Tykerb is a brand-name prescription medication. It’s FDA-approved to treat certain types of HER2-positive (HER2+) breast cancer in adults. (HER2+ means the cancer cells have abnormally high levels of a protein called HER2, which promotes cell growth.)

Tykerb is approved to treat HER2+ breast cancer that’s:

  • Advanced or metastatic* and has been treated before with anthracyclines, taxanes, and trastuzumab. For this purpose, Tykerb can be used in both women and men, and it’s taken with the chemotherapy drug capecitabine (Xeloda).†
  • Hormone-receptor-positive (HR+) and metastatic. For this purpose, Tykerb is taken with letrozole (Femara) by women who’ve gone through menopause, if hormone therapy is recommended as part of their treatment plan.

Tykerb comes as a tablet that you take by mouth. It belongs to a class of medications called tyrosine kinase inhibitors (TKIs). A medication class is a group of medications that work in a similar way.

Tykerb contains the active drug lapatinib.

* Metastatic cancer has spread to other parts of the body, such as the bones.

† Before a person is treated with Tykerb and capecitabine, their cancer needs to have progressed while being treated with trastuzumab.

Effectiveness

For information on Tykerb’s effectiveness, see the “Tykerb uses” section below.

Tykerb is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Tykerb contains the active drug lapatinib.

Tykerb can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Tykerb. These lists do not include all possible side effects.

For more information on the possible side effects of Tykerb, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Tykerb, you can do so through MedWatch.

Mild side effects

Mild side effects of Tykerb can include*:

  • diarrhea†
  • hand-foot syndrome (skin reaction, usually on the hands and feet)
  • nausea and vomiting
  • rash
  • fatigue (lack of energy)
  • stomatitis (swelling or sores in your mouth)
  • headache
  • hair loss†
  • shortness of breath
  • back and leg pain

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Tykerb. To learn about other mild side effects, talk with your doctor or pharmacist, or view Tykerb’s package instructions.

† For more information on these side effects, see “Side effect details” below.

Serious side effects

Serious side effects from Tykerb aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency phone number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information on these side effects, see “Side effect details” below.

† Tykerb has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Liver damage” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Tykerb, although it’s not known how often this happens. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Tykerb. Call 911 or your local emergency phone number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Hair loss

Some people may experience hair loss while taking Tykerb. In clinical studies:

  • 10% to 13% of people who took Tykerb had hair loss, depending on the condition the drug was treating
  • 2% to 7% of people who took medications other than Tykerb had hair loss, depending on the condition the drug was treating

If you’re concerned about hair loss while taking Tykerb, talk with your doctor. They may recommend treatment options for your hair loss. Or they may recommend trying a medication other than Tykerb to treat your cancer.

Liver damage

Tykerb has a boxed warning for liver damage. This is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about a drug’s effects that may be dangerous.

In clinical trials and since being released onto the market, Tykerb has been shown to cause liver damage. In some people, the liver damage has been severe.

Very rarely, deaths due to liver damage have been reported in people taking Tykerb. It’s important to note that it’s not known what role, if any, Tykerb had in the deaths. If you have a history of liver disease, be sure to tell your doctor before taking Tykerb.

Clinical studies

One way to check for liver damage is by looking for high levels of liver enzymes (proteins) in the blood. High levels of these enzymes can be a sign of liver damage. In clinical studies:

  • 6% to 53% of people who took Tykerb had high levels of liver enzymes. Less than 1% of these people had severe liver damage.
  • 6% to 43% of people who took medications other than Tykerb had high levels of liver enzymes. Less than 1% of these people had severe liver damage.

These results varied according to the condition Tykerb was being used to treat and if the drug was taken with other medications.

Checking for liver damage

Most people with high levels of liver enzymes don’t have any symptoms, especially if their levels aren’t that high.

However, symptoms of severe liver damage may include jaundice (yellowing of the skin and whites of your eyes), pain and swelling in your abdomen (belly), and swelling in your ankles or legs.

Before you take Tykerb, your doctor will order a test to check your liver function, which will include checking the levels of liver enzymes in your blood. Your doctor will continue checking these levels every 4 to 6 weeks during your Tykerb treatment. If your level of liver enzymes gets too high, your doctor may lower your Tykerb dose or have you switch to a different drug.

Interstitial lung disease/pneumonitis

Tykerb can cause lung problems in some people taking the drug. Specifically, Tykerb may cause a condition known as interstitial lung disease. This refers to more than 200 different inflammatory conditions that can affect your lungs. Pneumonitis is a type of interstitial lung disease.

