When your doctor prescribes a drug called Larotrectinib for you or someone you know, it's normal to have a lot of questions about it. What kind of drug is this? What will happen with it? Are there any side effects? You may be wondering. Don't worry. Let's talk about this drug simply, in a way that you can understand.
What is Larotrectinib?
Simply put, larotrectinib is a special type of medicine that stops the growth of cancer cells. This is called 'targeted therapy'. This means that this medicine goes directly to and affects only a specific protein in cancer cells, stopping those cells from growing.
But this is not a drug that is given to all types of cancer. Your cancer cells are tested to see if they have a special mutation in a gene called NTRK (neurotrophic receptor tyrosine kinase gene fusion) . Only people with that genetic mutation will benefit from this drug. So if your doctor has prescribed this drug for you, it means that your type of cancer is likely to respond well to it.
Things to tell your doctor before starting medication
Before starting this medication, it is very important to give your doctor a complete description of your health condition. Be sure to tell them about the following in particular:
| Status | What you need to inform |
|---|---|
| Liver disease | If you have any liver disease. |
| Nerve disorder | If your limbs are tingling or you have other nerve problems. |
| Allergies | If you have an allergy to this medicine, other medicines, foods, or dyes. |
| Pregnancy | If you are pregnant, trying to get pregnant, or have any doubts about it. |
| Breastfeeding | If you are breastfeeding your baby. |
How should I use this medicine?
The most important thing is to take the medicine exactly as the doctor says.
- Swallow this capsule whole with a glass of water .
- Do not break, crush, or chew the capsule.
- You can take this before or after meals. But try to take it at the same time every day .
- Very important: Never take this medicine with grapefruit juice.
- Do not stop taking your medication without your doctor's advice.
If given to children: This medicine can sometimes be prescribed even to young children. However, it requires special precautions. Talk to your pediatrician about this.
What to do if the dose increases (overdose)?
If you think you have taken too much of this medicine, do not panic. Immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What if I forget to take my medicine?
If you miss a dose, take it as soon as you remember. However, if it is less than 6 hours until your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once.
Other things that may interact with this medicine (Interactions)
This medicine may interact with other medicines and foods. Therefore, tell your doctor about everything you are taking. This includes prescription medicines, over-the-counter medicines, herbal products, vitamins, and supplements. Also, tell your doctor if you smoke or drink alcohol.
Below are some things that may interact with this medication.
- Medicines for HIV or AIDS
- Some antibiotics (such as clarithromycin)
- Medicines for fungal infections (such as ketoconazole)
- Medicines for epilepsy (such as carbamazepine, phenytoin)
- Some heart disease medications
- Immunosuppressant medications (such as cyclosporine, tacrolimus)
- Some anti-cancer drugs (chemotherapy)
- The herb St. John's Wort
- Grapefruit juice
This list is not complete, so it is important to inform your doctor about all medications you are taking.
Things to consider when taking medication
- Blood tests: While taking this medication, your doctor will order blood tests from time to time to check things like your liver function.
- Tasks that require attention: This medication may make you feel dizzy, drowsy, or confused. Therefore, avoid tasks that require attention, such as driving or operating machinery, until you know exactly how this affects your body.
- Pregnancy and breastfeeding (very important):
- Women: Avoid becoming pregnant while taking this medicine and for at least one week after stopping the medicine. If you are planning to become pregnant or suspect that you are pregnant, tell your doctor immediately.
- Men: Avoid fathering a child while taking this medication and for at least one week after stopping the medication.
- Avoid breastfeeding your baby while taking this medicine and for one week after stopping.
- Fertility: This medicine may affect your ability to have children. If you have any concerns about this, talk to your doctor.
Side effects of the medicine
Like any medication, this one can have side effects. Some are minor, while others require immediate attention.
| Side effects that should be reported to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Liver injury signs | Dark yellow/brown urine, yellowing of the eyes or skin, pain in the upper right part of the stomach, nausea, loss of appetite, pale stools. |
| Nervous system problems | Dizziness, confusion, loss of balance, pain or numbness in the limbs, difficulty speaking. |
| Common side effects that should be reported to the doctor if they persist | |
| Vomiting | Diarrhea |
| Constipation | Cough |
| Tiredness | |
If you experience any other unusual symptoms not mentioned on this list, talk to your doctor about them as well.
Take-Home Message
- Larotrectinib is a targeted therapy specifically for cancers with an NTRK gene fusion.
- It is essential to tell your doctor about all other medications, herbal products, and supplements you are taking.
- Avoid drinking grapefruit juice completely while taking this medication.
- Follow strict precautions regarding pregnancy, breastfeeding, and childbearing while taking the medication and for one week after stopping.
- Seek immediate medical attention if symptoms such as liver damage or severe neurological problems occur.
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