What is erlotinib?

Erlotinib is used to treat non-small cell lung cancer and pancreatic cancer. It may sometimes be used to treat other cancers. It is best to read this information with our general information about targeted therapy drugs and the type of cancer you have.

Erlotinib belongs to a group of targeted therapy drugs known as cancer growth inhibitors. Erlotinib blocks (inhibits) a protein called epidermal growth factor receptor (EGFR) that can cause the cancer to grow.

Non-small cell lung cancer (NSCLC)

Erlotinib can be used to treat non-small cell lung cancer (NSCLC) that has spread (metastatic cancer). You may have a test to check if you are likely to benefit from erlotinib. This test is done on samples of cancer cells taken by biopsy or during surgery.

Pancreatic cancer

Erlotinib can also be used with the chemotherapy drug gemcitabine, to treat people with pancreatic cancer that has spread (metastatic cancer).

Your doctor, nurse or pharmacist will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

More information about this treatment

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

How erlotinib is given

Erlotinib comes as tablets, so you can take it at home.

During treatment you usually see a:

  • cancer doctor
  • chemotherapy nurse or specialist nurse
  • specialist pharmacist.

This is who we mean when we mention doctor, nurse or pharmacist in this information.

During your treatment you will have regular blood tests and appointments with your nurse, pharmacist or doctor. They will talk to you about your blood results and ask you how you have been feeling.

Your course of treatment

Your nurse, pharmacist or doctor will discuss your treatment plan with you. Erlotinib may be given on its own, or with other chemotherapy drugs. Usually, you continue taking erlotinib for as long as it is working for you and side effects can be managed. Do not stop taking it without your doctor’s advice.

The nurse or pharmacist will give you the tablets to take home. Always take them exactly as explained. This is important to make sure they work as well as possible for you. You may be given tablets of different strengths.

Your nurse or pharmacist may also give you anti-sickness drugs and other medicines to take home.

Taking erlotinib tablets

Erlotinib must be swallowed whole with a glass of water. The tablets should not be chewed, broken or crushed. Take your tablets at least 1 hour before eating anything, or take them 2 hours after you have eaten. Take them at the same time every day.

Do not eat grapefruit or drink grapefruit juice during treatment with erlotinib. It may increase the side effects of erlotinib.

If you take any medicines to reduce stomach acid, talk to your doctor first. These drugs may interfere with the way erlotinib works. Your doctor will advise you which medicines you can take and how to take them safely.

If you forget to take your tablets, you should take the missed dose as soon as possible within the same day. If a full day has gone by, let your doctor or nurse know. Do not take a double dose unless your doctor tells you to.

Other things to remember about your tablets:

  • Wash your hands after taking your tablets.
  • Other people should avoid direct contact with the drugs.
  • Keep them in the original package and at room temperature, away from heat and direct sunlight.
  • Keep them safe and out of sight and reach of children.
  • If you are sick just after taking the tablets, contact the hospital. Do not take another dose.
  • If your treatment is stopped, return any unused tablets to the pharmacist.

About side effects

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here.

You may have some rarer side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor, nurse or pharmacist can give you drugs to help control some side effects. It is important to take them exactly as they tell you. This means the drugs will be more likely to work for you. Your doctor, nurse or pharmacist will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Common side effects

Skin changes

You may develop an acne-like rash on your face during the first 2 to 3 weeks of treatment. Always tell your doctor or nurse about any skin changes. They can give you advice and prescribe creams or medicines to help. Do not use any over the counter acne products, as this can make the skin problems worse.

This treatment may also cause skin changes, including:

  • a rash
  • itching
  • dry or cracked skin. 

Here are some things you can do to look after your skin during treatment:

  • Wash with lukewarm water using mild, unperfumed, soap-free cleansers.
  • Moisturise your skin regularly with unperfumed moisturisers. Ask your doctor or nurse what is best.
  • Do not use anti-acne products or any products containing alcohol on your skin.
  • If you are out in the sun, use a sun cream with a high sun protection factor (at least SPF 30), or protective clothing to protect your skin.

Rarely, a much more serious skin condition can develop. You may have:

  • a skin rash which then blisters
  • peeling skin
  • flu-like symptoms, such as a high temperature and joint pain.

If you have any of these symptoms, contact your doctor or hospital straight away.

Nail changes

This treatment can affect your nails. They may grow more slowly or break more easily. You might notice ridges or white or dark lines across your nails. Sometimes nails can become loose or fall out. When treatment finishes, any changes usually disappear as the nails grow out.

There are things you can do to look after your nails:

  • Moisturise your nails and cuticles regularly.
  • Keep your nails clipped short.
  • Wear gloves to protect your nails when you are doing things in the house or garden.
  • Keep your hands and nails clean to help avoid infection, but avoid bathing in very hot water.
  • Do not use false nails, gels or other acrylics during this treatment, as they may increase the risk of infection.
  • It is fine to wear nail varnish, but try to use a water-based polish. Avoid using harsh chemicals, such as acetone, when taking off the polish.
  • If your toenails are affected, wear well-fitted shoes to cushion them.

Tell your doctor or nurse if you notice changes to your nails. They can give you advice or arrange for you to see a podiatrist for foot care advice if needed.

Diarrhoea

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.

Your hospital team may give you anti-diarrhoea drugs to take at home.

If you have diarrhoea or a mild increase in stoma activity:

  • follow any advice from your cancer team about taking anti-diarrhoea drugs
  • drink at least 2 litres (3 1/2 pints) of fluids each day
  • avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.