It’s not known how often these lung problems have occurred in people taking Tykerb.

Symptoms of interstitial lung disease can include shortness of breath and dry cough. Call your doctor right away if you experience these symptoms during your Tykerb treatment. Your doctor may lower your Tykerb dose or have you switch to a different drug.

Hand-foot syndrome

Tykerb may cause a skin condition known as hand-foot syndrome. In clinical trials:

  • 8% to 53% of people who took Tykerb had hand-foot syndrome. Up to 12% of people taking Tykerb had hand-foot syndrome that was considered severe.
  • Less than 1% to 51% of people who took medications other than Tykerb had hand-foot syndrome. Up to 14% of people taking other medications had hand-foot syndrome that was considered severe.

These results depended on the condition the drug was being used to treat and if it was taken with other medications.

Symptoms of hand-foot syndrome may include pain, redness, and swelling in the palms of the hands and soles of the feet. Some people can have symptoms in multiple places on their body, while others may only have them in one hand or foot. More severe symptoms include burning or tingling sensation, blisters, deeply cracked skin, and severe pain.

Call your doctor if you develop symptoms of hand-foot syndrome while taking Tykerb. Your doctor may lower your dose of Tykerb or have you switch to a different drug.

Infection around a nail

While taking Tykerb, it’s possible to develop paronychia (infection of the skin around your fingernail or toenail). This was shown in clinical studies of Tykerb, which involved women with hormone-receptor-positive (HR+), HER2-positive (HER2+) breast cancer that’s metastatic.

In the studies, some women took Tykerb along with trastuzumab (Herceptin) and an aromatase inhibitor. Others took Tykerb with an aromatase inhibitor. A third group took trastuzumab and an aromatase inhibitor.

In the studies:

  • 30% of women taking Tykerb with trastuzumab and an aromatase inhibitor had paronychia
  • 15% of people who took Tykerb with an aromatase inhibitor had paronychia

No one who took trastuzumab with an aromatase inhibitor had paronychia. And paronychia wasn’t reported in clinical trials of people taking Tykerb for other types of HER2+ cancer.

Symptoms of paronychia

Symptoms of paronychia can include:

  • redness or tenderness of the skin around your nail
  • changes in the color, shape, or texture of your nail
  • pus-filled blisters around your nail
  • nail detachment

If you develop symptoms of paronychia while taking Tykerb, call your doctor. They may prescribe a medication to treat the infection. They may also lower your dose of Tykerb or have you switch to a different medication.

Diarrhea

Diarrhea is a common side effect of Tykerb. In clinical trials, diarrhea was the most common reason why people stopped taking Tykerb.

In clinical trials:

  • 51% to 69% of people who took Tykerb had diarrhea. Of these cases, 6% to 13% were considered severe.
  • 9% to 40% of people who took drugs other than Tykerb had diarrhea. Of these cases, up to 10% were considered severe.

These results depended on the condition the drug was being used to treat and if it was taken with other medications.

Severe diarrhea can lead to dehydration (low fluid levels). Although very rare, there have been deaths due to diarrhea in people taking Tykerb. It’s not known how often this has occurred.

In most cases, diarrhea happens when you first start taking Tykerb. Most people experience it within the first 6 days of starting treatment. It typically lasts 4 to 5 days.

If you get diarrhea during Tykerb treatment

Call your doctor if you develop diarrhea while taking Tykerb. They’ll likely recommend a medication to treat your diarrhea. They may also recommend taking in more fluids and electrolytes than normal.

If your diarrhea is severe, your doctor may prescribe an antibiotic. They may also lower your dose of Tykerb or have you switch to a different medication.

The Tykerb dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Tykerb to treat
  • whether you’ve experienced any side effects while taking Tykerb
  • other medical conditions you may have
  • other medications you may take

Typically, your doctor will start you on the standard dosage. They may adjust it over time if you experience side effects while taking Tykerb. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used 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.

Drug forms and strengths

Tykerb comes as a tablet that you take by mouth. Tykerb tablets are only available in one strength: 250 mg.

Dosage for breast cancer

Your dosage of Tykerb will depend on the type of HER2-positive (HER2+) breast cancer you’re using it to treat.

Dosage for advanced or metastatic HER2+ breast cancer

Tykerb is used on a 21-day dosing cycle when used for advanced or metastatic HER2+ breast cancer that’s been treated before. For this purpose, Tykerb is taken with the chemotherapy drug capecitabine (Xeloda). Capecitabine comes as a tablet that’s taken by mouth.

