can prescribe anti-diarrhoea drugs to control it. You may be given these before you leave hospital. It’s important to take them exactly as your nurse or pharmacist explained. If you have diarrhoea, it is important to drink plenty of fluids. Try to drink around two litres (three and a half pints) of fluids per day.
If you have diarrhoea more than four to six times a day, or at night, contact the hospital straight away on the numbers your nurse gave you. Your doctor may ask you to stop taking afatinib until the diarrhoea is better. Sometimes your doctor will reduce the dose of afatinib that you take.
Sore mouth and lips
Your mouth may become sore and you may get ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth 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.
You may also notice your lips are chapped or swollen. The corners of your mouth may also be sore and irritated.
Tell your nurse or doctor if you have any problems with your mouth or lips. They can prescribe medicines to prevent or treat mouth infections and reduce any soreness.
Afatinib may cause an acne-like rash that mainly affects the head, chest and back. This usually begins during the first two to three 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 avoid 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. They can dry your skin and make your symptoms worse.
- Moisturise your skin regularly and 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 and nails from the detergent.
- Protect your skin in the sun. Sunlight can make skin symptoms worse. During treatment with afatinib, and for several months afterwards, you will be more sensitive to the sun. This means 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. If the skin changes are more severe, your doctor may stop afatinib for a few days to let your skin recover.
Afatinib may cause infections in your nails or the beds of your finger or toe nails. If you get pain, redness or swelling around your nails, let your nurse or doctor know.
Soreness and redness of palms of hands and soles of feet
This is called palmar-plantar or hand-foot syndrome. It gets better when treatment ends. Your doctor or nurse can give you advice and prescribe creams to improve the symptoms. It can help to keep your hands and feet cool. Try to avoid tight-fitting socks, shoes and gloves.
If you feel sick, your doctor can prescribe anti-sickness (anti-emetic) drugs to prevent or reduce sickness. If the drugs don’t help, tell your nurse or doctor. They can change the anti-sickness drugs to one that works better for you.
Loss of appetite
You may lose your appetite during your treatment. Try to eat small meals regularly. Don’t worry if you don’t eat much for a day or two. If your appetite doesn’t improve after a few days, let your nurse or dietitian know. They can give you advice on getting more calories and protein in your diet. They may give you food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.
Your eyes may become dry and feel sore, or get red and inflamed. Your doctor can prescribe eye drops to help with these problems.
Symptoms of eye problems include:
- severe pain in your eyes
- watery eyes
- your eyes become sensitive to light
- changes in your vision.
If you notice any of these symptoms, tell your doctor straight away.
Changes in the way the kidneys and liver work
Afatinib can affect how your kidneys and liver work. This is usually mild and goes back to normal after treatment. You will have regular blood tests during treatment to check how well your kidneys and liver are working.
Afatinib may cause nosebleeds or you may have a runny nose. Tell your doctor straight away if a nosebleed doesn’t stop after 15 minutes.
Less common side effects of afatinibBack to top
Afatinib may cause breathing problems, but this is not common. If you become breathless, your breathing suddenly 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.
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.
Other information about afatinibBack to top
Some medicines, including ones you can buy in a shop or chemist, can interact with or be harmful when you are taking afatinib. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Your doctor will advise you not to become pregnant or to father a child during treatment. This is because afatinib may harm a developing baby. It’s important to use effective contraception during and for at least a month after taking afatinib. 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 afatinib in their breast milk.
Medical and 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 afatinib. Give them the contact details for your cancer doctor.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always tell your dentist you are taking afatinib.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (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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