Eribulin (Generic Name)
Other Names: Halaven®
About This Drug
Eribulin is a drug used to treat cancer. This drug is given in the vein (IV).
Possible Side Effects (More Common)
- Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 72 to 96 hours. Medicines are available to stop or lessen these side effects.
- Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually happens 7 to 10 days after the drug is given and may raise your risk of infection, make you feel tired and weak (fatigue), and raise your risk of bleeding.
- Hair loss: Hair loss is often complete scalp hair loss and can involve loss of eyebrows, eyelashes, and pubic hair. You may notice this a few days or weeks after treatment has started. Most often hair loss is temporary; your hair should grow back when treatment is done.
- Constipation (not able to move bowels)
- Loose bowel movements (diarrhea) that may last for a few days
- Weight loss and decreased appetite (decreased hunger)
- Changes in your liver function. Your doctor will check your liver function as needed.
- Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak).
- Effects on the nerves called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped, but it does not get better in all people.
- Feeling short of breath
- Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt
Possible Side Effects (Less Common)
- Changes in the tissue of your heart. Some changes may happen that can cause your heart to have less ability to pump blood. Your heart function will be checked as needed.
- Your heart tissue can be harmed. This may cause your heart to beat in a way that is not normal. Your doctor may order an EKG to check this.
- Arm and leg pain
- Electrolyte changes. Your blood will be checked for electrolyte changes as needed.
- Urinary tract infection. Symptoms may include:
- Pain or burning when you pass urine
- Feeling like you have to pass urine often, but not much urine comes out when you do.
- Tender or heavy feeling in your lower abdomen
- Cloudy urine and/or urine that smells bad.
- Pain on one side of your back under your ribs. This is where your kidneys are.
- Fever, chills, nausea and/or throwing up
- Infusion Reactions. While you are getting this drug in your vein (IV), you may have a reaction. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.
These reactions may happen up to 24 hours after you get this drug. Call 911 for emergency care.
Serious allergic reactions including anaphylaxis are rare. While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these symptoms of an allergic reaction:
- Trouble catching your breath
- Feeling like your tongue or throat are swelling
- Feeling your heart beat quickly or in a not normal way (palpitations)
- Feeling dizzy or lightheaded
Treating Side Effects
- Drink 6 to 8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
- Talk with your nurse about getting a wig before you lose your hair. Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “ Look Good ... Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans, and scarves as well as makeup techniques and skin and nail care.
- Ask your doctor or nurse about medicine to help stop or lessen constipation, nausea, and throwing up (vomiting).
- If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
- Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after every meal and at bedtime.
- If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
- If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
Food and Drug Interactions
There are no known interactions of eribulin with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.
When to Call the Doctor
Call your doctor or nurse right away if you have any of these symptoms:
- Fever of 100.5 F (38 C) or above
- Easy bruising or bleeding
- Wheezing or trouble breathing
- Rash or itching
- Feeling dizzy or lightheaded
- Feeling that your heart is beating in a fast or not normal way (palpitations)
- Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
- Blurred vision or other changes in eyesight
- Pain when passing urine; blood in urine
- Pain in your lower back or side
- Confusion or agitation
- Nausea that stops you from eating or drinking
- Throwing up more than 3 times a day
- Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
- Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
- Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin.
Call your doctor or nurse as soon as possible if any of these symptoms happen:
- Change in hearing, ringing in the ears
- Decreased urine
- Unusual thirst or passing urine often
- Pain in your mouth or throat that makes it hard to eat or drink
- Nausea that is not relieved by prescribed medicines
- Rash that is not relieved by prescribed medicines
- Heavy menstrual period that last longer than normal
- Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
- Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
- Swelling of legs, ankles, or feet
- Weight gain of 5 pounds in one week (fluid retention)
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Fatigue that interferes with your daily activities
- Headache that does not go away
- Painful, red, or swollen areas on your hands or feet.
- No bowel movement for 3 days or you feel uncomfortable
- Extreme weakness that interferes with normal activities
Sexual problems and reproduction concerns may happen. In both men and women, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
- In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
- In women, menstrual bleeding may become irregular or stop while you are taking this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
- Women may go through signs of menopause (change of life) such as vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
- Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
- Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
- Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug, because this drug may enter the breast milk and badly harm a breast-feeding baby.
Revised July 2014