Erbitux (Cetuximab)  

Brand Name: Erbitux® 

Generic name:Cetuximab  

Other names: C225 

Therapeutic Class: monoclonal antibody/ signal transduction inhibitor 

Manufacturer / Distributor:  Merck-Lipha  

Availability: Erbitux is available by prescription only  

Dosage form: Erbitux is given by injection into a vein  

Indications: Erbitux is used to treat colorectal cancer, particularly in patients who have not responded to other chemotherapy drugs. Erbitux can be used alone or in combination with Irinotecan, another chemotherapy drug that blocks the action of topoisomerase I, an enzyme that cells need to divide/multiply. Erbitux can also be used in combination with radiotherapy in the treatment of neck and head cancers.   

Erbitux is sometimes used to treat other medical conditions that are mentioned in this article; talk to your physician or pharmacist for more information on Erbitux.  

Dosage: usually, Erbitux is given by injection into a vein, once a week. The injection usually lasts for about two hours. However, your oncologist can change the dosage, and recommend you to take the medication on a regular basis. Erbitux can be taken in combination with irinotecan, radiotherapy or alone. Your oncologist will consider several criteria (your age, health, weight / height) to determine the most appropriate and effective dosage for your condition. The dosage given is usually determined depending on your body surface area (BSA), medical conditions and also the response of your body therapy.  

In any case, you should not deflect the instructions recommended by your doctor. During the treatment and even after, it is important to drink plenty of water and other fluids to avoid damage to your kidneys, stomach and even your liver.  

Overdose: the fact that Erbitux is given in hospital by health professionals, the risk of overdose is virtually nonexistent; The maximum single dose of Erbitux administered to a patient is 1000mg, and no adverse effects is reported. However, In case you are experience symptoms of overdose – severe headache, heart failure or other signs - contact your doctor immediately.  

Missing dose: Erbitux is administered in hospital; therefore, it is very important to be present at each appointment to take the medication as prescribed. If for some reasons you cannot be present, contact your oncologist before the date of the appointment. As all chemotherapy drugs, misusing Erbitux can be fatal.  

Contraindications : Erbitux is contraindicated or should be used with precaution in the following conditions:  

• very elderly 
• pregnancy/breastfeeding  
• liver failure 
• kidney failure 
• allergy to Erbitux or any of its ingredients  
• cardio-respiratory disorders  
• Severe alteration of general condition. 

Mechanism of action (MOA):  t he cells receive hormonal signals that cause them to multiply and then die (natural death of cells). Among the agents in your body that involve in these processes include the epidermal growth factor receptor (EGFR). EGFR is a particular type of protein that exists on the cell surface, which transmits growth signals to the inside of the cell. ; EGFR is found on the surface of both cancerous and non cancerous cells.    

Cancer cells live by diving anarchically. Erbitux works by binding to EGFR on the surface of cancer cells, preventing them to receive the signals necessary to multiply.  

Interactions: Before beginning the treatment, tell your doctor about all medications you are taking, whether prescription or non prescription. Talk to your doctor before taking vitamins, nutritional supplements and st john worth. Consult with your doctor before taking these drugs: 

• Ganciclovir, an antiviral drug
• Azathioprine, an immune system inhibitor 
• Barbiturates, depressant drug that causes relaxation and sleepiness
• Cimetidine , a drug used to inhibit the production of acid in the stomach
• Colchicines , a medication used to treat pain of gouty arthritis
• Live vaccines: BCG vaccine, yellow fever vaccine, etc.  
• Cyclophosphamide (Cytoxan), a medication of the alkylating agent family used to treat a variety of cancers 
• Cyclophosphamide (Cytoxan, Cytoxan, Neosar, Procytox, Revimmune), a drug used to treat several types of cancers 
• Celecoxib, a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, painful menstruation, colon and rectum polyps, etc. 
• Etc.  

Side effects: Erbitux can cause adverse effects in some patients. Most common Erbitux side effects include:  

• sneezing
• hoarseness
• diarrhea 
• fatigue 
• heartburn
• decreased appetite
• weight loss 
• light Sensitivity (Photophobia) 
• hair loss  
• dry mouth  
• dry skin  
• chapped lips
• mouth sores  
• headache  
• tiredness  
• weakness
• Insomnia  
• depression
• nausea and vomiting
• constipation  
• Stomach pain.  

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor immediately if you experience any of these symptoms:   

• renal failure  
• lung disease such as formation of blood clots in the lungs 
• unconsciousness  
• heart attack or fast heart beat 
• coughing up blood or dry cough 
• shaking of the hands that you cannot control 
• sudden tightening of the hands or feet 
• hypotension 
• breathing difficulty 
• sore throat or difficulty swallowing 
• pain or burning sensation in eye(s)  
• Infections (which can be indicated by sore throat, fever, chills).  

References: 

1 - pharmacyescrow.com 

2 - erbitux.com, Erbitux  

3 - nlm.nih.gov