You’ll take 1,250 mg (five tablets) of Tykerb once a day on days 1 through 21. On days 1 through 14, you’ll also take 2,000 mg per meters squared (mg/m2) of capecitabine, split into two doses at least 12 hours apart. (The capecitabine dosage is based on your body surface area.)

Take your Tykerb dose at least 1 hour before or 1 hour after a meal. Capecitabine should be either taken with food or within 30 minutes of eating a meal.

After 21 days, the cycle is usually repeated until your cancer progresses or you need to stop treatment because of negative side effects.

Dosage for HER2+ breast cancer that’s HR+ and metastatic

Tykerb is taken once a day to treat HER2+ breast cancer that’s hormone-receptor-positive (HR+) and metastatic. For this purpose, the Tykerb dosage is 1,500 mg (six tablets) once a day, every day. (In this case, the drug isn’t given in cycles.)

For this use, you’ll take letrozole (Femara) with Tykerb. Letrozole is a type or hormone therapy. It comes as a tablet that’s taken by mouth. The typical dosage is 2.5 mg (one tablet) taken once a day. However, your doctor may decide a different dose is best for you.

You’ll take Tykerb every day for as long as your doctor prescribes.

What if I miss a dose?

If you miss a dose, just skip that dose and take your next dose at your regular time the next day. Never take a double dose to make up for a missed dose. This can raise your risk for side effects.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Yes, Tykerb is meant to be used as a long-term treatment. If you and your doctor determine that Tykerb is safe and effective for you, you’ll likely take it long term. You’ll likely take it until your cancer gets worse or until the side effects become too severe.

Tykerb is used in combination with other drugs to treat HER2-positive (HER2+) breast cancer.

Tykerb and Xeloda

Tykerb is taken with capecitabine (Xeloda) when used for advanced or metastatic HER2+ breast cancer. (Metastatic means the cancer has spread to other parts of the body, such as the bones.)

Xeloda is also available as a generic medication, capecitabine. Talk with your doctor if you have questions about taking Tykerb with Xeloda to treat your cancer.

Tykerb and Femara

Tykerb is taken with letrozole (Femara) when used for HER2+ breast cancer that’s hormone-receptor-positive (HR+) and metastatic.

Femara is also available as a generic medication, letrozole. Talk with your doctor if you have questions about taking Tykerb with Femara to treat your cancer.

The Food and Drug Administration (FDA) approves prescription drugs such as Tykerb to treat certain conditions. Tykerb may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Tykerb for breast cancer

Tykerb is FDA-approved to treat HER2-positive (HER2+) breast cancer in adults. (HER2+ means the cancer cells have abnormally high levels of a protein called HER2, which promotes cell growth.) See below for details on the specific types of HER2+ breast cancer it can treat.

Tykerb for advanced or metastatic breast cancer that’s HER2-positive

Tykerb is approved to treat HER2+ breast cancer that’s advanced or metastatic and that’s been treated before with anthracyclines, taxanes, and trastuzumab. (Cancer is metastatic when it’s spread to other parts of the body, such as the bones.) For this purpose, Tykerb can be used in both women and men. It’s taken with the chemotherapy drug capecitabine (Xeloda).

Effectiveness for advanced or metastatic breast cancer that’s HER2+

Clinical trials have shown that Tykerb, when used with the chemotherapy drug capecitabine (Xeloda), is effective for treating advanced or metastatic breast cancer that’s HER2+.

Everyone participating in the study had previously received treatment for their cancer. In the study, they took either Tykerb with capecitabine or capecitabine by itself.

The effectiveness of each drug or drug combination was measured by how long it kept someone’s cancer from progressing (getting worse). In the studies:

  • at least half of people who took Tykerb with capecitabine went 27.1 weeks or longer without their cancer getting worse
  • at least half of people who took capecitabine alone went 18.6 weeks or longer without their cancer getting worse

Tykerb for HR-positive metastatic breast cancer that’s HER2+

Tykerb is also approved to treat HER2+ cancer that’s hormone-receptor-positive (HR+) and metastatic. For this purpose, Tykerb is taken with letrozole (Femara) by women who’ve gone through menopause, if hormone therapy is recommended as part of their treatment plan.

Effectiveness for HR+ metastatic breast cancer that’s HER2+

A clinical study showed Tykerb to be effective for treating HER2+ cancer that’s HR+ and metastatic. Women in this study had gone through menopause and had never received treatment for metastatic cancer. In the study, they took either Tykerb with letrozole (Femara) or letrozole by itself.

