eribulin

High Alert

Metastatic breast cancer that has progressed despite ≥2 previous regimens that included an anthracycline and a taxane in either the adjuvant or metastatic setting.
Unresectable or metastatic liposarcoma in patients who have received a prior regimen that included an anthracycline.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Severe hepatic impairment;
Severe renal impairment (CCr <15 mL/min);
Congenital long QT syndrome;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

HF, bradyarrhythmias, concurrent use of drugs known to prolong the QT interval (including Class Ia and III antiarrhythmics), or electrolyte abnormalities (↑ risk of arrhythmias);
Moderate renal impairment;
Mild or moderate hepatic impairment;
Rep: Women of reproductive potential and men with female partners of reproductive potential;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: peripheral edema, QT interval prolongation

Derm: alopecia, stevens-johnson syndrome, toxic epidermal necrolysis, rash

EENT: ↑lacrimation

F and E: hypokalemia

GI: anorexia, constipation, nausea, abdominal pain, abnormal taste, diarrhea, dry mouth, dyspepsia, mucositis, PANCREATITIS, vomiting

GU: urinary tract infection

Hemat: anemia, neutropenia

MS: arthralgia, myalgia

Neuro: fatigue, weakness, depression, dizziness, headache, insomnia, peripheral neuropathy

Resp: cough, dyspnea, upper respiratory tract infection

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

↑risk of bone marrow depression with other antineoplastics or radiation therapy.
↓antibody response and ↑ risk of adverse reactions with live-virus vaccines.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 0.5 mg/mL

Route/Dosage ⬆ ⬇

IV (Adults ): 1.4 mg/m² on days 1 and 8 of a 21-day cycle.

Renal Impairment

IV (Adults ): CCr 15–49 mL/min: 1.1 mg/m² on days 1 and 8 of a 21-day cycle.

Hepatic Impairment

IV (Adults ): Mild hepatic impairment: 1.1 mg/m² on days 1 and 8 of a 21-day cycle Moderate hepatic impairment: 0.7 mg/m² on days 1 and 8 of a 21-day cycle.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits intracellular microtubule growth phase, causing G₂/M cell-cycle block resulting in apoptotic cell death.

Therapeutic effects:

Death of rapidly replicating cells, particularly malignant ones.
Improved survival in breast cancer or liposarcoma.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: antimicrotubulars

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Minimal metabolism, mostly excreted unchanged in feces (82%) and less in urine (9%).

Half-Life: 40 hr.

Time/Action Profile ⬆ ⬇

(effects on blood counts)

ROUTE	ONSET	PEAK	DURATION
IV	within days	7–14 days	up to 2 wk

Patient/Family Teaching ⬆ ⬇

Advise patient to notify health care professional if fever of ≥100.5°F or other signs or symptoms of infection (chills, cough, burning or pain on urination) or rash occur.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Advise patient not to receive vaccinations without consulting health care professional.
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception during and for at least 2 wk after last dose of therapy. Advise males with female partners of reproductive potential to use effective contraception for 3.5 mo after final dose. Instruct females of reproductive potential to notify health care professional immediately if pregnancy is planned and to avoid breastfeeding during therapy. May cause male infertility.

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Indications ⬇