Xalkori is brand-name prescription drug. It’s FDA-approved for use in adults with metastatic non-small cell lung cancer (NSCLC) that’s anaplastic lymphoma kinase-positive (ALK+) or ROS proto-oncogene 1-positive (ROS1+).

ALK+ or ROS1+ means that either the ALK or ROS1 gene is abnormal. Problems with these genes cause cells to grow too quickly, leading to the growth of cancer cells.

Xalkori belongs to a class of drugs called kinase inhibitors. Xalkori targets the ALK or ROS1kinases (proteins), which turns on the ALK or ROS1 gene. By blocking these genes from turning on, Xalkori stops cancer cells from spreading. This helps decrease the size of your tumor (mass of cancerous cells) and slow cancer growth.

Xalkori comes as capsules that you take by mouth. The capsules are available in two strengths: 200 mg and 250 mg.

Effectiveness

To learn about Xalkori’s effectiveness, see the “Xalkori for lung cancer” section.

Xalkori 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 tend to cost less than brand-name drugs.

Xalkori contains one active drug ingredient: crizotinib.

Xalkori can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Xalkori. These lists don’t include all possible side effects.

For more information on the possible side effects of Xalkori, 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 Xalkori, you can do so through MedWatch.

Mild side effects

Mild side effects of Xalkori can include:*

  • nausea and vomiting
  • diarrhea
  • constipation
  • swelling in your hands, feet, face, or eyes
  • fatigue (lack of energy)
  • decreased appetite
  • upper respiratory infection (like a common cold)
  • dizziness
  • neuropathy (tingling, burning, or numbness in arms, hands, legs, or feet)
  • changes in weight
  • fever
  • imbalance of certain electrolytes, such as phosphorus or potassium (in some cases, this may be serious)
  • higher levels of liver enzymes (in some cases, this may be a sign of serious liver damage)

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 Xalkori. To learn about other mild side effects, talk with your doctor or pharmacist, or view the drug’s medication guide.

Serious side effects

Call your doctor right away if you have serious side effects from Xalkori. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Bradycardia (slowed heart rate). Symptoms can include:
    • dizziness
    • fatigue
    • shortness of breath
    • fainting
  • Increased QT interval (changes in heart rhythm). Symptoms can include:
    • fast heartbeat
    • shortness of breath
    • fainting
  • Neutropenia or lymphopenia (low number of white blood cells). Symptoms can include:
    • fever
    • chills or sweating
    • fatigue

Other serious side effects are explained below in “Side effect details.” These include:

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 Xalkori. 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 Xalkori. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Changes in weight

Some people may experience weight gain or weight loss while taking Xalkori. In one study of people with ALK+ metastatic NSCLC, 8% of people taking Xalkori gained weight. In comparison, 2% of those receiving chemotherapy gained weight.

In a separate study of people taking Xalkori for ALK+ metastatic NSCLC who had received previous treatment, 10% of people lost weight. In comparison, 4% of those receiving chemotherapy lost weight.

The amount of weight people gained or lost in these clinical studies wasn’t reported. Talk with your doctor if you have concerns about weight changes while taking Xalkori.

Vision problems

Vision problems, including vision loss, may be a side effect of Xalkori. In clinical studies, these vision problems were minor in most people. However, about 1% of people in clinical studies had serious vision problems, including partial or complete vision loss.

In clinical studies of people with ALK+ metastatic NSCLC, 60% to 71% of those taking Xalkori had vision problems. In comparison, 9% to 10% of those taking chemotherapy had vision problems. In a study of people taking Xalkori for ROS1+ NSCLC, 92% of people had vision problems. There was no comparison with a placebo (a treatment with no active drug) or chemotherapy.

In studies of people taking Xalkori, vision problems usually occurred within 1 week of taking the drug. Most people with vision problems reported that the symptoms had little or no impact on their daily activities.

Types of reported vision problems include:

Talk with your doctor right away if you have any of these symptoms after taking Xalkori. Depending on how severe your vision problems are, you doctor may have you stop taking Xalkori until more testing can be done.

Liver problems

Xalkori can cause liver problems in some people. Liver problems caused by Xalkori range from mild to severe.

In very rare cases, liver problems caused by Xalkori can be fatal. In clinical trials, liver problems caused death in 0.1% of people taking Xalkori.

