Eribulin is a chemotherapy drug used to treat breast cancer that has spread to other parts of the body (advanced or metastatic breast cancer).
Eribulin is usually used after a person has had at least two courses of chemotherapy for their advanced breast cancer.
In England, eribulin is usually available via NHS England’s Cancer Drugs Fund. In Scotland and Wales, eribulin is not available on the NHS, so it may not be widely used. If you live in Northern Ireland, you can find out from your cancer specialist whether eribulin is available. We can give you more information on what you can do if a treatment isn’t available where you live.
You usually have eribulin in a chemotherapy day unit. A chemotherapy nurse will give it to you, into a vein. During treatment, you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse. T his is who we mean when we mention a doctor or nurse in this information.
Before or on the day of treatment, a nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check your blood count is okay for you to have chemotherapy.
You will also see a doctor or nurse before you have chemotherapy. They will ask you how you have been. If your blood results are alright, the pharmacy will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Your nurse will give you the chemotherapy and anti-sickness drugs through one of the following:
- A short, thin tube (cannula) that the nurse puts into a vein in your arm or hand.
- A fine tube that goes under the skin of your chest and into a vein close by (central line).
- A fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line).
Your nurse will give you eribulin as a drip (infusion) into your cannula or line. This takes about 2–5 minutes.
Your course of chemotherapyBack to top
You will have chemotherapy as a course of several sessions (cycles) of treatment over a few months.
Each cycle of eribulin usually takes 21 days (three weeks). You will have your eribulin on days 1 and 8 of the cycle. At the end of the 21 days, you start your second cycle. This is the same as your first cycle. Occasionally, your doctor may reduce the dose of the eribulin if you have side effects.
Your doctor or nurse will tell you how many cycles you are likely to have.
Before you go home, the nurse or pharmacist will give you anti-sickness drugs. Take all your tablets exactly as they have been explained to you.
Possible side effects of eribulinBack to top
We explain the most common side effects of eribulin here. But we don’t include all the rare ones that are unlikely to affect you.
You may get some of the side effects we mention, but you are very unlikely to get all of them. Always tell your doctor or nurse about the side effects you have.
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. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, they will start to improve.
Your nurse will give you a telephone number to call the hospital if you feel unwell or need advice at any time of the day or night. Save this in your mobile phone or keep it somewhere safe.
Risk of infection
Eribulin can reduce the number of white blood cells in your blood. This is known as neutropenia. This will make you more likely to get an infection.
Contact the hospital straight away if:
- your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your chemotherapy team
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
Your white blood cells usually increase steadily and return to normal before your next treatment. You will have a blood test before having more chemotherapy. If your number of white blood cells is still low, your doctor may delay your treatment for a short time.
Numb or tingling hands or feet
Eribulan can affect the nerves and cause numb or tingling hands or feet. This is called peripheral neuropathy. You may find it hard to fasten buttons or do other fiddly tasks.
Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug. The symptoms usually improve slowly after treatment finishes, but in some people they may never go away. Talk to your doctor if you are worried about this.
Your hair may thin, or you may lose all the hair from your head. This usually starts after your first or second cycle of chemotherapy. It is almost always temporary and your hair will grow back after chemotherapy ends. It is important to cover your head to protect your scalp when you are out in the sun. Your nurse can give you advice about coping with hair loss.
Feeling sick or being sick
You may feel or be sick in the first few days after chemotherapy. Your doctor will prescribe antisickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It’s easier to prevent sickness than to treat it after it has started.
If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti-sickness drug 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.
Feeling very tired is a common side effect. It’s often worse towards the end of treatment and for some weeks after it’s finished. 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.
Eribulin may make you constipated. Drinking at least two litres of fluids (three and a half pints) every day will help. Try to eat more foods that contain fibre (such as fruit, vegetables and wholemeal bread) and take some regular gentle exercise.
Your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.