The effectiveness of each drug or drug combination was measured by how long it kept someone’s cancer from progressing (getting worse). In the study:

  • at least half of the women who took Tykerb with letrozole went 35.4 weeks or longer without their cancer getting worse
  • at least half of the women who took letrozole alone went 13 weeks or longer without their cancer getting worse

Tykerb and children

Tykerb is not approved for use in children. It’s not known whether Tykerb is safe or effective in children because it’s only been studied in adults.

There aren’t any known interactions between Tykerb and alcohol.

However, certain side effects of Tykerb can be made worse if you drink alcohol. These include diarrhea, headache, and heart problems.

Alcohol is known to cause liver problems. Tykerb can also cause liver damage, so drinking alcohol while taking Tykerb may increase your risk for serious liver damage.

If you drink alcohol, talk with your doctor. They’ll help determine how much, if any, alcohol is safe for you to drink while taking Tykerb.

Tykerb can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Tykerb and other medications

Below is a list of medications that can interact with Tykerb. This list does not contain all drugs that may interact with Tykerb.

Before taking Tykerb, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Tykerb and strong CYP3A4 inhibitors

Taking Tykerb with medications that inhibit (slow down) the activity of an enzyme called CYP3A4 can increase the levels of Tykerb in your body. CYP3A4 helps your body break down drugs. When this process is slowed down, it raises your risk for side effects from Tykerb.

Examples of CYP3A4 inhibitors include:

  • antibiotics, such as clarithromycin
  • antifungals, such as ketoconazole and itraconazole (Sporanox)
  • antivirals, such as ritonavir (Norvir)
  • calcium channel blockers, such as diltiazem (Cardizem CD, Cartia XT) and verapamil (Verelan, Calan SR)

Talk with your doctor if you’re taking any of these medications. They may adjust your dose of Tykerb. Your doctor may also choose to prescribe a drug other than Tykerb to treat your condition.

Tykerb and strong CYP3A4 inducers

Taking Tykerb with medications that induce (speed up) the activity of the CYP3A4 enzyme can lower the amount of Tykerb in your body. CYP3A4 helps your body break down drugs. When this process is sped up, Tykerb may not be as effective.

Examples of CYP3A4 inducers:

  • antibiotics, such as rifampin (Rifadin)
  • anticonvulsants, such as carbamazepine (Tegretol) and phenytoin (Dilantin)
  • antivirals, such as efavirenz (Sustiva) and nevirapine (Viramune)
  • corticosteroids, such as dexamethasone

Talk with your doctor if you’re taking any of these drugs. Your doctor may adjust your dose of Tykerb or your other medication. Or they may prescribe a different drug to treat your condition.

Tykerb and P-glycoprotein inhibitors

Taking Tykerb with medications that inhibit (slow down) the activity of a protein known as P-glycoprotein (P-gp) can increase the amount of Tykerb in your body. This is because P-gp helps get drugs to the correct place in your body. P-gp can also help your body get rid of medications. Using a P-gp inhibitor with Tykerb may raise your risk for side effects of Tykerb.

Examples of P-gp inhibitors include:

  • cyclosporine (Gengraf, Neoral, Sandimmune)
  • ritonavir (Norvir)
  • tacrolimus (Astagraf XL, Prograf)
  • verapamil (Verelan, Calan SR)

Talk with your doctor if you’re taking any of these drugs. Your doctor may adjust your dosage of Tykerb or your other medication. Or they may prescribe a different drug to treat your condition.

Tykerb and herbs and supplements

You shouldn’t take the herbal supplement St. John’s wort if you take Tykerb. Taking them together may decrease the amount of Tykerb in your body. This can make the drug less effective.

If you take St. John’s wort, tell your doctor before you start taking Tykerb. They may have you stop taking it during your Tykerb treatment.

Check with your doctor or pharmacist before using any other herbs or supplements while taking Tykerb.

Tykerb and foods

You should avoid eating grapefruit or drinking grapefruit juice while taking Tykerb.

Eating grapefruit or drinking grapefruit juice may increase the levels of Tykerb in your body. This is because grapefruit may slow down how well your body breaks down Tykerb. This can increase your risk for side effects or make side effects worse.