Symptoms of liver problems can include:

  • jaundice (yellowing of the skin or whites of the eyes)
  • itching
  • loss of appetite
  • swelling
  • weight loss
  • pain in the abdomen (belly)

Talk with your doctor right away if you have any of these symptoms during your Xalkori treatment.

Blood tests

Your doctor will order blood tests during your treatment to check for liver problems. These tests are usually done every 2 weeks for the first 2 months of treatment. After that, the tests are usually done once a month.

Certain enzymes are found in the liver, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST). If tests show that these enzyme levels are higher than usual, your doctor may decrease your Xalkori dosage or have you stop taking it for a while. They may also have you stop taking Xalkori altogether and switch to a different treatment.

Talk with your doctor if you currently have liver problems or have had them in the past. Your doctor may adjust your Xalkori dosage or choose a different medication for you.

Lung problems

Xalkori may cause lung problems. Some problems are mild, and others can be severe or life threatening.

Examples of lung problems include:

Interstitial lung disease or pneumonitis usually occurs within 3 months of starting Xalkori. These conditions can cause trouble breathing and can be very severe.

In clinical studies, 2.9% of people taking Xalkori had interstitial lung disease or pneumonitis. In very rare cases, these conditions can even lead to death. Of those taking Xalkori, 0.5% had interstitial lung disease or pneumonitis that was fatal.

Talk with your doctor right away if you have trouble breathing or develop a cough while taking Xalkori. After checking your symptoms, your doctor may want to adjust your Xalkori dosage or have you switch to a different treatment.

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

  • other medications you take
  • any side effects you get from Xalkori
  • other medical conditions you may have

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

Xalkori comes as capsules that are taken by mouth. It’s available in the following strengths: 200 mg and 250 mg.

Dosage for lung cancer

For metastatic non-small cell lung cancer (NSCLC), the recommended dosage is 250 mg taken twice a day. Your doctor may adjust your dosage during your treatment, depending on your specific health needs and how you react to the drug.

What if I miss a dose?

If you miss a dose of Xalkori, take it as soon as possible, unless it’s within 6 hours of your next dose. If it’s within 6 hours of your next dose, just wait to take your next dose as scheduled. If you vomit after taking a dose, don’t take another one. Instead, wait until your next scheduled dose.

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?

Xalkori is meant to be used as a long-term treatment. If you and your doctor determine that Xalkori is safe and effective for you, you’ll likely take it long term.

The Food and Drug Administration (FDA) approves prescription drugs such as Xalkori to treat certain conditions. Xalkori is FDA-approved for use in adults with metastatic non-small cell lung cancer (NSCLC) that’s anaplastic lymphoma kinase-positive (ALK+) or ROS proto-oncogene 1-positive (ROS1+). (Cancer is metastatic when it has spread to other parts of the body.)

Effectiveness for lung cancer

One study involved adults with ALK+ NSCLC who hadn’t had treatment for their cancer before. They took either 250 mg of Xalkori twice a day or a combination of chemotherapy drugs.

  • Of the people who took Xalkori, at least half of them experienced 10.9 months of progression-free survival. (This is a period of time when their cancer stopped getting worse.) Of the people who received chemotherapy, at least half of them experienced progression-free survival for 7 months.
  • Of the people taking Xalkori, 74% had their tumor shrink or go away completely during treatment. In comparison, 45% of those receiving chemotherapy achieved this result.

Another study looked at adults with ALK+ NSCLC who had previously taken either 250 mg of Xalkori twice a day or received chemotherapy such as pemetrexed (Alimta) or docetaxel (Taxotere).

  • Of the people who took Xalkori, at least half of them experienced 7.7 months of progression-free survival. Of the people who received chemotherapy, at least half of them experienced progression-free survival for about 3 months.
  • Of the people taking Xalkori, 65% had their tumor shrink or go away completely during treatment. In comparison, 20% of those receiving chemotherapy achieved this result.

Xalkori and children

Xalkori isn’t approved for use in children. It’s not known if the drug is safe or effective for use in children.

There is no known interaction between Xalkori and alcohol. However, some of Xalkori’s side effects may get worse with alcohol use.

Examples of these side effects include:

  • nausea and vomiting
  • diarrhea
  • dizziness
  • changes in vision
  • liver problems
  • fatigue (lack of energy)

If you drink alcohol, talk with your doctor about how much is safe for you to drink during your Xalkori treatment.

Xalkori 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.

