Eribulin is a chemotherapy drug used to treat breast cancer that has spread to other parts of the body (advanced or metastatic breast cancer).
HOW IS ERIBULIN ADMINISTERED?
Eribulin is given in the chemotherapy day unit or during a hospital stay. A chemotherapy nurse will give it to you.
Before the day of treatment, a nurse will take a blood sample from you to see if you are fit for chemotherapy.
You will also be able to see a doctor or nurse before having chemotherapy. They will ask you how you have been feeling. If the results of your blood test are good on the day of your treatment, the pharmacist will prepare your chemotherapy. Your nurse will give you medication for nausea and, sometimes, steroids administered intravenously. Chemotherapy drugs may be given in the following ways:
- Through a thin tube (line) inserted into a vein in the arm or hand by a nurse
- Through a tube that goes below the skin of your chest to a nearby vein (central line)
- Through a thin tube that is placed in a vein of the arm and goes up through a vein toward the chest (PICC)
Your nurse will give you eribulin as a drip (infusion) into your line. This takes 2-5 minutes.
YOUR CHEMOTHERAPY CYCLE
You will have chemotherapy as part of a course or cycle, consisting of several treatment sessions and lasting several months.
Each cycle of eribulin normally lasts 21 days. You will take eribulin on days 1 to 8 of the cycle. After 21 days, the second cycle begins. This is the same as the first cycle. Your doctor may lower the dose of eribulin if you have side effects.
Your doctor or nurse will tell you how many cycles you are likely to have.
POSSIBLE SIDE EFFECTS OF ERIBULIN
You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you receive other chemotherapy drugs, you may have other side effects that are not mentioned here. Always inform your doctor of the effects you experience.
Your doctor can prescribe medication to help control some of the side effects. It is very important to take the medication exactly as your doctor says for it to have the highest chance of working well. Your nurse will advise you on managing the side effects. After treatment, the side effects start to get better.
RISK OF INFECTION
Eribulin may lower the number of white blood cells in your blood. This will make you more susceptible to infection. Your nurse can tell you when you might have the lowest levels of these cells. When the number of white blood cells is low, this is called neutropenia.
Contact your hospital immediately if any of the following happens:
- your temperature goes above 38 ° C
- you suddenly feel unwell, even if your temperature is normal.
- You have symptoms of infection, which may include sore throat, coughing, or the need to urinate frequently.
The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy session. You will have a blood test before your next chemotherapy. If your white blood cells are still low, your doctor may postpone the treatment for a short period of time.
TINGLING IN THE HANDS OR FEET
These symptoms are caused by the effect of eribulin on the nerves. It is called peripheral neuropathy. It may also be hard for you to press buttons and it can make other tasks more uncomfortable. You may also feel a certain degree of pain at your nerve endings.
Tell your doctor if you have these symptoms. It is sometimes necessary to lower the drug dose. The symptoms normally get better slowly once the treatment is over, though in some people they never go away. Talk to your doctor if you are worried about this.
Usually, people lose all of their hair. Also, the eyelashes, eyebrows, and other parts of the body may lose their hair. This normally starts after your first or second cycle of chemotherapy. It is almost always temporary, and the hair will continue to grow after you finish your chemotherapy. Until the time when you hair grows back, it is important to cover your head so as to protect the scalp while it is exposed to the sun's rays. Your nurse can give you advice on how to cope with losing your hair.
This can happen on the first few days after chemotherapy. Your doctor will prescribe you antiemetic drugs to help prevent or control your nausea. It is easier to prevent nausea than it is to treat it once it has begun.
If you still have nausea or are vomiting, get in touch with the hospital as soon as possible. They can give you advice and change your medication to one that works better.
LOSS OF APPETITE
You may lose your appetite during the treatment. Try to eat in small quantities and have frequent meals. Don't worry if you don't eat much for a day or two. If your appetite doesn't get any better after a few days, tell your nurse or dietitian. They can give you nutritional supplements or good-tasting meal-replacement drinks.
Feeling very tired is a common side effect. Fatigue is often worst toward the end of treatment and for a few months after the treatment has finished. Try to pace yourself and rest as much as you need to. Help balance this with a bit of light exercise, such as short walks. If you feel drowsy, don't drive or operate heavy machinery.
Eribulin can cause constipation. Drinking at least two liters of fluids each day will help if this is the case. Try to eat more high-fiber foods such as fruit, vegetables, and whole-grain bread and get some light exercise.
Your doctor can prescribe medicines to control diarrhea. Let them know if your diarrhea is severe or if it doesn't get better. Make sure you drink at least two liters of fluids each day if you have diarrhea.
