Alectinib (Alecensa®)

How to Take Alectinib

Alectinib is taken by mouth in capsule form. This medication should be taken with food. Swallow the capsules whole; do not crush, chew, break or open the capsules. If you miss a dose, do not take two doses to make up for a missed dose. If you vomit after taking your dose, do not take another dose. Take the next dose at its normally scheduled time. Consult with your pharmacist or provider if you are having trouble swallowing the medication.

You may need to take a number of capsules to achieve the full dose. It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.

Storage and Handling

Store your medication in the original, labeled container at room temperature and in a dry location (unless otherwise directed by your healthcare provider or pharmacist). This medication should not be stored in a pillbox. Keep containers out of reach of children and pets.

If a caregiver prepares your dose for you, they should consider wearing gloves or pour the pills directly from their container into the cap, a small cup, or directly into your hand. They should avoid touching the pills. They should always wash their hands before and after giving you the medication. Pregnant or nursing women should not prepare the dose for you. Ask your oncology team where to return any unused medication for disposal. Do not flush it down the toilet or throw it 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 the distribution of this medication and shipment directly to your home.

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals depending upon prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be 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 care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Fatigue

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.

Constipation

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.

Swelling (Edema)

This medication can cause swelling (edema) in the face, especially around the eyes, and extremities. This can be a sign of other problems, so be sure to report any abnormal swelling to your healthcare team for further evaluation.

Low Red Blood Cell Count (Anemia)

Your red blood cells are responsible for carrying oxygen to the tissues in your body. When the red cell count is low, you may feel tired or weak. You should let your oncology care team know if you experience any shortness of breath, difficulty breathing, or pain in your chest. If the count gets too low, you may receive a blood transfusion.

High Blood Sugar

This medication can cause elevated blood sugar levels in patients with and without diabetes. Your oncology care team will monitor your blood sugar. If you develop increased thirst, urination or hunger, blurry vision, headaches or your breath smells like fruit, notify your healthcare team. Diabetics should monitor their blood sugar closely and report elevations to the healthcare team.

Sun Sensitivity

This medication can make your skin more sensitive to the sun especially while taking the medication and for the seven days following your last dose. This sensitivity can result in severe sunburn or rash. Sun sensitivity can last even after chemotherapy is completed. Avoid the sun between 10-2 p.m., when it is strongest. Wear sunscreen (at least SPF 30 with UVA/UVB protection) every day and reapply when in the sun for extended periods of time); wear sunglasses with UVA/UVB protection, a hat, and long sleeves/pants to protect your skin and seek out shade whenever possible.

Less common, but important side effects can include:

• Liver Toxicity: 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, your 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 3 months of treatment and then as indicated by your provider.
• Interstitial Lung Disease: Patients can develop inflammation, stiffness, and damage to 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.
• 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.
• Muscle Pain and Weakness: This pain can be associated with damage to the muscles, which can become severe. Your provider will do blood tests to monitor your creatine phosphokinase level 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.
• Kidney Problems: This medication can cause kidney problems, including an increased creatinine level, which your oncology care team may monitor for using blood tests. Notify your healthcare provider if you notice decreased urine output, blood in the urine, swelling in the ankles, or loss of appetite.
• Hemolytic Anemia:This medication can cause the breakdown of red blood cells (hemolytic anemia). You may not even be aware that you have this problem, so you should report the following symptoms of red blood cell breakdown to your care team: jaundice (yellowing of the skin or whites of the eyes), weakness, dizziness, or shortness of breath.

Reproductive Concerns

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. You should not breastfeed while taking this medication or for one week after your last dose.