Muscle or joint pain
You may get pain in your joints or muscles for a few days after chemotherapy. Tell your doctor if this happens so they can prescribe painkillers. It’s important to let them know if the pain does not get better. Try to get plenty of rest. Taking regular warm baths may help.
Eribulin may cause headaches. If this happens, talk to your doctor or nurse. They can give you painkillers.
Less common side effects of eribulinBack to top
Anaemia (low number of red blood cells)
Eribulin can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If your number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells (a blood transfusion).
Bruising or bleeding
Eribulin can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets.
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 and/or dentures every 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.
You may get a dry mouth. Drink plenty of fluids, and add sauces and gravies to your food to keep
it moist. Sucking ice cubes can also help, but don’t do this if you have a sore mouth or other mouth problems. If you have dry lips, using a lip balm or Vaseline® can help.
Your nails may become brittle and break easily. They may get darker or discoloured, and/or you may get lines or ridges on them. These changes will grow out after treatment finishes. To help protect your nails during treatment, Wear gloves when washing dishes or using detergents.
Eribulin can make you feel dizzy or unsteady. Let your doctors know if this happens.
Eribulin may cause indigestion. This often feels like a burning sensation in your chest area. Let your doctor know if you get these symptoms. They can give you medicines to treat heartburn.
You may get pain or discomfort in your tummy (abdomen), feel bloated or have wind. Your doctor can prescribe drugs to help improve these symptoms. Tell them if the pain doesn’t improve or gets worse.
Chemotherapy may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. You may get a rash, which may be itchy. 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.
Your eyes may become watery and feel sore. They may also become red and inflamed, which is called conjunctivitis. Tell your doctor if you notice any of these changes. You may need antibiotic eye drops.
Eribulin may affect your sleep. Let your doctor know if this is a problem.
Changes in the way your liver works
You will have regular blood tests to check how well your liver is working. Any changes in the way your liver works will usually go back to normal after treatment finishes.
Effects on the lungs
Always tell your doctor if you develop wheezing, a cough or a fever, or if you 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.
Changes in the way the heart works
Sometimes eribulin may cause changes to your heartbeat. Usually this doesn’t cause serious problems and it goes back to normal after treatment finishes. Let your doctor know if you notice your heartbeat is fast.
It is important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Other information about eribulinBack to top
Blood clot risk
Cancer increases the chances of a blood clot (thrombosis). Having chemotherapy can add to this risk. A blood clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. Contact your doctor straight away if you have any of these symptoms. A blood clot is serious, but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can interact with your chemotherapy. This can be harmful. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Eribulin may affect your fertility (your ability to get pregnant or father a child). If you are worried about this, talk to your doctor before treatment starts.
Your doctor will advise you not to become pregnant or father a child during treatment. This is because the drugs may harm a developing baby. It’s important to use contraception during and for a few months after chemotherapy. You can talk to your doctor or nurse about this.
If you have sex within the first couple of days of having chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluid.
Changes to your periods
Chemotherapy can sometimes stop the ovaries working. Women may not get a period every month and they may eventually stop. In some women this is temporary, but for others it is permanent and they start the menopause.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is chemotherapy in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always let the doctors and nurses know you are having chemotherapy. Tell them the name of your cancer doctor so they can ask for advice if they need to.
Talk to your cancer doctor or nurse if you think you need dental treatment. And always tell your dentist you are having chemotherapy.
This section has been compiled using information from a number of reliable sources, including:
- British National Formulary. 67: March–September 2014.
- Electronic Medicines Compendium (eMC). www.medicines.org.uk (accessed February 2014).
- Halaven website.www.halaven.com (accessed February 2014).
If you’d like further information on the sources we use, please feel free to contact us.
With thanks to: Dr Mark Beresford, Consultant Oncologist and Lead for Radiotherapy; Christine Clarke, Macmillan Specialist Oncology Pharmacist ; Dr Rebecca Roylance, Clinical Senior Lecturer; Professor Christopher Twelves, Professor of Clinical Pharmacology and Oncology; who reviewed this edition.
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