Xalkori and other medications

Below is a list of medications that can interact with Xalkori. This list doesn’t contain all drugs that may interact with Xalkori.

Before taking Xalkori, 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.

Xalkori and strong or moderate CYP3A inhibitors

Xalkori can interact with drugs that inhibit (slow down) an enzyme called CYP3A. (This enzyme breaks down drugs in your body.) Taking Xalkori with these drugs can increase the level of Xalkori in your body. This can raise your risk for side effects.

Examples of CYP3A inhibitors include:

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

Talk with your doctor if you’re taking any of these medications. They may have you stop taking the CYP3A inhibitor, adjust your Xalkori dosage, or suggest other treatment options for you.

Xalkori and strong CYP3A inducers

Xalkori can interact with medications that induce (speed up) an enzyme called CYP3A. This enzyme breaks down drugs in your body. Taking Xalkori with these drugs can decrease the level of Xalkori in your body. This can make Xalkori less effective.

Examples of CYP3A inducers include:

  • antibiotics, such as rifampin (Rifadin)
  • anticonvulsants, such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin)
  • antivirals, such as efavirenz (Sustiva), etravirine (Intelence)

Talk with your doctor if you’re taking any of these medications. They may have you stop taking the CYP3A inducer, adjust your Xalkori dosage, or suggest other treatment options for you.

Xalkori and certain medications metabolized by CYP3A

Xalkori can interact with other medications that are broken down by an enzyme called CYP3A. Taking Xalkori with these drugs can increase the levels of the other drugs in your body.

In cases where a small change in the level of the other medication in your body could be harmful, avoid taking Xalkori with this type of drug. If you have to take the other drug, your doctor may adjust your Xalkori dosage or suggest a different medication instead of Xalkori.

Examples of medications broken down by CYP3A include:

  • lovastatin (Altoprev)
  • midazolam
  • rivaroxaban (Xarelto)
  • tacrolimus (Prograf, Astagraf XL)

Xalkori and drugs that increase the QT interval

Certain medications, including Xalkori, can increase your QT interval. This means the drugs may affect the rhythm of your heartbeat. Taking Xalkori with other drugs that also increase the QT interval can raise your risk for side effects.

Examples of drugs that increase the QT interval include:

  • certain antibiotics, such as azithromycin (Zithromax), ciprofloxacin (Cipro), levofloxacin (Levaquin)
  • certain antidepressants, such as citalopram (Celexa), escitalopram (Lexapro)
  • certain antifungals, such as fluconazole, ketoconazole
  • certain antipsychotics, such as haloperidol (Haldol), ziprasidone (Geodon)

Talk with your doctor if you’re taking any of these medications. They’ll help decide if you need to make any changes to your treatment plan.

Drugs that cause bradycardia

Xalkori can cause bradycardia (slow heart rate). Taking Xalkori with other medications that also slow your heart rate can raise your risk for side effects.

Examples of drugs that slow your heart rate include:

  • beta-blockers, such as bisoprolol (Ziac), metoprolol (Lopressor, Toprol XL), propranolol (Inderal LA)
  • calcium channel blockers, such as verapamil (Verelan), diltiazem (Cardizem CD, Cartia XT)
  • clonidine (Catapres)
  • digoxin (Lanoxin)

Talk with your doctor if you’re taking any of these medications. They’ll help decide if you need to make any changes to your treatment plan.

Xalkori and herbs and supplements

Taking Xalkori with an herbal supplement called St. John’s wort can decrease the level of Xalkori in your body. This can make the drug less effective. To avoid this, you shouldn’t take St. John’s wort during your Xalkori treatment.

Xalkori and foods

Xalkori may interact with grapefruit or grapefruit juice. It’s best to avoid these while taking Xalkori because consuming grapefruit may increase the levels of Xalkori in your body. This can raise your risk for side effects or worsen any side effects you do have.

Talk with your doctor if you regularly drink grapefruit juice or eat grapefruit.

As with all medications, the cost of Xalkori can vary. To find current prices for Xalkori in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Xalkori 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 approving coverage for Xalkori. 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 request and let you and your doctor know if your plan will cover Xalkori.

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

Financial and insurance assistance

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

Pfizer, the manufacturer of Xalkori, offers a program called Pfizer Oncology Together that provides information on cost assistance. For more information about financial support, and to find out if you’re eligible for it, call 877-744-5675 or visit the program website.

