Gefitinib

Gefitinib comes in tablets, so you can take it at home. You usually take gefitinib for as long as it is controlling the cancer. 

During treatment you usually see a cancer doctor, a cancer nurse or specialist nurse, and a specialist pharmacist. This is who we mean when we mention doctor, nurse or pharmacist in this information.

The nurse or pharmacist will give you the tablets to take home. Always take your tablets exactly as your nurse or pharmacist explains. This is important to make sure they work as well as possible for you. Do not stop taking your tablets unless your doctor tells you to. 

Your nurse or pharmacist may also give you anti-sickness drugs and other medicines to take at home. Take all your drugs exactly as they have been explained to you.

Before and during treatment, a nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check the level of your blood cells and to check how well your liver and kidneys are working.

You usually take gefitinib as a tablet once a day. Take it at about the same time each day. Swallow it whole with a glass of water. You can take it with or without food.

If you have trouble swallowing tablets, put the tablet in half a glass of water and leave it to dissolve. Do not crush gefitinib tablets and do not use any other type of liquid to dissolve them. It may take 20 minutes for a tablet to completely dissolve. Once it has dissolved, drink it straight away. Then refill the glass with water and drink it to make sure you have taken all the gefitinib.

If you forget to take the tablets, take the missed dose as soon as you remember. But if there is less than 12 hours until your next dose, do not take the missed dose. Never take a double dose.

Antacids or medicines to reduce stomach acid such as ranitidine or Gaviscon^®, can affect how gefitinib works. Do not take antacids 2 hours before or 1 hour after taking gefitinib.

During treatment with gefitinib, you should not use the herbal remedy St John’s wort. This is because it can make gefitinib less effective.

Other things to remember about your tablets:

• 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.

You may develop a rash and your skin may become red, dry or flaky. Some people also feel itchy. These side effects are usually mild but sometimes can be more severe. 

During this treatment, you should protect your skin from the sun as this can make rashes worse. Cover up and use a high-factor sun cream of SPF 30 or above. 

If you have any skin changes, speak to your doctor or nurse. They can advise you about creams or lotions and give you medicines to relieve itching. 

If you have more severe side effects, your doctor may stop giving you gefitinib for a few days to allow your skin to recover.

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

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

• taking anti-diarrhoea medicines 
• drinking enough fluids to keep you hydrated and to replace lost salts and minerals
• any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

This treatment can affect your appetite. Don’t worry if you do not eat much for 1 or 2 days. But if your appetite does not come back after a few days, or if you are losing weight, tell your doctor, nurse or pharmacist. 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.

This treatment may cause a sore or dry 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 or dry:

• 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.

Your doctor, nurse or pharmacist will prescribe anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as they tell you to, even if you do not feel sick. It is easier to prevent sickness than to treat it after it has started.

If you feel sick, take small sips of fluid often and eat small amounts regularly. It is important to drink enough fluids. If you continue to feel sick, or if you are sick (vomit) 1 to 2 times in 24 hours, contact the hospital on the 24-hour number as soon as possible. They will give you advice. They may change your anti-sickness treatment. Let them know if you still feel sick.

Feeling tired is a common side effect of this treatment. It is often worse towards the end of treatment and for some weeks after it ends. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can help you feel less tired. 

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

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.

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.

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: 

• medicines you have been prescribed
• medicines you buy in a shop, pharmacy or online
• vitamins or supplements 
• herbal drugs and complementary or homeopathic therapies
• recreational drugs – for example, cannabis.

Cancer doctors usually recommend that people with cancer have vaccinations for flu and coronavirus (covid). They may also recommend other vaccines, such as Shingrix^® for shingles. These all help reduce your risk of serious illness from these infections. Most people can have these vaccines, including people with weak immune systems.

You should not have live vaccines if your immune system is weak. This includes if you are having or recently had chemotherapy, radiotherapy or other cancer treatments that affect your immune system. Live vaccines can make you unwell because they contain a very weak version of the illness they protect you against. There are several live vaccines. These include the yellow fever vaccine and Zostavax^®, which is a different type of shingles vaccine.

It is important to ask your doctor, nurse or pharmacist for advice about having vaccinations. They can explain what vaccines are right for you and when it is best to have them.

This treatment contains lactose. If you have an intolerance to some sugars, talk to your doctor before you start this treatment.

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.

Your doctor, nurse or pharmacist will advise you not to get pregnant or make someone pregnant while having this treatment and for some time afterwards. The drugs may harm a developing baby. It is important to use contraception to prevent pregnancy. Follow their advice about:

• what types of contraception to use 
• how long after treatment you should continue to use contraception. 

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

Your doctor, nurse or pharmacist can give you more information.

If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.