Other drugs are available that can treat breast cancer. Some may be a better fit for you than others. If you’re interested in finding an alternative to Tykerb, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for breast cancer

Examples of other drugs that may be used to treat HER2-positive (HER2+) breast cancer include:

  • chemotherapy, such as:
    • carboplatin
    • cyclophosphamide
    • docetaxel (Taxotere)
    • doxorubicin (Doxil)
    • paclitaxel (Abraxane)
  • hormone therapy, such as:
    • tamoxifen (Soltamox)
  • targeted therapy, such as:
    • ado-trastuzumab emtansine (Kadcyla)
    • pertuzumab (Perjeta)
    • trastuzumab (Herceptin)

You may wonder how Tykerb compares with other medications that are prescribed for similar uses. Here we look at how Tykerb and Herceptin are alike and different. (Note: This comparison does not address Herceptin Hylecta, a drug that’s similar to Herceptin.)

Ingredients

Tykerb contains the active ingredient lapatinib. Herceptin contains the active ingredient trastuzumab.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Tykerb and Herceptin to treat.

Tykerb is FDA-approved to treat:

  • HER2-positive (HER2+) breast cancer that’s advanced or metastatic and that’s been treated before with anthracyclines, taxanes, and trastuzumab. (Cancer is metastatic if it’s spread to other parts of the body, such as the bones.) For this purpose, Tykerb can be used in both women and men, and it’s taken with the chemotherapy drug capecitabine (Xeloda).
  • HER2+ breast cancer that’s hormone-receptor-positive (HR+) and metastatic. For this purpose, Tykerb is taken with letrozole (Femara) by women who’ve gone through menopause, if hormone therapy is recommended as part of their treatment plan.

Herceptin is FDA-approved to treat:

  • HER2+ breast cancer. For this purpose, Herceptin is used as an adjuvant treatment (add-on therapy).
  • HER2+ breast cancer that’s metastatic.
  • HER2+ metastatic gastric (stomach) cancer or gastroesophageal junction adenocarcinoma.

Drug forms and administration

Tykerb comes as a tablet that you take by mouth.

Herceptin comes as a powder that’s mixed with liquid to form a solution. It’s given as an intravenous (IV) infusion, which goes into your vein. (An infusion is an injection that lasts a certain length of time.) You’ll receive Herceptin from a healthcare provider, most likely at your doctor’s office or a hospital.

Side effects and risks

Tykerb and Herceptin have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Tykerb and Herceptin (when taken individually).

  • Can occur with Tykerb:
    • hair loss
    • hand-foot syndrome (skin reaction, usually on the hands and feet)
  • Can occur with Herceptin:
  • Can occur with both Tykerb and Herceptin:
    • diarrhea
    • nausea and vomiting
    • rash
    • fatigue (lack of energy)
    • headache
    • back and leg pain
    • shortness of breath

Serious side effects

These lists contain examples of serious side effects that can occur with Tykerb, with Herceptin, or with both drugs (when taken individually).

  • Can occur with Herceptin:
    • anemia (low levels of red blood cells)
    • kidney problems
    • neuropathy (nerve damage)
    • infusion reactions†
  • Can occur with both Tykerb and Herceptin:
    • allergic reaction
    • heart problems†
    • lung problems†

* Tykerb has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning: Liver damage” at the beginning of this article.

Herceptin has boxed warnings for these side effects.

Effectiveness

Tykerb and Herceptin haven’t been directly compared in clinical studies. However, studies have found both drugs to be effective for treating breast cancer.

Costs

Tykerb and Herceptin are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

To find current prices for Tykerb and Herceptin, go to WellRx.com. Your cost for either drug could depend on your dosage and the condition you’re using the drug to treat. The actual price you’ll pay for either drug will depend on your insurance plan, your location, and if applicable, the pharmacy you use.

Tykerb and Nerlynx are prescribed for similar uses. Here we look at how these drugs are alike and different.

Ingredients

Tykerb contains the active ingredient lapatinib. Nerlynx contains the active ingredient neratinib.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Tykerb and Nerlynx to treat.

Tykerb is FDA-approved to treat:

  • HER2-positive (HER2+) breast cancer that’s advanced or metastatic and that’s been treated before with anthracyclines, taxanes, and trastuzumab. (Cancer is metastatic if it’s spread to other parts of the body, such as the bones.) For this purpose, Tykerb can be used in both women and men, and it’s taken with the chemotherapy drug capecitabine (Xeloda).
  • HER2+ breast cancer that’s hormone-receptor-positive (HR+) and metastatic. For this purpose, Tykerb is taken with letrozole (Femara) by women who’ve gone through menopause, if hormone therapy is recommended as part of their treatment plan.

Nerlynx is FDA-approved to treat:

  • Advanced or metastatic HER2+ breast cancer in women and men who’ve had at least two previous treatments for their breast cancer. It is taken with capecitabine (Xeloda).
  • Early-stage HER2+ breast cancer. Nerlynx helps prevent the return of this type of cancer in women and men who’ve previously taken trastuzumab (Herceptin). For this purpose, Nerlynx is used as an adjuvant treatment (add-on therapy).