Other drugs are available that can treat non-small cell lung cancer (NSCLC). Some may be a better fit for you than others. If you’re interested in finding an alternative to Xalkori, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below 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 ALK+ NSCLC

Examples of other drugs that may be used to treat ALK+ NSCLC include:

  • ceritinib (Zykadia)
  • alectinib (Alecensa)
  • brigatinib (Alunbrig)
  • lorlatinib (Lorbrena)

Alternatives for ROS1+ NSCLC

Examples of other drugs that may be used to treat ROS1+ NSCLC include:

  • ceritinib (Zykadia)
  • lorlatinib (Lorbrena)
  • entrectinib (Rozlytrek)

You may wonder how Xalkori compares with other medications that are prescribed for similar uses. Here we look at how Xalkori and Alecensa are alike and different.

Ingredients

Xalkori contains the active ingredient crizotinib. Alecensa contains the active ingredient alectinib.

Uses

Xalkori and Alecensa are both FDA-approved for use in adults with metastatic non-small cell lung cancer (NSCLC) that’s ALK+ or ROS1+. (Cancer is metastatic when it has spread to other parts of the body.)

ALK+ or ROS1+ means that either the ALK or ROS1 gene is abnormal. Problems with these genes cause cells to grow too quickly, leading to the growth of cancer cells.

Drug forms and administration

Xalkori and Alecensa both come as capsules that are taken by mouth, usually twice a day.

Side effects and risks

Mild side effects

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

  • Can occur with Xalkori:
    • decreased appetite
    • dizziness
    • neuropathy (tingling, burning, or numbness in arms, hands, legs, or feet)
    • weight loss
    • fever
  • Can occur with Alecensa:
    • muscle pain
    • anemia (low number of red blood cells)
  • Can occur with both Xalkori and Alecensa:
    • nausea and vomiting
    • diarrhea
    • fatigue (lack of energy)
    • constipation
    • swelling in hands, feet, face, or eyes
    • weight gain
    • imbalance of certain electrolytes, such as phosphorus or potassium (in some cases, this may be serious)
    • higher levels of liver enzymes (in some cases, this may be a sign of serious liver damage)

Serious side effects

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

  • Can occur with Xalkori:
    • increased QT interval (changes in heart rhythm)
    • vision problems
  • Can occur with Alecensa:
    • kidney problems
    • severe muscle pain and increase in creatinine phosphokinase (which can be a sign of muscle breakdown)
  • Can occur with both Xalkori and Alecensa:
    • liver problems
    • lung problems

Effectiveness

The only condition both Xalkori and Alecensa are approved to treat is ALK+ NSCLC that’s metastatic.

The use of Xalkori and Alecensa in treating ALK+ metastatic NSCLC has been compared in clinical studies. The effectiveness of the drugs was measured by looking at progression-free survival. (This refers to the length of time someone lives without their disease getting worse.)

These studies found that people taking Alecensa were 51% to 66% more likely to experience progression-free survival for a longer time than those taking Xalkori.

Costs

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

According to estimates on WellRx.com, Xalkori is more expensive than Alecensa. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Xalkori and Rozlytrek are prescribed for similar uses. Below are details of how these drugs are alike and different.

Ingredients

Xalkori includes the active ingredient crizotinib. Rozlytrek includes the active ingredient entrectinib.

Uses

Xalkori is FDA-approved for use in adults with metastatic non-small cell lung cancer (NSCLC) that’s ALK+ or ROS1+. (Cancer is metastatic when it has spread to other parts of the body.) Rozlytrek is FDA-approved for use in adults with metastatic NSCLC that’s ROS1+.

ALK+ or ROS1+ means that either the ALK or ROS1 gene is abnormal. Problems with these genes cause cells to grow too quickly, leading to the growth of cancer cells.

Rozlytrek is also FDA-approved for use in adults and in children ages 12 years and older with certain solid tumors.

Drug forms and administration

Xalkori and Rozlytrek are both taken by mouth. Xalkori is usually taken twice a day, and Rozlytrek is usually taken once a day.

Side effects and risks

Xalkori and Rozlytrek have some similar side effects and others that vary. 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 Xalkori, with Rozlytrek, or with both Xalkori and Rozlytrek (when taken individually).

