Afatinib (Giotrif®)

Afatinib (Giotrif®) is a targeted therapy drug used to treat non-small cell lung cancer. It may also be used to treat other cancers as part of a clinical trial.

Afatinib is given as tablets. Your cancer doctor or nurse will tell you how often you will have it.

Like all targeted therapy drugs, afatinib can cause side effects. Some of these can be serious so it’s important that you read the detailed information below.

Your healthcare team can give you advice on how to manage any side effects. Tell your doctor or nurse straight away if you:

  • have a temperature
  • feel unwell
  • have severe side effects, including any we do not mention here.

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

If you need medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.

What is afatinib?

Afatinib is a targeted therapy drug that is also known as Giotrif®. It is used to treat non-small cell lung cancer (NSCLC) that has started to spread outside the lung or to other parts of the body. It may also be used to treat other cancers as part of a clinical trial.

It is best to read this information with our general information about lung cancer or the type of cancer you have.

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

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.


How afatinib works

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.

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos


When afatinib is given

Afatinib may be used to treat non-small cell lung cancer (NSCLC) that has:

  • spread to surrounding tissues (locally advanced)
  • spread to other parts of the body (advanced or metastatic).

Afatinib only works for cancers that have an abnormal form of a protein called epidermal growth factor receptor (EGFR). Tests are 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.


Taking afatinib tablets

You take afatinib as a tablet once a day. Take the tablets with a glass of water, at least 1 hour before you eat or 3 hours after. 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. Other things to remember about your tablets:

  • 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 the missed dose as soon as possible within the same day. But if there is less than eight hours until your next regular dose, do not take the missed dose. Take your next dose at the usual time. Never take a double dose.
  • Keep them in the original package and at room temperature, away from heat and direct sunlight.
  • Keep them safe and out of the reach of children.
  • Make sure you have plenty of tablets before you go away for holidays.
  • If your treatment is stopped return any unused capsules or tablets to the pharmacist. You usually take afatinib for as long as it controls the cancer.


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.

Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects.

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.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

The nurses were always prepared to answer the phone 24 hours a day, if you had side effects that you didn’t understand or couldn’t cope with. They were really helpful.

Rob


Common side effects

Diarrhoea

This is the most common side effect. It usually starts in the first two weeks of treatment. It can sometimes be severe. Your nurse or doctor may give you anti-diarrhoea drugs to take at home. It’s important to take them exactly as your nurse or pharmacist explained.

It is important to:

  • Follow any advice you have been given about taking anti-diarrhoea drugs.
  • Drink at least 2 litres (3½ pints) of fluids each day if you have diarrhoea.
  • Contact the hospital straight away if you have diarrhoea more than four to six times a day, or at night.

Your doctor may ask you to stop taking afatinib until the diarrhoea is better. Sometimes they may reduce the dose of afatinib.

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.

Your lips may become dry, cracked 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 infections and reduce any soreness.

Skin changes

This treatment may cause an acne-like rash affecting the head, chest and back. This usually begins during the first 2 to 3 weeks of treatment. Your skin may also become dry and itchy, or feel tender and peel.

There are some things that may help:

  • Use tepid water and mild, non-scented soap.
  • Avoid skincare products containing alcohol.
  • Don’t use anti-acne products.
  • Moisturise your skin regularly and after a bath or shower.
  • Protect your skin in the sun during treatment and for several months afterwards. Wear suncream with a high sun protection factor (SPF) and cover up with clothing and a hat. If you’re having radiotherapy, do not 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 skin changes are more severe, your doctor may stop the treatment for a few days to let your skin recover.

Nail infections

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. Wear gloves to protect your nails when you are doing things in the house or garden.

Sore and red hands and feet

Having sore and red palms of hands and soles of feet 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 and to avoid tight-fitting socks, shoes and gloves.

Feeling sick

Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.

Loss of appetite

This treatment can affect your appetite. Don’t worry if you don’t eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.

Eye problems

Your eyes may become dry and feel sore, or get red and inflamed (conjunctivitis). Your doctor can prescribe eye drops to help with these problems. Tell your doctor straight away if any eye symptoms get worse or if you have:

  • pain in your eyes
  • watery eyes
  • your eyes become sensitive to light
  • any changes in your vision.

Changes in the way your liver or kidneys work

This treatment can affect how your kidneys and liver work. This is usually mild and goes back to normal after treatment. You will have blood tests to check how well your kidneys and liver are working.

Nosebleeds

Afatinib may cause nosebleeds or you may have a runny nose. Tell your doctor if you have these side effects. If a nosebleed doesn’t stop after 15 minutes contact a doctor straight away.

Amrik reading a book

Alan on treatment and side effects

'The thought that I would not be able to carry on with these activities was extremely upsetting.'


Less common side effects of afatinib

Breathing problems

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

Other drugs

Some medicines, including ones you buy in a shop or chemist, can be harmful while you are having this treatment. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.

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.

Contraception

Your doctor will advise you not to get pregnant or father a child while having this treatment and for some time afterwards. The drugs may harm the developing baby. It is important to use effective contraception.

Breastfeeding

Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that 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 this treatment.