Drug forms and administration

Tykerb and Nerlynx both come as tablets that you take by mouth. Tykerb is taken at least 1 hour before or 1 hour after a meal. Nerlynx is taken with food.

Side effects and risks

Tykerb and Nerlynx have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Tykerb and Nerlynx (when taken individually).

  • Can occur with Tykerb:
    • hair loss
    • headache
    • shortness of breath
  • Can occur with Nerlynx:
    • abdominal (belly) pain
    • decreased appetite
  • Can occur with both Tykerb and Nerlynx:
    • diarrhea
    • fatigue (lack of energy)
    • stomatitis (swelling or sores in your mouth)
    • nausea and vomiting
    • rash
    • back and leg pain
    • hand-foot syndrome (a type of skin reaction that usually occurs on the hands and feet)

Serious side effects

These lists contain examples of serious side effects that can occur with Tykerb or with both drugs (when taken individually).

Effectiveness

Tykerb and Nerlynx have different FDA-approved uses, but they’re both used to treat advanced or metastatic HER2+ breast cancer.

A clinical study compared the use of Tykerb and Nerlynx in treating breast cancer. Researchers followed adults with metastatic HER2+ breast cancer for up to 2 years. People in the study took either Tykerb with the chemotherapy drug capecitabine (Xeloda), or they took Nerlynx with capecitabine.

The effectiveness of each drug was measured by how long it kept someone’s cancer from progressing (getting worse). In the studies:

  • at least half of people who took Tykerb with capecitabine went 5.5 months or longer without their cancer getting worse
  • at least half of people who took Nerlynx with capecitabine went 5.6 months or longer without their cancer getting worse

Costs

According to estimates on WellRx.com, Tykerb costs significantly less than Nerlynx. The actual price you’ll pay for either drug will depend on your insurance plan, your location, and the pharmacy you use.

Tykerb and Nerlynx are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

As with all medications, the cost of Tykerb can vary.

The actual price you’ll pay will depend on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you may have to get Tykerb at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before they approve coverage for Tykerb. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Tykerb, contact your insurance plan.

Financial and insurance assistance

If you need financial support to pay for Tykerb, or if you need help understanding your insurance coverage, help is available.

Novartis, the manufacturer of Tykerb, offers a program called the Novartis Oncology Universal Co-Pay Program. For more information and to find out if you’re eligible for support, call 877-577-7756. Or you can visit the program website.

Generic version

Tykerb is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

You should take Tykerb according to your doctor or healthcare provider’s instructions.

When to take

You’ll take your Tykerb dose once a day. You should take all the tablets at once to get the full dose. Don’t split up the dose (for example, taking two tablets in the morning and two tablets at night). Doing this could raise your risk for side effects.

To help make sure you don’t miss a dose, try setting a reminder in your phone. A medication timer may be useful, too.

Taking Tykerb with food

You shouldn’t take Tykerb with food. Take your dose either 1 hour before or 1 hour after a meal. Taking Tykerb with food lowers the amount of the drug in your body, which may make it less effective.

Can Tykerb be crushed, split, or chewed?

No, you shouldn’t crush, split, or chew Tykerb. You should swallow the tablets whole.

Talk with your doctor or pharmacist if you’re having trouble swallowing the tablets. They may be able to suggest ways to make it easier to take this medication. Or they may recommend other drugs that could be easier for you to take.

Tykerb is FDA-approved to treat HER2-positive (HER2+) breast cancer in adults. (HER2+ means the cancer cells have abnormally high levels of a protein called HER2, which promotes cell growth.)

Tykerb is approved to treat HER2+ breast cancer that’s:

  • Advanced or metastatic (has spread to other parts of the body, such as the bones) and that’s been treated before with anthracyclines, taxanes, and trastuzumab. For this purpose, Tykerb can be used in both women and men, and it’s taken with the chemotherapy drug capecitabine (Xeloda).
  • Hormone-receptor-positive (HR+) and metastatic. For this purpose, Tykerb is taken with letrozole (Femara) by women who’ve gone through menopause, if hormone therapy is recommended as part of their treatment plan.

About HER2+ breast cancer

Human epidermal growth factor receptor 2 (HER2) is a gene that makes proteins in the breast. HER2+ breast cancer occurs when HER2 cells in the breast tissue tell your body to make too many copies of the cells. This causes tumors to form.