  • Can occur with Xalkori:
    • decreased appetite
    • neuropathy (tingling, burning, or numbness in arms, hands, legs, or feet)
    • weight loss
    • higher levels of liver enzymes (in some cases, this may be a sign of serious liver damage)
  • Can occur with Rozlytrek:
    • changes in the way things taste
    • cough
    • dysesthesia (pain, itching, or burning)
    • muscle or joint pain
    • trouble concentrating (in some cases, can be serious)
  • Can occur with both Xalkori and Rozlytrek:
    • fatigue (lack of energy)
    • diarrhea
    • constipation
    • swelling in hands, feet, face, or eyes
    • dizziness
    • nausea and vomiting
    • weight gain
    • fever

Serious side effects

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

Effectiveness

The only condition both Xalkori and Rozlytrek are approved to treat is metastatic ROS1+ NSCLC.

These drugs haven’t been directly compared in clinical studies. However, studies have found both Xalkori and Rozlytrek to be effective for treating ROS1+ metastatic NSCLC.

Costs

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

According to estimates on WellRx.com, Xalkori is significantly more expensive than Rozlytrek. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

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

When to take

Xalkori is usually taken by mouth twice a day. Try to take it at the same times each day. If you have certain liver or kidney issues or have certain side effects, your doctor may have you take Xalkori once a day instead. Never make changes to your dosage without talking to your doctor.

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

Taking Xalkori with food

You can take Xalkori with or without food.

Can Xalkori be crushed, split, or chewed?

No, Xalkori capsules should be swallowed whole. They shouldn’t be crushed, split or chewed.

Xalkori is FDA-approved for use in adults with metastatic non-small cell lung cancer (NSCLC) that’s ALK+ or ROS1+. (Cancer is metastatic when it has spread to other parts of the body.)

ALK+ or ROS1+ means that either the ALK or ROS1 gene is abnormal. Problems with these genes cause cells to grow too quickly, leading to the growth of cancer cells.

About NSCLC

There are two main kinds of lung cancer: small cell lung cancer and non-small cell lung cancer (NSCLC).

NSCLC is the more common type of lung cancer. In fact, about 80% to 85% of all lung cancer cases are NSCLC.

Smoking is a main risk factor for both types of lung cancer. In addition, risk factors for NSCLC include being exposed to secondhand smoke, asbestos, and certain paints or chemicals.

Treatment options for NSCLC include surgery, chemotherapy, radiation, and targeted therapies such as Xalkori.

What Xalkori does

Xalkori is a targeted therapy that belongs to a class of drugs called kinase inhibitors. Xalkori targets the ALK or ROS1kinases (proteins), which turn on the ALK or ROS1 gene.

By blocking these genes from turning on, Xalkori stops cancer cells from spreading. This helps decrease the size of your tumor (mass of cancerous cells) and slow cancer growth.

How long does it take to work?

Xalkori begins working against cancer cells as soon as you start taking it. You probably won’t notice Xalkori working because it doesn’t treat the symptoms of cancer. Instead, it slows the growth of cancer cells and decreases the size of your tumor (mass of cancerous cells).

Xalkori is usually given until you can no longer tolerate it due to side effects or until it’s no longer working well. Your doctor will order tests throughout your treatment to check how well Xalkori is working for you.

Xalkori shouldn’t be taken during pregnancy. Women taking should avoid becoming pregnant during their Xalkori treatment and for at least 45 days after their last dose.

In animal studies, Xalkori has been shown to cause harm to a fetus. It’s not known if it causes the same side effects in humans. Your doctor may ask you to take a pregnancy test before starting Xalkori.

For some men and women, taking Xalkori may lead to fertility problems (trouble conceiving a child). If you and your partner are planning a pregnancy, talk with your doctor before starting Xalkori.

Xalkori 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 Xalkori.

Women should use contraception during their Xalkori treatment and for at least 45 days after their last dose. Men who have a partner who could become pregnant should wear condoms during their Xalkori treatment and for at least 90 days after their last dose.

If you have questions about your birth control options, talk with your doctor.

It’s not known if it’s safe to breastfeed while taking Xalkori or if the drug passes into breast milk. In general, it’s recommended that you avoid breastfeeding during Xalkori treatment and for at least 45 days after the last dose.

If you’re currently breastfeeding or planning to breastfeed while taking Xalkori, talk with your doctor about the risks and benefits.

Here are answers to some frequently asked questions about Xalkori.

Is Xalkori a type of chemotherapy?

