Xalkori Generic Name & Formulations
Legal Class
General Description
Pharmacological Class
See Also
How Supplied
Caps—60; Oral pellets—60
Manufacturer
Generic Availability
Mechanism of Action
Xalkori Indications
Indications
Limitations of Use
Xalkori Dosage and Administration
Adult
Swallow caps whole. If unable to swallow caps, may use oral pellets. Empty the oral pellets in the encapsulated shells directly into the mouth or into an oral dosing spoon or medicine cup. IMT: 250mg twice daily. ALCL (young adults): usually 280mg/m2 twice daily. Dosage based on BSA (may combine different strengths, if needed): see full labeling. Continue until disease progression or unacceptable toxicity. Provide antiemetic and antidiarrheal agents for GI toxicities. Consider replacing electrolytes, IV or oral hydration for patients at risk of dehydration. Dose modifications for concomitant strong CYP3A inhibitors, moderate/severe hepatic impairment, severe renal impairment, hematologic and non-hematologic toxicities: see full labeling.
Children
ALCL or IMT: <1yr or (BSA <0.60m2): not established. Swallow caps whole. If unable to swallow caps, may use oral pellets. Empty the oral pellets in the encapsulated shells directly into the mouth or into an oral dosing spoon or medicine cup. ≥1yr: usually 280mg/m2 twice daily. Dosage based on BSA (may combine different strengths, if needed): see full labeling. Continue until disease progression or unacceptable toxicity. Provide antiemetic and antidiarrheal agents for GI toxicities. Consider replacing electrolytes, IV or oral hydration for patients at risk of dehydration. Dose modifications for concomitant strong CYP3A inhibitors, moderate/severe hepatic impairment, severe renal impairment, hematologic and non-hematologic toxicities: see full labeling.
Xalkori Contraindications
Not Applicable
Xalkori Boxed Warnings
Not Applicable
Xalkori Warnings/Precautions
Warnings/Precautions
Monitor ALT, AST and total bilirubin every 2 weeks during first 2 months, then monthly, and more frequently for elevated transaminases; temporarily suspend, reduce dose, or permanently discontinue as clinically indicated. Monitor CBCs (including differential) weekly for the first month, then at least monthly, and more frequently if Grade 3 or 4 abnormalities, fever or infection occurs. Risk of severe interstitial lung disease (ILD)/pneumonitis: monitor for pulmonary symptoms; permanently discontinue if occurs. Congenital long QT syndrome; avoid. History of or predisposition for QTc prolongation (eg, CHF, bradyarrhythmias, electrolyte abnormalities, or those who are taking drugs known to prolong the QT interval): consider monitoring ECG, electrolytes periodically. Torsade de pointes, ventricular tachycardia, serious arrhythmia: permanently discontinue if QTc >500ms or ≥60ms change from baseline. Monitor HR and BP regularly; discontinue if life-threatening bradycardia occurs. Perform eye assessment monthly in all patients. In ALCL or IMT (peds & young adults): obtain eye exam prior to and within 1 month of initiation (include retinal exam), then every 3 months thereafter; permanently discontinue if Grade 3 or 4 ocular disorders or severe visual loss occurs. Hepatic impairment. Severe renal impairment. Embryo-fetal toxicity. Use effective contraception during and for at least 45 days (females) or 90 days (males w. female partners) after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 45 days after the last dose).
Xalkori Pharmacokinetics
Distribution
Mean volume of distribution: 1772 L (after a single IV dose). Plasma protein bound: 91%.
Elimination
Xalkori Interactions
Interactions
Xalkori Adverse Reactions
Adverse Reactions
Xalkori Clinical Trials
See Literature
Xalkori Note
Not Applicable
Xalkori Patient Counseling
See Literature
Xalkori Generic Name & Formulations
Legal Class
General Description
Pharmacological Class
See Also
How Supplied
Caps—60; Oral pellets—60
Manufacturer
Generic Availability
Mechanism of Action
Xalkori Indications
Indications
Xalkori Dosage and Administration
Adult
Confirm ALK or ROS1-positive NSCLC with an FDA-approved test before treating. Swallow caps whole. If unable to swallow caps, may use oral pellets. Empty the oral pellets in the encapsulated shells directly into the mouth or into an oral dosing spoon or medicine cup. 250mg twice daily until disease progression or intolerance. Concomitant strong CYP3A inhibitors (if unavoidable): reduce to 250mg once daily. Moderate hepatic impairment (AST and total bilirubin >1.5–≤3×ULN): 200mg twice daily; severe (AST and total bilirubin >3×ULN): 250mg once daily. Severe renal impairment (CrCl <30mL/min) not requiring dialysis: 250mg once daily. Dose modifications for hematologic and non-hematologic toxicities: see full labeling.
Children
Xalkori Contraindications
Not Applicable
Xalkori Boxed Warnings
Not Applicable
Xalkori Warnings/Precautions
Warnings/Precautions
Monitor ALT, AST and total bilirubin every 2 weeks during first 2 months, then monthly, and more frequently for elevated transaminases; temporarily suspend, reduce dose, or permanently discontinue as clinically indicated. Monitor CBCs (including differential) weekly for the first month, then at least monthly, and more frequently if Grade 3 or 4 abnormalities, fever or infection occurs. Risk of severe interstitial lung disease (ILD)/pneumonitis: monitor for pulmonary symptoms; permanently discontinue if occurs. Congenital long QT syndrome; avoid. History of or predisposition for QTc prolongation (eg, CHF, bradyarrhythmias, electrolyte abnormalities, or those who are taking drugs known to prolong the QT interval): consider monitoring ECG, electrolytes periodically. Torsade de pointes, ventricular tachycardia, serious arrhythmia: permanently discontinue if QTc >500ms or ≥60ms change from baseline. Monitor HR and BP regularly; discontinue if life-threatening bradycardia occurs. Perform eye assessment monthly in all patients. In ALCL or IMT (peds & young adults): obtain eye exam prior to and within 1 month of initiation (include retinal exam), then every 3 months thereafter; permanently discontinue if Grade 3 or 4 ocular disorders or severe visual loss occurs. Hepatic impairment. Severe renal impairment. Embryo-fetal toxicity. Use effective contraception during and for at least 45 days (females) or 90 days (males w. female partners) after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 45 days after the last dose).
Xalkori Pharmacokinetics
Distribution
Mean volume of distribution: 1772 L (after a single IV dose). Plasma protein bound: 91%.
Elimination
Xalkori Interactions
Interactions
Xalkori Adverse Reactions
Adverse Reactions
Xalkori Clinical Trials
See Literature
Xalkori Note
Not Applicable
Xalkori Patient Counseling
See Literature