In many cases, these extra copies of the cells spread to other areas of the body. This means the cancer is metastatic.

What Tykerb does

Tykerb contains the active ingredient lapatinib, which belongs to a class of medications called tyrosine kinase inhibitors (TKIs). (A medication class is a group of drugs that work in a similar way).

TKIs like Tykerb target and attach to receptors (docking stations) on cancer cells. By permanently attaching to these receptors, Tykerb blocks the cancer cell from receiving signals to grow and expand. Eventually, this causes the cancer cells to die.

How long does it take to work?

Tykerb begins working in your body right after you take a dose. However, it’s unlikely that you’ll notice the drug working. This is because Tykerb can help prevent your cancer from getting worse, but it may not relieve symptoms of your cancer.

During your Tykerb treatment, your doctor will perform tests to check that the drug is working for you.

You shouldn’t take Tykerb while pregnant. Animal studies suggest that Tykerb may cause harm to a fetus.

Studies of pregnant rats and rabbits that received Tykerb resulted in birth defects or death of the fetus. Negative side effects were also seen in the mother. It’s important to note, however, that animal studies don’t always predict what will happen in humans.

Before taking Tykerb, your doctor will likely order a pregnancy test. This is to confirm you aren’t pregnant before you start taking the drug.

If you’re pregnant or planning a pregnancy, talk with your doctor about your treatment options.

Tykerb isn’t safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, you’ll need to use birth control while taking Tykerb. You should continue using birth control for at least 1 week after your last dose.

For more information about taking Tykerb during pregnancy, see the “Tykerb and pregnancy” section above.

You shouldn’t breastfeed while using Tykerb. It’s not known whether Tykerb can pass into breast milk.

The drug’s manufacturer recommends that you don’t breastfeed during your Tykerb treatment and for at least 1 week after your last dose.

If you have questions about breastfeeding or the best way to feed your child during your treatment, talk with your doctor.

Here are answers to some frequently asked questions about Tykerb.

Is Tykerb chemotherapy?

No, Tykerb isn’t a chemotherapy drug.

Chemotherapy drugs kill cells in your body that grow rapidly. Cancer cells are usually fast-growing cells, so they’re affected by chemotherapy. However, some healthy cells (like hair cells) are also fast growing. Chemotherapy can also affect these growing healthy cells, which raises your risks for side effects.

Tykerb contains the active drug lapatinib, which belongs to a class of medications called tyrosine kinase inhibitors (TKIs). (A medication class is a group of drugs that work in a similar way).

TKIs target and attach to receptors (docking stations) on cancer cells. By permanently attaching to these receptors, Tykerb blocks the cancer cell from receiving signals to grow and expand. Eventually, this causes the cancer cells to die.

Will Tykerb cure my cancer?

No, Tykerb won’t cure breast cancer. There’s currently no cure for cancer. However, in clinical studies, Tykerb has been shown to help slow the growth of breast cancer.

Talk with your doctor if you have questions about how Tykerb works to treat your cancer.

How long can I take Tykerb?

Tykerb is meant to be used as a long-term treatment. If the drug works for you, you’ll likely take it until your cancer gets worse or the side effects become too severe.

If you have questions about how long you should take Tykerb, talk with your doctor.

Does Tykerb cause hair loss?

It’s possible that you’ll experience hair loss while taking Tykerb. In clinical studies, hair loss was reported in 10% to 13% of people who took Tykerb, depending on the condition the drug was treating. Of the people taking medications other than Tykerb in these studies, 2% to 7% reported hair loss.

If you’re concerned about hair loss while taking Tykerb, talk with your doctor. They may recommend treatment options for your hair loss. Or, they may recommend trying a medication other than Tykerb.

Can Tykerb and Herceptin be used together?

Tykerb and Herceptin may be used together, although this combination isn’t FDA approved.

A clinical study involved women who had gone through menopause and who had HER2-positive (HER2+) breast cancer that’s hormone-receptor-positive and metastatic.

In the studies, people taking Tykerb, Herceptin, and an aromatase inhibitor went longer without their cancer getting worse than people who only took Herceptin and an aromatase inhibitor or Tykerb and an aromatase inhibitor. The aromatase inhibitors used included anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara).

More research is needed to determine who this drug combination should be used in, and when it should be used. If you’re interested in taking Herceptin with Tykerb, talk with your doctor.

Can Tykerb be used by men with breast cancer?

Yes, Tykerb can be used by both men and women with advanced or metastatic HER2-positive (HER2+) breast cancer. (Cancer is metastatic if it’s spread to other parts of the body, such as the bones.)