Contact the hospital straight away if:

  • you have diarrhoea at night
  • you have diarrhoea more than 4 times in a day
  • you have a moderate or severe increase in stoma activity
  • the anti-diarrhoea drugs do not work within 24 hours

You may need to go to hospital to have fluids through a drip.

Tummy (abdominal) pain

Some people have pain or discomfort in their tummy (abdomen) during treatment. Tell your doctor if this happens.

Very rarely, erlotinib can cause a hole (perforation) in the bowel. Contact your doctor immediately if you:

  • have severe pain in the tummy
  • are bleeding from the back passage
  • have black stools (poo)
  • are vomiting up blood (or vomit that looks like coffee grounds).

If you cannot get through to your doctor, call the NHS urgent advice number on 111.

Feeling tired (fatigue)

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

  • helps you sleep better
  • reduces stress
  • improves your bone health.

If you feel sleepy, do not drive or operate machinery.

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is sometimes called neutropenia.

An infection can be very serious when the number of white blood cells is low. It is important to get any infection treated as soon as possible. Contact the hospital straight away on the 24-hour contact number you have been given if:

  • your temperature goes over 37.5°C (99.5°F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection
  • your temperature goes below 36°C (96.8°F).

Symptoms of an infection include:

  • feeling shivery and shaking
  • a sore throat
  • a cough
  • breathlessness
  • diarrhoea
  • needing to pass urine (pee) a lot, or discomfort when you pass urine.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time, until your cell count increases.

Feeling sick

Your doctor will give you anti-sickness drugs to help prevent or control sickness during your treatment. Take the drugs exactly as your nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.

If you feel sick, take small sips of fluids often and eat small amounts regularly. It is important to drink enough fluids. If you continue to feel sick, or are sick (vomit) more than once in 24 hours, contact the hospital as soon as possible. They will give you advice. Your doctor or nurse may change the anti-sickness drug to one that works better for you.

Sore mouth and throat

This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get a mouth or throat infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth or throat is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco, and foods that irritate your mouth and throat.

Sucking ice chips may sometimes help relieve mouth or throat pain. But if you are having radiotherapy to the head or neck, do not suck on ice. It can cause damage.

Nosebleeds

You may experience bleeding from your nose. Talk to your doctor or nurse about the best way to manage this if it happens. If a nosebleed does not stop, call the NHS urgent advice number on 111.

Loss of appetite

This treatment can affect your appetite. Don't worry if you do not eat much for a day or 2. But if your appetite does not come back after a few days, or if you are losing weight, tell your nurse or dietitian. They can give you advice. They may give you food or drink supplements. Or they may suggest changes to your diet or eating habits to help.

Effects on the lungs

This treatment can cause changes to the lungs. Contact the hospital straight away if you develop:

  • a cough
  • wheezing
  • breathlessness
  • a fever, with a temperature over 37.5°C (99.5°F).

Let them know if symptoms have come on suddenly. You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.

Eye problems

Some people develop sore, red eyes (conjunctivitis) or dry eyes while they are having this treatment. Tell your doctor if you develop any of these symptoms. Your doctor can prescribe eye drops to help with this.

Tell your doctor or nurse straight away if you have eyesight changes, or if your eyes become more painful or sensitive to light. Your eyelashes may also grow longer, curlier, turn inwards or grow in the wrong direction. If this causes a problem, your doctor can give you advice.

Numb or tingling hands or feet (peripheral neuropathy)

This treatment may affect the nerves, which can cause numb, tingling or painful hands or feet. 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 for some people they may never go away. Talk to your doctor if you are worried about this.

Headaches

This treatment may cause headaches. If you have headaches, tell your doctor. They may give you painkillers to help.

Mood changes

You may have some mood changes during this treatment. You may feel low or depressed. Let your doctor or nurse know if you notice any changes.

Effects on the liver

This treatment may affect how your liver works. This is usually mild. You will have blood tests to check how well your liver is working.

Less common and rare side effects

Hair changes

Some people may have some hair thinning or hair loss. Changes to hair sometimes develop after three months or more. You may notice that your head and body hair is finer, curlier or more brittle.

Other information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

  • throbbing pain or swelling in a leg or arm
  • reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
  • suddenly feeling breathless or coughing.

Always call 999 if you have:

  • chest pain
  • difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Smoking

Smoking reduces the level of erlotinib in the blood and may make it less effective. If you smoke, try to stop before you start treatment. Your doctor or nurse can suggest ways to help. Tell your doctor or pharmacist if you stop smoking during treatment.

Other medicines

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

Lactose

These tablets contain a type of sugar called lactose. If you have been told by a doctor that you cannot digest some sugars or are lactose intolerant, talk to your doctor before taking this drug.

Vaccinations

Vaccinations can reduce your risk of getting certain infections. Your doctor or nurse may talk to you about having vaccinations.

Doctors usually recommend that people with cancer have a flu vaccination and a coronavirus (covid) vaccination. These are both inactivated vaccinations that can help reduce the risk of infection. People with weak immune systems can have these, as they are not live vaccinations. 

If your immune system is weak, you need to avoid live vaccinations. This is because they can make you unwell. Live vaccines contain a very weak version of the illness they are vaccinating you against. Your cancer doctor or GP can tell you more about live and inactivated vaccinations.

Contraception

Your doctor will advise you not to get pregnant or make someone pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for a while after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.

Breastfeeding

You are advised not to breastfeed while having this treatment, or for some time after treatment finishes. This is because the drugs could be passed to the baby through breast milk.

Your doctor or nurse can give you more information.

Sex

If you have sex during a course of this treatment, you should use barrier protection such as a condom or dental dam. This will protect your partner if any of the drug is in your semen or vaginal fluid.

Fertility

Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 01 September 2023
|
Next review: 01 September 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

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