Ceritinib (Zykadia®)

Ceritinib (Zykadia®) is a targeted therapy drug used to treat non-small cell lung cancer.

It is best to read this information with our general information about targeted therapies and the type of cancer you have.

Ceritinib is given as capsules. You usually have it as an outpatient. Your cancer doctor or nurse will tell you how often you will have it.

Like all cancer treatments, ceritinib can cause side effects. Some of the side effects can be serious, so it is important to 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 or nurse 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 ceritinib (Zykadia®)?

Ceritinib (Zykadia®) is a targeted therapy drug used to treat non-small cell lung cancer (NSCLC). 

It is only used if tests show the cancer cells have a gene change, also called a gene mutation. This change affects a gene called anaplastic lymphoma kinase (ALK). NSCLC that has this gene change is called ALK-positive NSCLC.

It is best to read this information with our general information about targeted therapies and 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.

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


Taking ceritinib capsules

The nurse or pharmacist will give you the ceritinib capsules to take at home. They may also give you drugs to prevent sickness or diarrhoea, and other medicines to take home.

Take all your drugs exactly as they have been explained to you. This is important to make sure they work as well as possible. You usually keep taking ceritinib as long as it is effective and as long as its side effects are manageable.

You take ceritinib once a day with food. Take your capsules at the same time every day. You must swallow them whole, with a glass of water. You should not chew, open or crush them.

If you are unable to eat, you may need to take a different dose of ceritinib. Your cancer doctor will explain how and when to take your capsules. Do not change your dose unless your cancer doctor tells you to.

You should not eat grapefruit or drink grapefruit juice during your course of treatment. Grapefruit can cause harmful levels of ceritinib in your blood.

You should not take drugs that treat heartburn or indigestion at the same time as ceritinib. These may reduce the effect of ceritinib. Ask your doctor or pharmacist for advice about how and when to take any drugs for heartburn.

If you forget to take the capsules, you should take the missed dose as soon as possible. But if more than 12 hours have gone by, do not take the missed dose. Let your doctor or nurse know and take the next dose at the usual time.

Other things to remember about your capsules:

  • 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 capsules, contact the hospital. Do not take another dose.
  • If your treatment is stopped, return any unused capsules to the pharmacist.


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 haven’t listed here. 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. 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.

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.


Possible side effects

Diarrhoea

This treatment may cause severe diarrhoea. Your nurse or doctor may give you anti-diarrhoea drugs to take at home.

If you have diarrhoea:

  • follow any advice you have been given about taking anti-diarrhoea drugs
  • drink at least 2 litres (3½ 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 6 times in a day
  • the anti-diarrhoea drugs do not work within 24 hours.

Some people may need to go to hospital to have fluids through a drip. You may need to take antibiotics.

Feeling sick

You may feel sick in the first few days after this treatment. Your doctor will give you anti-sickness drugs to help prevent or control sickness. 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 and eat small amounts often. If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you.

Effects on the heart

This treatment can affect the way the heart works. Contact a doctor straight away if you:

  • have pain or tightness in your chest
  • feel breathless or dizzy
  • feel your heart is beating too fast or too slowly.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor.

High blood sugar

This treatment can cause high blood sugar. You will have blood tests to check your blood sugar levels. Tell your doctor if you:

  • feel thirsty all the time
  • pass urine more often than usual.

These may be a sign your blood sugar is high.

Effects on the lungs

This treatment can cause changes to the lungs. Tell your doctor if you develop: 

  • a cough
  • wheezing
  • a fever (high temperature)
  • breathlessness.

You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.

Loss of appetite

This treatment can affect your appetite. Do not worry if you do not 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.

Tummy pain and heartburn

This treatment can cause pain in the tummy (abdomen) and heartburn (indigestion). Tell your nurse or doctor if you have pain. Ask them for advice about how and when to take any drugs for heartburn.

Constipation

This treatment can cause constipation. Here are some tips that may help:

  • drink at least 2 litres (3½ pints) of fluids each day
  • eat high-fibre foods, such as fruit, vegetables and wholemeal bread
  • do regular gentle exercise, like going for short walks.

If you have constipation, contact the hospital for advice. Your doctor can give you drugs called laxatives to help.

Feeling tired

Feeling tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it has finished. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Skin changes

This treatment 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. It can cause 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.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the 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. This is called a blood transfusion.

Effects on the liver

This treatment can affect how your liver works. You will have blood tests to check how well your liver is working. Tell your doctor if you have:

  • yellowing of your skin or the whites of your eyes
  • pain on the right side of your tummy
  • dark or brown urine
  • bleeding or bruises that you cannot explain.

These may be a sign of liver problems.

Effects on the kidneys

This treatment can affect how your kidneys work. You will have blood tests to check how well your kidneys are working. Tell your doctor if you stop passing urine (peeing) or are passing very little urine. This may be a sign of kidney problems.

Eyesight changes

This treatment may affect your eyesight. Tell your doctor if you notice any changes. Do not drive or operate machinery if you notice eyesight changes.


Other information

Other medicines

Some medicines can affect chemotherapy or be harmful when you are having it. This includes medicines you can buy in a shop or chemist. Tell your cancer doctor about any drugs you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.

Sex

If you have sex during this course of chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluids.

Contraception

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

Breastfeeding

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

Fertility

Some cancer drugs can affect whether you can get pregnant or father a child. 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 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 cancer treatment.