Classification: kinase inhibitor
About Alectinib (Alecensa®)
Alectinib is a type of targeted therapy called a tyrosine kinase inhibitor. This medication works by targeting and blocking receptors found on the cancer cells, which in turn blocks tumor growth. This medication acts specifically on tumors that have an abnormality in a gene called ALK (anaplastic lymphoma kinase). Your oncology team will test your tumor for this abnormality, which must be present in order to receive the medication.
How to Take Alectinib
Alectinib comes in a capsule form to be taken by mouth (orally). It is taken twice a day with food. Swallow the capsules whole; Do not crush, chew, break or open the capsules. If a dose is missed or if you vomit after taking the dose, do not take an extra dose. Take the next dose at your regularly scheduled time.
Storage and Handling
Store this medication at room temperature in the original container. Protect from light and moisture. If you prefer to use a pillbox, discuss this with your oncology pharmacist. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.
Where do I get this medication?
Alectinib is available through select specialty pharmacies. Your oncology team will work with your prescription drug plan to identify an in-network specialty pharmacy for distribution of this medication and shipment directly to your home.
This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, are also available. Your care team can help you find these resources, if they are available.
Possible Side Effects of Alectinib
There are a number of things you can do to manage the side effects of alectinib. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day, and keep active. A stool softener once or twice a day may prevent constipation. If you do not have a bowel movement for 2-3 days, you should contact your healthcare team for suggestions to relieve the constipation.
Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.
Muscle Pain or Weakness
This pain can be associated with damage to the muscles, which can become severe. Your provider will do blood tests every two weeks for the first month of treatment and then as needed to check for muscle damage. If you are experiencing any unexplained muscle pain, tenderness or weakness, notify your provider right away.
This medication can cause swelling (edema) in the face and extremities. However, this can be a sign of other problems, so be sure to report any abnormal swelling to your healthcare team for further evaluation.
This medication can cause liver toxicity, which your provider will monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, feeling more tired than usual, feeling less hungry than usual, skin is itchy, nausea, bleeding or bruising more than normal, your urine appears dark or brown or pain in your abdomen, as these can be signs of liver toxicity. You will have lab work to monitor your liver function every 2 weeks for the first 2 months of treatment and then as indicated by your provider.
Patients can develop inflammation, stiffness and damage of the lungs while taking this medication. Notify your healthcare provider right away if you develop any new or worsening symptoms, including shortness of breath, trouble breathing, cough or fever.
Slow Heartbeat (Bradycardia)
Bradycardia is a lower than normal heart rate, which can be a serious problem. Report any dizziness, light-headedness and fainting to your provider immediately. Your provider will monitor your heart rate and blood pressure regularly during therapy.
This medication can make your skin more sensitive to the sun, which can result in severe sunburn or rash. This sensitivity lasts for up to 7 days after completion of treatment with alectinib. Avoid the sun between 10-2pm, when it is strongest. Wear sunscreen and lipbalm with a SPF of 50 or greater everyday; wear sunglasses, a hat and long sleeves/pants to protect your skin and seek out shade whenever possible.
Some patients may develop a rash, very dry or itchy skin. Others may develop a rash that looks like acne, it is not, and should not be treated with acne medications. Use an alcohol free moisturizer on your skin and lips; avoid moisturizers with perfumes or scents. Your doctor or nurse can recommend a topical medication if itching is bothersome. If your skin does crack or bleed, be sure to keep the area clean to avoid infection. Be sure to notify your healthcare provider of any rash that develops, as this can be a reaction. They can give you more tips on caring for your skin.
While receiving alectinib, some patients may develop changes in your eyesight. Notify your healthcare team if you develop any blurred vision, "floaters", visual impairment, eye strain or double vision.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment and for at least 1 week for women and 3 months for men after treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. Do not breastfeed while receiving this medication, or for 1 week after stopping this medication.