A targeted cancer tablet
Erlotinib
A targeted cancer tablet for EGFR-driven lung and pancreatic cancer, taken on an empty stomach.
What is Erlotinib?
Erlotinib is a targeted cancer tablet that blocks a signal called EGFR. It is used for non-small-cell lung cancer with an EGFR mutation and, in some cases, for advanced pancreatic cancer. It is started and monitored by a cancer specialist but taken regularly at home, on an empty stomach. The most common effects are an acne-like rash on the face and body and diarrhoea, which the team can help manage. It has several drug interactions, grapefruit should be avoided, and pregnancy must be avoided.
Education and reference only. This is a plain-language guide to Erlotinib — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Erlotinib is a targeted cancer therapy known as an EGFR inhibitor. EGFR (the epidermal growth factor receptor) is a signal on the surface of some cancer cells that drives them to grow, and in certain lung cancers a gene change makes this signal overactive. Erlotinib blocks it. It is used mainly for EGFR-mutated non-small-cell lung cancer and sometimes for advanced pancreatic cancer. It is a tablet taken at home, started and supervised by an oncology team.
How it works
In EGFR-driven cancers, the EGFR signal is stuck switched on, constantly telling the cancer cells to multiply. Erlotinib blocks this receptor, slowing or stopping the cancer's growth. Because EGFR is also active in the skin and gut lining, blocking it commonly causes a rash and diarrhoea. It is taken continuously, and the team checks regularly how the cancer is responding and how you are tolerating it.
Company & origin
Originated / developed by: Originally Roche (now also generic).
A targeted cancer tablet used in the UK for certain lung and pancreatic cancers driven by EGFR changes.
Practical use
How to take Erlotinib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it on an empty stomach, around an hour before or two hours after food, at the same time each day.
- Take it exactly as prescribed and do not change or stop it on your own, even if the rash is a nuisance.
- Avoid grapefruit and grapefruit juice, which can raise the level of the medicine in your body.
- Use gentle skin care and sun protection, and ask your team about treatments for the rash and for diarrhoea.
- If you smoke, ask for help to stop, as smoking can lower the level of the medicine and make it less effective.
Weighing it up
Advantages & disadvantages of Erlotinib
Advantages
- A targeted tablet that can work well in lung cancers driven by an EGFR mutation.
- Taken at home as a tablet rather than given as an infusion, while overseen by specialists.
- Works on a specific cancer signal, which can control the disease for a period of time.
Disadvantages
- Commonly causes an acne-like rash and diarrhoea, which can be troublesome.
- Must be taken on an empty stomach, and smoking can reduce how well it works.
- Has several drug and grapefruit interactions and rarely can affect the lungs, liver or eyes.
Practical use
Good to know
The most common effects of erlotinib come from blocking EGFR in the skin and gut: an acne-like rash, often on the face, chest and back, and diarrhoea. Interestingly, the rash is sometimes a sign the treatment is working; your team can advise on creams, gentle skin care and treatments to manage it, and sun protection helps. It must be taken on an empty stomach, as food raises its level. Smoking can lower its level, so it is best to stop. It has several drug interactions and grapefruit should be avoided. Report severe or watery diarrhoea, breathlessness, eye problems or signs of infection, do not stop it without advice, and avoid pregnancy.
Who should not take it / use with caution
- It must not be used in pregnancy, and effective contraception is needed because it can harm an unborn baby.
- It is used with caution, and extra monitoring, in people with liver problems or lung disease.
- People taking medicines that strongly interact with it may need those changed or carefully managed.
Monitoring
- Regular reviews and scans to check how the cancer is responding.
- Watching the skin and managing the rash and any diarrhoea.
- Blood tests for liver function and checking for breathlessness or eye problems.
Side effects
- An acne-like rash and dry, itchy skin, and diarrhoea, are very common.
- Loss of appetite, tiredness, mouth soreness and changes to the nails or eyes can occur.
- Less commonly, lung inflammation (report new or worsening breathlessness), liver changes or severe diarrhoea that need prompt review.
Key interactions
- Processed by the same liver enzyme as many medicines, so some antibiotics, antifungals and epilepsy drugs can change its level.
- Acid-reducing and indigestion medicines can lower how much is absorbed, and grapefruit can raise its level.
- Smoking can lower the level of erlotinib, and it can affect blood thinners such as warfarin.
Available as: Tablets taken by mouth.
Answers
Erlotinib: frequently asked questions
Is the rash a bad sign?
The acne-like rash is a common and expected effect of erlotinib, and is sometimes a sign the treatment is working; your team can help manage it with skin care and treatments rather than stopping the medicine.
Why must I take it on an empty stomach?
Food raises how much erlotinib your body absorbs, so it is taken on an empty stomach, about an hour before or two hours after eating, to keep the level steady and safe.
Does smoking affect erlotinib?
Yes. Smoking can lower the level of erlotinib in your body and make it less effective, so it is best to stop; ask your team for help.
What should I do about diarrhoea?
Diarrhoea is common; tell your team, as they can advise on treatment and fluids, and severe or watery diarrhoea should be reported promptly.
Can I take indigestion remedies with it?
Some acid-reducing and indigestion medicines lower how much erlotinib is absorbed, so check with your pharmacist or team about timing or alternatives.
Authoritative sources
- BNF
- NICE CKS
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