Eribulin (Intravenous)

Overview

Eribulin is a medication for breast cancer and is used together with other forms of chemotherapy. Doctors use the medication for the treatment of metastatic breast cancer, which means that cancer that is in the breast has spread past the breast and into other areas of the body. Originally, Eribulin derived from Japanese culture. It came from a marine sponge from Japan that is called Halichondria okadai. It has a natural origin and has been very effective in treating cancers. The effectiveness is so great that doctors are exploring the use of it on other malignancies besides breast cancer.

The US Food and Drug Administration, or FDA, approved the use of Eribulin for metastatic breast cancer in 2010, though the drug had been in existence far longer than that. They based their approval on the widespread improvement on cancer. The United States was not the only country to notice the benefits of Eribulin. Currently, there are 40 countries using the medication for cancer treatment.

Eribulin is in a medicine group entitled antineoplastics, which is a fancy name for medications that treat cancer. It is typically used when two or more treatments haven't been successful in fighting the malignancies in the breast and are continuing to spread. Since the medication kills unhealthy cells, the healthy ones that remain in the body can be affected by this as well. If this happens, this commonly causes side effects and/or sickness as a result.

Eribulin is given to the patient through an injection into their veins. It works by directly hitting the cancer cells at their growth to stop the spreading and killing the remaining cells. The side effects can be delayed in its onset for months after the medicine is given and up to years thereafter.

Eribulin works in a similar way to other cancer treatment medications. However, Eribulin works at a different stage towards killing the cancer cells. When a patient starts chemotherapy with Eribulin, they are normally taking other medicines for cancer and other chemotherapy methods as well. Eribulin is added to fight off the cancer cells as they are at a resting point. At this stage, they are starting to divide. What Eribulin does it keep them at bay so they continue to die off.

The survival rates for women who have breast cancer have grown when they have Eribulin added to their chemotherapy. It has given some women a longer lifespan compared to if they were to stick to the chemotherapy they were already taking. The drug shows highly effective results and even with severe side effects reported by some patients, doctors are confident enough in using this anticancer medication despite the risks.

Conditions Treated

  • Metastatic breast cancer

Type Of Medicine

  • Antineoplastics (medications for cancer)

Side Effects

The possibilities of side effects with any drug are high. You are introducing something new to your body and the body will act accordingly. The reactions will vary with each individual like anything else. With Eribulin, some of the more common side effects that have been noted include weight loss, back pain, loss of appetite, problems with sleep, heartburn, muscle stiffness, losing hair, dizziness, problems with swallowing, diarrhea, cracked lips, depression, pain within the joints, and upset stomach.

The side effects listed above may go away after your body gets used to the treatment or shortly after the treatment is complete. Other side effects that are more concerning and should be seen by a doctor are:

  • Black Stools
  • Tingling and numbness
  • Chills
  • Coughing
  • Convulsing
  • Lower amount of urination
  • Problems catching your breathe
  • Heachaches
  • Dry mouth
  • Blood in urine or urine being a cloudy substance
  • Swelling
  • Pain when urinating
  • Fever
  • Constant need to urinate
  • Vomiting more than 5 times in a day
  • Nausea
  • Weight loss or weight gain
  • Sneezing
  • A sore throat
  • Tightening in the chest region
  • Bleeding of any kind
  • Sores within the mouth
  • Changes occurring in the mood
  • Excessive tiredness in addition to weakness
  • Fainting
  • Irregular heartbeats

Side effects not listed can still occur. Any new appearances of symptoms should be reported to your doctor.

Many clinical trials have been conducted with Eribulin and have seen even more side effects than listed above. Over 90% of the patients tested in the clinical trials were women in their late 50s, although the patient's ages did range from 17 to 85. These side effects found through the clinical trials have shown adverse reactions with many of the women. The adverse reactions are:

Peripheral neuropathy, which has made several of the patients to stop taking the medicine altogether

  • Neutropenia
  • QT prolongation
  • Anemia
  • Asthenia
  • Alopecia
  • Eye complications such as an increase in lacrimation
  • Gastrointestinal disorders such as dyspepsia, pain in the abdomen, and stomatitis
  • Infections and/or infestations such as an upper respiratory tract infection
  • Metabolism and nutrition disorders such as hypokalemia
  • Skin disorders
  • Subcutaneous tissue damage such as a severe rash
  • Nervous system disorders such as dysgeusia and dizziness
  • Severe mental disorders such as insomnia and depression

Dosage

Eribulin is administered in a treatment center for cancer or a hospital setting, where a doctor or nurse will give the patient the medication. The medicine is given through the patient's veins in two doses throughout 21 days. The regular dose for each treatment is 1mg per 2ml. Normally, the treatment falls on Day 1 and Day 8 in the 21-day span of the treatment. It is then repeated every 21 days until progress is shown with the cancer cells or until the doctor decides to stop this treatment.

There are a few ways the medicine can be given to a patient. The nurse or doctor can give the chemotherapy drugs as well as any drugs to stop any sickness resulting from the chemo at the same time by:

A cannula, which is a petite, thin tube, that is given directly through the vein into the arm or hand

A fine tube going under your skin in the chest region through a vein

A fine tube that goes from a vein in your arm all the way to your chest

The Eribulin medication treatment is not a long process. It normally takes between 2 to 5 minutes each time. It is similar to how an IV is administered. The medication is an infusion that drips until it is completed.

