Lorbrena Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Lorbrena Tablet (generic name: lorlatinib) is a prescription kinase inhibitor used to treat adults with a specific type of metastatic non-small cell lung cancer (NSCLC) caused by an abnormal ALK gene. It works by blocking the ALK protein, including forms that have become resistant to other ALK-targeted medicines, helping to slow or stop tumor growth, including tumors that have spread to the brain. A healthcare provider performs a test to confirm Lorbrena is the right treatment before starting it.

What is Lorbrena Tablet

Lorbrena is a prescription medicine used to treat adults with a specific type of non-small cell lung cancer (NSCLC). It is used when the cancer is caused by an abnormal ALK gene and has spread to other parts of the body. A healthcare provider performs a test to confirm Lorbrena is the right treatment.

Lorbrena Tablet uses

• Treatment of adults with metastatic non-small cell lung cancer (NSCLC) whose tumors are ALK-positive, as detected by an FDA-approved test

Benefits of Lorbrena Tablet

• Can shrink or stop the growth of ALK-positive NSCLC tumors, including tumors that have spread to the brain
• In clinical trials, a majority of patients taking Lorbrena had their tumors shrink or disappear
• Lorbrena has been shown to help shrink ALK+ NSCLC tumors that have spread to the brain

How Lorbrena Tablet works

Lorbrena blocks the ALK protein, including forms of ALK that have become resistant to other ALK-targeted medicines. By blocking this protein, it can help slow down or stop the growth and spread of ALK-positive tumors. It is also designed to cross into the brain to treat tumors that have spread there.

Lorbrena Tablet dosage

Take this medicine exactly as your healthcare provider tells you to. Do not change your dose or stop taking it unless your healthcare provider tells you to.

Swallow tablets whole. Do not chew, crush, or split the tablets, and do not take a tablet if it is broken, cracked, or otherwise not intact.

Take it once a day, at the same time each day. You may take it with or without food.

If you miss a dose, take it as soon as you remember, unless it is close to your next scheduled dose (within 4 hours), in which case skip the missed dose and take your next dose at the regular time. Do not take two doses at once to make up for a missed dose.

If you vomit after taking a dose, do not take an extra dose; just take your next dose at the regular time.

Tell your healthcare provider about all medicines, vitamins, and herbal supplements you take, since this medicine can interact with many other drugs.

Available forms and strengths

• Tablet (25 mg film-coated tablet)
• Tablet (100 mg film-coated tablet)

Side effects of Lorbrena Tablet

Common

• Swelling in arms, legs, hands, and feet (edema)
• Numbness and tingling feeling in joints or arms and legs (peripheral neuropathy)
• Weight gain
• Problems with thinking, such as forgetfulness or confusion
• Tiredness (fatigue)
• Difficulty breathing
• Pain in joints
• Diarrhea
• Changes in mood, such as depression and irritability
• High cholesterol and triglyceride levels in the blood
• Cough

Serious

• Liver problems from interactions with other medicines
• Central nervous system effects including confusion, mood changes, hallucinations, seizures, speech changes, and sleep changes
• Large increases in blood cholesterol and triglyceride levels
• Heart problems including very slow or abnormal heartbeats
• Severe or life-threatening lung inflammation (interstitial lung disease/pneumonitis)
• High blood pressure
• High blood sugar
• Decreased fertility in males

Warnings and precautions

• Do not take this medicine together with certain other medicines called strong CYP3A inducers, as this combination can cause serious liver damage.
• This medicine may cause a range of central nervous system effects, including problems with thinking, mood changes (including thoughts about suicide), hallucinations, seizures, speech changes, and sleep changes.
• Most people will have an increase in blood cholesterol and triglyceride levels during treatment, and may need medicine to manage it.
• This medicine may cause very slow or abnormal heartbeats. Heart rhythm will be checked before and during treatment.
• This medicine may cause severe or life-threatening lung inflammation that can lead to death.
• This medicine can cause high blood pressure, which will be monitored regularly during treatment.
• This medicine can increase blood sugar levels, which will be monitored during treatment.
• This medicine can harm an unborn baby. A pregnancy test is done before starting treatment. 
• Women who can become pregnant should use effective non-hormonal birth control during treatment and for at least 6 months after the last dose, because this medicine can make hormonal birth control less effective.
•  Men with partners who can become pregnant should use effective birth control during treatment and for at least 3 months after the last dose.
• It is not known if this medicine passes into breast milk. Do not breastfeed during treatment and for 7 days after the final dose.
• Tell your healthcare provider if you have kidney problems. People with severe kidney impairment need a lower dose.
• This medicine can cause serious liver problems, especially when combined with certain other medicines. Tell your doctor about all medicines you take.
• Discuss alcohol use with the oncology team, particularly if dizziness, cognitive effects, or liver abnormalities occur.
• This medicine can moderately affect your ability to drive or use machines because it may cause central nervous system effects. Use caution when driving or operating machinery.

Storage

• Store at room temperature between 68°F to 77°F (20°C to 25°C)
• Keep this medicine and all medicines out of the reach of children

When to see a doctor

• Get medical help right away if you feel dizzy or faint, or notice an abnormal heartbeat.
• Get medical help right away if you have new or worsening trouble breathing, shortness of breath, cough, or fever.
• Get medical help right away if you develop headaches, dizziness, blurred vision, chest pain, or shortness of breath, which can be signs of high blood pressure.
• Get medical help right away if you notice signs of high blood sugar, such as feeling very thirsty, urinating more than usual, feeling very hungry, feeling sick to your stomach, feeling weak or tired, or feeling confused.
• Tell your healthcare provider if you experience any new or worsening symptoms affecting thinking, mood, speech, or sleep.

Alternatives

• Alectinib
• Brigatinib
• Ceritinib