No, Xalkori isn’t a type of chemotherapy. Chemotherapy drugs work by killing all rapidly growing cells in your body. These drugs can affect healthy cells as well as cancer cells. This is why chemotherapy can have such serious side effects.

Xalkori is a targeted therapy that belongs to a class of drugs called kinase inhibitors. Xalkori targets the ALK or ROS1kinases (proteins), which turn on the ALK or ROS1 gene.

By blocking these genes from turning on, Xalkori stops cancer cells from spreading. This helps decrease the size of your tumor (mass of cancerous cells) and slow cancer growth.

Will Xalkori cure my lung cancer?

No, Xalkori hasn’t been shown to cure lung cancer. However, it can slow the cancer growth and decrease tumor size. This can help keep your cancer from progressing (getting worse).

At this time, there’s no known cure for lung cancer.

Do I need any blood work or other tests while I’m taking Xalkori?

Yes, your doctor will likely order many tests throughout your treatment. They’ll draw blood to check your liver and kidney function and your electrolyte levels (such as sodium, potassium, and phosphorus). Your doctor will also look at your white blood cell counts to make sure they’re normal.

You may also need to have imaging tests, called radiology scans, or have tests to monitor your heart function.

How can I tell if Xalkori is working to treat my lung cancer?

Even though you may not feel differently, your cancer may be responding to Xalkori. Your doctor will do tests during your Xalkori treatment to monitor your tumor size and check whether the drug is working for you.

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

  • Liver problems. Taking Xalkori can cause liver problems. If you already have liver problems, you may have higher levels of Xalkori in your body after taking it. This can raise your risk for side effects. (See “Side effect details” above for more information.) Tell your doctor if you have liver problems. They may lower your dose of Xalkori, choose a different medication, or monitor you more closely.
  • Kidney problems. Taking Xalkori can cause kidneys to work less effectively. If you have existing kidney problems, using Xalkori could make these problems worse. Tell your doctor if you have kidney problems. They may lower your dose of Xalkori, choose a different medication, or monitor you more closely.
  • Heart problems. Taking Xalkori can increase the QT interval, which means it might affect the rhythm of your heartbeat. If you were born with heart problems, including rhythm issues, your doctor will likely recommend a different treatment. Taking Xalkori could make your condition worse and lead to serious side effects.
  • Vision problems. Xalkori is known to cause a range of vision problems, from mild to serious. If you have vision problems (such as blurred vision, double vision, or floaters), tell your doctor before taking Xalkori. They may recommend a different treatment for you or choose to monitor you more closely.
  • Pregnancy. It’s not safe to take Xalkori during pregnancy. For more information, see the “Xalkori and pregnancy” section above.
  • Breastfeeding. Xalkori isn’t recommended for breastfeeding mothers. For more information, see the “Xalkori and breastfeeding” section above.

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

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

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 go to the nearest emergency room right away.

When you get Xalkori 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.

Xalkori capsules should be stored at room temperature from 68°F to 77°F (20°C to 25°C). They should be kept in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Xalkori 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

Xalkori is approved by the FDA for the treatment of metastatic non-small cell lung cancer that’s anaplastic lymphoma kinase-positive (ALK+) or ROS proto-oncogene 1-positive (ROS1+). ALK+ or ROS1+ means that either the ALK or ROS1 genes are abnormal. Problems with these genes cause cells to grow too quickly, leading to the growth of cancer cells.

Xalkori is not approved for use in children, as its safety and efficacy are not known in this group.

Mechanism of action

Xalkori belongs to a class of medications known as kinase inhibitors. It inhibits receptor tyrosine kinases, including ALK and ROS1, to decrease tumor size and cancer cell growth.

Pharmacokinetics and metabolism

Peak concentration of Xalkori occurs in 4 to 6 hours, with an average absolute bioavailability of 43%. It has a half-life of 42 hours after single doses.

Xalkori is metabolized primarily by CYP3A. Drug-drug interactions involve CYP3A substrates, inducers, and inhibitors. It can take up to 45 days to clear from the system.

Xalkori is eliminated primarily in feces and urine.

Contraindications

Though there are no contraindications for Xalkori, the medication is associated with several warnings and precautions. For more details, see the “Xalkori precautions” section.

Storage

Xalkori should be stored at room temperature from 68°F to 77°F (20°C to 25°C). Variations in temperature are permitted between 59°F and 86°F (15°C to 30°C). The medication should be stored away from moisture and light.

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.

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