Nerlynx (neratinib) is a brand-name drug that’s prescribed to treat certain types of breast cancer in adults. Nerlynx comes as an oral tablet that’s typically taken once per day.
Nerlynx is approved by the Food and Drug Administration (FDA) to treat:
- early stage HER2-positive breast cancer
- advanced or metastatic HER2-positive breast cancer
Nerlynx belongs to a drug class called kinase inhibitors. Nerlynx isn’t available in a generic version.
Keep reading for specific information about the dosage of Nerlynx, including its strength and how to take the medication. For a comprehensive look at Nerlynx, see this article.
Note: This article describes typical dosages for Nerlynx provided by the drug’s manufacturer. When taking Nerlynx, always follow the dosage prescribed by your doctor.
The typically recommended dosages for Nerlynx are described below.
Nerlynx form
Nerlynx comes as an oral tablet.
Nerlynx strength
Nerlynx comes in one strength of 40 milligrams (mg).
Typical dosages
The following information describes dosages that are commonly prescribed or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for adjuvant therapy in early stage HER2-positive breast cancer
Nerlynx is used as adjuvant therapy in HER2-positive breast cancer to prevent it from coming back. Nerlynx is taken after treatment with Herceptin to reduce the risk of your cancer returning.
If your doctor prescribes Nerlynx as adjuvant therapy of early stage HER2-positive breast cancer, the recommended dose is 240 mg (6 tablets) taken by mouth once per day. Your doctor will likely recommend that you also take a medication called loperamide to help prevent diarrhea.
Sometimes, doctors may prescribe a lower dosage to start and slowly increase the dose for 2 weeks to the recommended dosage of 240 mg once per day. In this case, the recommended dosing schedule is shown in the table below:
| Time taking Nerlynx | Nerlynx dosage |
|---|---|
| Week 1 (days 1–7) | 120 mg once per day (3 tablets) |
| Week 2 (days 8–14) | 160 mg once per day (4 tablets) |
| Week 3 and beyond | 240 mg once per day (6 tablets) |
For more information about your specific dosage, talk with your doctor.
Dosage for advanced or metastatic HER2-positive breast cancer
Nerlynx is used to treat advanced or metastatic HER2-positive breast cancer in adults who have already tried two or more treatments. Metastatic breast cancer is cancer of the breast that has spread to other parts of the body. Nerlynx is typically taken with capecitabine (Xeloda) for this use.
If your doctor prescribes Nerlynx to treat advanced or metastatic HER2-positive breast cancer, the recommended dose is 240 mg (6 tablets) taken by mouth once per day. You’ll take it on days 1–21 of a 21-day cycle. It’s typically given with capecitabine, which is taken on days 1–14 of a 21-day cycle. Your doctor will likely recommend that you also take a medication called loperamide to help prevent diarrhea.
Sometimes, doctors may prescribe a lower dosage to start and slowly increase the dose for 2 weeks to the recommended dosage of 240 mg once per day. The recommended dosing schedule is shown in the table below:
| Time taking Nerlynx | Nerlynx dosage |
|---|---|
| Week 1 (days 1–7) | 120 mg once per day (3 tablets) |
| Week 2 (days 8–14) | 160 mg once per day (4 tablets) |
| Week 3 and going forward | 240 mg once per day (6 tablets) |
For more information about your specific dosage, talk with your doctor.
Long-term treatment
Nerlynx is meant to be taken as a long-term treatment for early stage breast cancer. Nerlynx is typically used for up to 1 year after completing treatment with trastuzumab (Herceptin).
For advanced or metastatic breast cancer, Nerlynx is taken as part of a 21-day treatment cycle. The number of treatment cycles you have will depend on how your cancer responds to treatment and whether you have side effects from the medication. If you and your doctor determine that Nerlynx is safe and effective for you, you’ll likely take it for the long term.
Before you start taking Nerlynx, your doctor will discuss your treatment plan with you.
The Nerlynx dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of breast cancer you’re taking Nerlynx to treat
- other medications you take
- side effects you may have with Nerlynx
Other medical conditions you have can also affect your Nerlynx dosage.
Dosage adjustments
Your doctor may need to adjust your dosage if you take antacids or certain medications that reduce stomach acid, such as famotidine or nizatidine. These drugs can affect the level of Nerlynx in your body if taken at the same time. Your doctor will likely have you take Nerlynx at a different time as these medications. There are also several medications that should be avoided while taking Nerlynx. To find out what drugs may interact with Nerlynx, see this article.
Your doctor may need to decrease your dosage if you have severe liver damage, such as advanced cirrhosis.
Be sure to tell your doctor about all medications you take and any health conditions you may have.
Nerlynx comes as an oral tablet that you swallow whole. Do not divide, crush, chew, or place the tablet in water. Be sure to take your dose with a meal or snack.
Nerlynx should be taken around the same time of day. This helps maintain a steady level of the drug in your body so Nerlynx can work effectively.
If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.
ACCESSIBLE DRUG LABELS AND CONTAINERSSome pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
If you’re having trouble opening medication bottles, ask your pharmacist about putting Nerlynx in an easy-open container. They also may recommend tools that can make it easier to open bottles.
If you miss a dose of Nerlynx, skip that dose and take your next scheduled dose. Do not take two doses to make up for the missed one.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.
It’s important that you don’t take more Nerlynx than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.
Symptoms of an overdose
Overdose symptoms of Nerlynx can include:
- nausea
- vomiting
- diarrhea
- dehydration
If you take more than the recommended amount of Nerlynx
Call your doctor right away if you believe you’ve taken too much Nerlynx. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
Below are some frequently asked questions about Nerlynx.
Is the dosage of Nerlynx similar to the dosage of Herceptin?
No, the forms and how often you take each drug are different.
Nerlynx comes as a tablet that you take once per day. Herceptin comes as a powder that’s mixed to make a liquid. It’s given as an intravenous (IV) infusion (an injection into your vein over a period of time). The infusion is always given by a healthcare professional.
The dose in milligrams for each drug differs because they have different active ingredients. Your doctor will prescribe the drug and the dosage that’s right for you.
To learn more about how these drugs compare, talk with your doctor.
How long does it take for Nerlynx to start working?
It’s not known how fast Nerlynx starts to work after your first dose. Because of how the drug works, you likely won’t feel the drug working in your body. Your doctor will monitor you during treatment to check whether the drug is working to treat your condition.
Talk with your doctor if you have questions about what to expect with Nerlynx treatment.
The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Nerlynx for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.
As with any drug, never change your dosage of Nerlynx without your doctor’s recommendation. If you have questions about the dosage of Nerlynx that’s best for you, talk with your doctor.
Besides learning about dosage, you may want other information about Nerlynx. These additional articles might be helpful:
- More about Nerlynx: For information about other aspects of Nerlynx, refer to this article.
- Side effects: To learn about side effects of Nerlynx, see the Nerlynx prescribing information.
- Details about breast cancer: For details about breast cancer, see our breast cancer hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.