JOINT AND/OR MUSCLE PAIN
You may have pain in your joints or muscles for a few days after chemotherapy. Tell your doctor if this happens so they can prescribe you some painkillers. Let them know if your pain doesn't go away. Try to get lots of rest. Taking warm baths on a regular basis can help.
Eribulin can cause headaches. If this happens, tell your doctor or nurse. They can give you painkillers for this.
LESS COMMON SIDE EFFECTS OF ERIBULIN
Eribulin may lower the number of red blood cells in your blood. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this. If you are very anemic, it's possible you will require a blood transfusion.
BRUISING AND BLEEDING
Eribulin may lower the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising. This includes nosebleeds, bleeding gums, blood spots, or skin eruptions (rashes). Some people may require additional platelets.
SORENESS OF THE MOUTH
You may have a sore mouth or mouth ulcers, which could make you more prone to getting a mouth infection. Lightly brush your teeth and/or dentures in the morning and night and after meals. Use a soft-bristle toothbrush. Your nurse might ask you to rinse your mouth out regularly or use mouthwash. It is important that you follow all the instructions you are given and that you drink a lot of fluids.
Tell your nurse or doctor if you have any mouth problems. They can prescribe you drugs to prevent or treat infections of the mouth and to treat any kind of pain.
DRYNESS OF THE MOUTH
You mouth may become dry. Drink lots of fluids and add sauces to food. Sucking on ice cubes can also help, though you shouldn't do this is you have a sore mouth or other mouth problems. If your lips are dry, use lip balm or vaseline.
CHANGES IN YOUR NAILS
Your nails may become fragile and break easily. They could darken or become discolored. These changes go away when the treatment is completed. During your treatment, try to protect your nails by wearing gloves to wash dishes. If you experience pain, reddening, or swelling around the nails, tell your doctor or nurse.
Eribulin may make you feel dizzy. Let your doctors know if this happens.
Eribulin can cause indigestion. This is often felt as a burning sensation in the chest area. Tell your doctor if you have these symptoms. They can give you medicine to treat your heartburn.
You may have stomach pain or discomfort, feel bloated or feel gassy. Your doctor can prescribe medication to help these symptoms get better.
Chemotherapy can affect your skin. If you feel your skin becomes dry, try to use a fragrance-free moisturizing cream every day. You may develop a rash which may sting. Always tell your doctor or nurse about any change to your skin. They can advise you and prescribe creams or medication that may help. Normally, changes in the skin are temporary and get better as soon as the treatment is over.
You may feel pain in your eyes or they may become inflamed (conjunctivitis). Tell your doctor if any of these develop, as you may need antibiotic eye drops.
Eribulin may affect your sleep. Tell your doctor if this is a problem.
CHANGES IN THE WAY THE LIVER FUNCTIONS
You will have periodic blood tests done to see how your liver is working. Usually, any changes in the way your liver works will stop after the treatment is over.
EFFECTS ON THE LUNGS
Always let your doctor know if you have wheezing, coughing, fever, or if you are out of breath. If necessary, tests can be done to check your lungs.
CHANGES IN THE HEART
Eribulin may cause changes in your heartbeat. This does not normally cause serious problems and returns to normal after the treatment is done. Tell your doctor if you notice that you have a fast heart rate.
MORE INFORMATION ABOUT ERIBULIN
BLOOD CLOT RISK
Cancer and chemotherapy increase the chances of a blood (thrombosis). The symptoms include pain, reddening or swelling in a leg, difficulty breathing, and pain in the chest. Get in touch with your doctor immediately if you have any of these symptoms.
Some medicines can interact with chemotherapy or be harmful if they are taken alongside chemotherapy. This includes medications that can be purchased in a store or pharmacy. Tell your doctor the medicines you are taking, including over-the-counter medications, complementary therapies, and herbal medicines.
Eribulin may affect your fertility. If this worries you, you can talk to your doctor before beginning treatment.
Your doctor will advise you not to become pregnant during the treatment. This is because the drugs can harm developing babies. It is important to use contraception during chemotherapy and for a few months after the treatment ends.
If you have sex within the first few days after chemotherapy, it is necessary to use a condom. This is to protect your partner in case there is chemotherapy in semen or vaginal fluid.
Women are recommended not to breastfeed during treatment and for a few months after chemotherapy has concluded. This is in case the chemotherapy enters their breast milk.
MEDICAL AND DENTAL TREATMENT
If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are having chemotherapy.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always let your dentist know that you are having chemotherapy.