Tykerb can be used in people who’ve previously had treatment with anthracyclines, taxanes, and trastuzumab. For this purpose, Tykerb is taken with the chemotherapy drug capecitabine (Xeloda).

If you have questions about treatment options for men with breast cancer, talk with your doctor.

Tykerb is also approved to treat cancer that’s hormone-receptor-positive (HR+) and metastatic. For this purpose, Tykerb is taken with letrozole (Femara) by women who’ve gone through menopause, if hormone therapy is recommended as part of their treatment plan. For information on this use, see the “Tykerb uses” section.

This drug comes with several precautions.

FDA warning: Liver damage

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

In clinical trials and since being released onto the market, Tykerb has been shown to cause liver damage. In some people, this liver damage has been severe or has even caused death. It’s not known what causes this side effect to occur. If you have a history of liver disease, be sure to tell your doctor before taking Tykerb.

Other precautions

Before taking Tykerb, talk with your doctor about your health history. Tykerb may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Low levels of potassium or magnesium. Tykerb can affect your heart rhythm. People with low levels of potassium or magnesium may have a higher risk for this side effect. Talk with your doctor about any history of low potassium or magnesium levels before taking Tykerb.
  • Heart disease. Tykerb can cause negative side effects that affect your heart. For example, it may cause your heart to pump blood less effectively or cause an irregular heartbeat. If you have a history of heart disease, talk with your doctor before taking Tykerb.
  • Allergic reaction. If you’ve had an allergic reaction to Tykerb or any of its ingredients, you shouldn’t take Tykerb. Ask your doctor what other medications are better options for you.
  • Pregnancy. It isn’t safe to take Tykerb while pregnant. For more information, see the “Tykerb and pregnancy” section above.
  • Breastfeeding. You shouldn’t breastfeed while taking Tykerb. For more information, see the “Tykerb and breastfeeding” section above.

Note: For more information about the potential negative effects of Tykerb, see the “Tykerb side effects” section above.

Using more than the recommended dosage of Tykerb can lead to serious side effects.

Do not use more Tykerb than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

  • side effects of Tykerb that may be worse than normal (to learn more about the side effects of Tykerb, see the “Tykerb side effects” section)
  • sore scalp
  • fast heart rate
  • swelling of mucous membranes (moist linings of body areas such as the stomach or lungs)

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency phone number, or go to the nearest emergency room right away.

When you get Tykerb from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Tykerb tablets should be stored at room temperature of about 77oF (25oC) in a tightly sealed container away from light. Tykerb may temporarily be stored at temperatures of 59oF to 86oF (15oC to 30oC), like if you’re traveling. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Tykerb and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Tykerb is indicated for the following conditions:

  • In combination with capecitabine, for use in adults with advanced or metastatic HER2-positive (HER2+) breast cancer. People taking Tykerb should have received prior treatment, specifically including an anthracycline, a taxane, and trastuzumab. They should exhibit disease progression on trastuzumab prior to beginning therapy with Tykerb plus capecitabine.
  • In combination with letrozole, for use in postmenopausal women with metastatic, HER2+, hormone-receptor positive (HR+) breast cancer, if hormonal therapy is indicated.

Administration

Tykerb should be taken by mouth once daily. The entire dose, which will consist of multiple tablets, should be taken at once.

Dividing the daily dose into multiple doses is not recommended, as this has resulted in two-fold higher exposures to the medication once at steady-state.

Tykerb should be taken at least 1 hour before or 1 hour after a meal.

Mechanism of action

The active molecule in Tykerb, lapatinib, is a tyrosine kinase inhibitor for both EGFR and HER2 receptors. Inhibition of tyrosine kinase inhibits tumor cell growth.

Pharmacokinetics and metabolism

Peak concentrations are reached about 4 hours after oral dosing. Steady-state is reached after 6 to 7 days, which indicates a half-life of approximately 24 hours.

Dividing daily doses of Tykerb has been shown to cause a two-fold increase in steady-state AUC compared to once-daily dosing.

Tykerb is >99% bound to plasma proteins, primarily albumin and alpha-1 acid glycoprotein (AGP).

Tykerb is primarily metabolized by CYP3A4 and CYP3A5. Dose adjustments may be necessary in people with severe hepatic impairment.

Contraindications

Do not use Tykerb in people with known contraindications to lapatinib or any component of the drug product.

Storage

Store Tykerb at a room temperature of 77oF (25oC). Excursions of 59oF to 86oF (15oC to 30oC) are permitted.

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 other 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.