Interactions With Other Drugs

It is important that you inform your doctor of any and all of the drugs you are taking. They do not have to be a prescribed drug for the doctor to know about it. This includes vitamins, over the counter medications, and any recreational drugs. Without this information, you could unknowingly be setting yourself up for bad reactions in correlation to all the drugs in your system. This could include serious aftermath, even as serious as any recreational drugs.

There are specific drugs and medications that should be avoided while taking Eribulin. Here are some drugs that have not interacted well with Eribulin:

  • Bepridil
  • Cisapride
  • Amifampridine
  • Amisulpride
  • Dronedarone
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Some other drugs have been identified as having a possible interaction with the chemotherapy. However, depending on the disease of the individual, their doctor may see it necessary for treatment. In these cases, the doctor can act accordingly with the dosage amounts and the frequency in which the drugs are given. These include:

  • Amiodarone
  • Anagrelide
  • Aripiprazole
  • Arsenic Trioxide
  • Buserelin
  • Clarithromycin
  • Crizotinib
  • Dabrafenib
  • Degarelix
  • Delamanid
  • Deslorelin
  • Domperidone
  • Donepezil
  • Efavirenz
  • Escitalopram
  • Fluoxetine
  • Gonadorelin
  • Goserelin
  • Histrelin
  • Hydroxychloroquine
  • Hydroxyzine
  • Ivabradine
  • Ketoconazole
  • Leuprolide
  • Levofloxacin
  • Metronidazole
  • Moxifloxacin
  • Nafarelin
  • Ondansetron
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Pimavanserin
  • Pitolisant
  • Quetiapine
  • Sevoflurane
  • Sotalol
  • Sulpiride
  • Tacrolimus
  • Triptorelin
  • Vandetanib
  • Vemurafenib
  • Vinflunine
  • Zuclopenthixol

Alcohol use doesn't seem to have a huge effect on the drug. However, heavy drinking should be avoided. Also, cigarettes always bring negative results and additional risks, whether you are sick or not. How much you drink and whether or not you smoke are factors you should make your doctor aware of.

Warnings

Women who are pregnant should not take Eribulin because it can hurt the baby inside the womb. Becoming pregnant is not ideal because of the huge risk for both the mother and the baby. A proper birth control method needs to be utilized for male and female patients during the entirety of the treatment with Eribulin and several months thereafter. Also, breastfeeding is not advised due to the drug being able to pass through to the baby. Women should wait a few months after treatment has ended to continue breastfeeding to avoid any medication remnants being left inside the body.

Eribulin has an effect on how many white blood cells your body produces. It is because of this fact that an infection can easily be picked up by a patient taking this drug. Avoid any contact with people who have any kind of infection or illness. Do not touch your mouth, nose or eyes if you have not recently washed them whenever possible so that any sickness you do encounter may not infect you.

Also, Eribulin can affect platelet numbers that make your blood clot. If you are going to shave, be careful not to cut yourself because of the amount of blood you could lose. Brushing your teeth with a toothbrush should be used with extreme caution for the potential of bleeding through the teeth or gums. Your doctor may give suggestions of other ways to clean your teeth to avoid this risk.

Other health issues can interfere with the medicine's effectiveness. These can be reoccurring or a health issue from years ago. Anyone who has or had the following conditions should consult and talk to the doctor before starting treatment with Eribulin:

  • Congestive heart failure
  • Nerve damage
  • It could make the nerve's worse than before.
  • Bone marrow problems
  • Blood issues
  • Kidney disease
  • Liver disease
  • Patients with this disease potentially have the option of having a lower dose.
  • Rhythmic heart

Someone who has this issue should not take Eribulin injections

Aspirin should be avoided with Eribulin treatment unless the doctor gives the ok to them. Also, the patient should not have any vaccinations of any kind while using this type of treatment.

Storage

Since the medication is given through the veins, it comes packaged in vials. They should be kept in the original cartons the vials were received in. Once they are received they should be maintained at 77 degrees in a refrigerated container. Do no freeze Eribulin at any time during the storage process. Syringes filled and undiluted with the medication can be stored at room temperature for 4 hours. They can also be stored for 4 hours diluted. Storage can resume in a 24-hour timeframe under refrigeration.

Make sure any part of the vial is thrown out if it is not used.

Summary

Cancer treatments are constantly improving. Year after year, new cancer medications are made in the hopes of killing off many more cancer cells than before. The progress that doctors and scientists have made in the discovery of treatments continues to grow. Currently, the realization that only one medication may not be enough to kill all the cancer cells in a patient is a sad but true one.

Eribulin is one of the medications that is an added part of a chemotherapy treatment plan for a patient who has breast cancer. When the cancer is not responding to just one form of chemotherapy, doctors have found that Eribulin has been very effective in survival for patients. Like other types of chemo, it is given as in infusion drip system, administered through the patient's veins.

The medication can take a toll on the patient. Everyone will have their own reaction to the medicine. Some can be more severe than others. It is important to take notice of anything irregular that happens after the treatment, though because even if it seems insignificant, it might be more serious than it appears.

Eribulin has been very helpful in curing breast cancer. Doctors have seen such high results that they are testing the effects on other cancer cells throughout the body. Adding this to the treatment plan of metastatic breast cancer patients seems to be worth the risk and discomfort it proves to have so that patients can fight the disease and go back to a normal, cancer-free life.