Brigatinib : Uses, Side Effects, Interactions & More

Brigatinib is used to treat a certain type of non-small cell lung cancer (NSCLC) that has spread to other parts of the body. Brigatinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells.

Brigatinib comes as a tablet to take by mouth. It is usually taken with or without food once a day. Take brigatinib at around the same times every day. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any parts you do not understand. Take brigatinib exactly as directed. Do not take more or less, or take it more often than prescribed by your doctor.

Swallow the tablets whole; do not chew or crush them.

If you vomit after taking brigatinib, do not take another dose. Continue with your usual dosing schedule.

Your doctor may start you on a low dose of brigatinib and increase your dose once after 7 days of treatment.

Your doctor may need to temporarily or permanently stop your treatment or decrease your dose of brigatinib or other medications that you are taking, depending on the side effects you experience during your treatment. Talk to your doctor about how you feel during your treatment. Do not stop taking brigatinib without consulting your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking brigatinib,

• Tell your doctor and pharmacist if you are allergic to brigatinib, any other medications, or any of the ingredients in brigatinib tablets. Ask your pharmacist for a list of the ingredients.
• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antifungals such as itraconazole (Onmel, Sporanox, Tolsura), ketoconazole, buprenorphine and naloxone (Suboxone), carbamazepine (Equetro, Tegretol, Teril, others), clarithromycin, cyclosporine (Gengraf, Neoral, Sandimmune) diltiazem (Cardizem, Cartia, Diltzac, others), efavirenz (Sustiva, in Atripla, Symfi), erythromycin (EES, Eryc, Erythrocin), indinavir (Crixivan), nefazodone, nelfinavir (Viracept), nevirabital), pineapple (Viracept); phenytoin (Dilantin, Phenytek), pioglitazone (Actos, in Actoplus Met, Duetact, Oseni), rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, in Rifamate, in Rifater), ritonavir (Norvir, in Kaletra, Technimivie (), Rapamune), tacrolimus (Astagraf, Envarsus, Prograf) or verapamil (Calan, Verelan, in Tarka). Your doctor may need to change the doses of your medications or monitor you closely for side effects. Many other medications can also interact with brigatinib, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• Tell your doctor what herbal products you are taking, especially St. John’s wort.
• Tell your doctor if you have or have ever had high blood pressure; a slow heartbeat; diabetes or other blood sugar problems; or kidney or liver disease.
• Tell your doctor if you are pregnant, plan to become pregnant, or plan to have a child. Brigatinib can interfere with the action of hormonal contraceptives (birth control pills, patches, rings, implants, or injections), so you should not use them as your only method of contraception during your treatment. You must use a non-hormonal method of birth control, such as a barrier method (a device that prevents sperm from entering the uterus, such as a condom or diaphragm). Ask your doctor to help you choose a method of birth control that works for you. If you are a woman, you will need to use non-hormonal contraception during your treatment and for 4 months after your final dose. If you are a man, you and your female partner must use birth control during your treatment and continue to use birth control for 3 months after your last dose. Brigatinib can harm the fetus.
• Tell your doctor if you are breastfeeding. You should not breastfeed during your treatment with brigatinib and for 1 week after your final dose.
• You should know that this medicine can decrease fertility in men. Talk to your doctor about the risks of taking brigatinib.

Avoid eating grapefruit and drinking grapefruit juice while taking brigatinib.

Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for the one you forgot.

If you forget to take brigatinib for 14 days or more, talk to your doctor before you start taking it again. You will probably have to go back to taking it at a lower dose.

Brigatinib may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• diarrhea
• vomiting
• constipation
• tiredness
• rash
• headache
• numbness, pain, tingling, or burning feeling in the feet or hands
• back or joint pain
• loss of appetite
• difficulty falling asleep or staying asleep

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• shortness of breath or difficulty breathing
• chest pain
• cough with or without mucus
• fever
• headache, dizziness, lightheadedness, or feeling faint
• blurred or double vision
• seeing flashes of light
• light hurting your eyes
• seeing ”floaters” or small specks
• extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness
• upper stomach pain that may spread to the back or get worse with eating; weight loss; or nausea
• slow or irregular heartbeat
• muscle pain, spasms, tenderness, or weakness

Brigatinib may cause other side effects. Call your doctor if you have any unusual problems while taking this medicine.

If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Store at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medicines out of the sight and reach of children, since many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach. http://www.upandaway.org

Unnecessary medications must be disposed of in special ways to ensure they cannot be consumed by pets, children, and others. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. See the FDA Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or is unable to wake up, immediately call 911 for emergency services.

Keep all appointments with your doctor and the laboratory. Your doctor will order a laboratory test before starting your treatment to see if your cancer can be treated with brigatinib. Your doctor will also order certain laboratory tests and monitor your blood pressure before and during your treatment to check your body’s response to brigatinib.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.