Information about Brigatinib

Generic Name : Brigatinib
Up-to-date prescription details regarding Brigatinib are provided here.

Pronunciation : bri-GAT-i-nib

Learn the correct pronunciation of the Brigatinib, understand it's uses, recommended dosages, its indications, how to take, when to take, when not to take, side effects, special precautions, warnings and its and its storage instructions.

You will also find a list of the medication's International and Indian brand or trade names, as well as its pricing information. For verification of the information presented on this page or for additional clarifications, it's advisable to consult your doctor.

Therapeutic Classification : Chemotherapy

Trade Names/Brand Names of Brigatinib

India :

Alunbrig

Overview of Brigatinib

• Brigatinib is an anticancer agent which was approved by FDA in April 2017 for the treatment of non- small cell lung cancer that spreads to another part of the body.

Why is Brigatinib Prescribed? (Indications)

Brigatinib is an anticancer drug which is prescribed to treat patients with anaplastic lymphoma kinase (ALK) positive metastatic non-small cell lung cancer (NSCLC) for patients who have progressed with or experience side effects with crizotinib, another drug used to treat the cancer.

When should Brigatinib not be taken? (Contraindications)

Brigatinib is not recommended in patients with the following conditions:

• Allergy to brigatinib
• Children less than 18 years, during pregnancy and breastfeeding

What is the dosage of Brigatinib?

• The recommended adult dose of brigatinib is 90 mg to be taken orally once a day for first 7 days which can be increased to 180 mg orally once a day if 90 mg of brigatinib is found to be tolerated by the patient.
• The tablets should be taken until disease progression or any reported toxicity.

Dose adjustment for adverse reactions:
• Temporary interruption or discontinuation of the treatment may be required in patients with side effects.

• The following dosage adjustments may be required in the presence of adverse reactions:
• If the patient is on 180 mg initially, the dosage can be reduced to 120 mg per day.
• When the adverse reactions occur at 90 mg dose the dose can be further reduced to 60 mg once daily.
• If adverse reactions occur with 60 mg dose, the brigatinib therapy should be discontinued.

How should Brigatinib be taken?

• Brigatinib comes as a tablet which should be taken by mouth along with food and should be taken at the same time each day.
• When the treatment with brigatinib tablets is stopped for more than 2 weeks due to adverse reactions, the treatment should be initiated with 90 mg once a day for 7 days instead of taking a higher previously tolerated dose.
• If vomiting occurs after taking brigatinib tablets or a dose is missed, do not take another dose and continue with the next scheduled dose.
• The tablets should be swallowed as a whole with sufficient quantity of water and must not be crushed or chewed.

What are the warnings and precautions for Brigatinib?

• Patients should be monitored for the occurrence of respiratory symptoms such as cough or difficulty in breathing and the therapy can be discontinued while the signs and symptoms are severe.

• High blood pressure should be controlled before starting brigatinib tablets. Patients should be monitored for blood pressure and heart rate 2 weeks after starting brigatinib therapy and at least at monthly intervals during the treatment.

• Therapy has to be withdrawn permanently when recurrent grade 4 hypertension occurs.

• Eye examination should be performed to assess patients with new or worsening visual symptoms and dose can be reduced in cases of reported grade 2 or 3 symptoms. However, the therapy should be discontinued in case of grade 4 visual disturbances.

• Monitor blood creatinine phosphokinase levels, glucose levels, and pancreatic enzyme levels and therapy should be discontinued permanently when the adverse reactions are severe.

What are the side effects of Brigatinib?

Common: Nausea, diarrhea , fatigue or tiredness, headache, cough

Gastrointestinal: Constipation , pain in the abdomen, vomiting, loss of appetite, raised levels of the pancreatic enzymes amylase and lipase
Cardiovascular: Decreased heartrate, prolonged activated partial thromboplastin time, high blood pressure
Central nervous system: Lack of sleep, peripheral neuropathy, headache
Respiratory: Difficulty in breathing, cough, interstitial lung disease/pneumonitis, pneumonia
Musculoskeletal: Muscle pain, back pain, joint pain, pain in the extremity
Skin: Exfoliative rashes, itching, pustular rashes, acneiform dermatitis
Eyes: Blurred vision, double vision, reduced visual acuity

Others: Anemia, lymphopenia, fever, urosepsis, increased level of liver enzymes, increase in creatinine phosphokinase, high blood glucose levels, fever, allergic reaction

What are the other precautions for Brigatinib?

• Women of child-bearing age should be advised to use non-hormonal birth control methods for at least 4 months and men are advised to use a condom for at least 3 months after the last dose of brigatinib. Brigatinib treatment may be associated with infertility.
• It is necessary to advise patients to report to their physician if they experience unusual muscle pain or muscle tenderness or weakness.

What are the Drug Interactions of Brigatinib?

• Antiviral drugs such as indinavir, nelfinavir, lopinavir, ritonavir and antifungal drugs such as ketoconazole, itraconazole, voriconazole should not be taken along with brigatinib as these drugs increase the concentrations of brigatinib leading to toxicity.
• Other enzyme inhibitors like clarithromycin and conivaptan also increase the blood concentration of brigatinib when taken together.
• Enzyme inducers like rifampin, carbamazepine, and phenytoin reduce the concentration of brigatinib therapy resulting loss of effectiveness of therapy.
• Brigatinib can reduce the concentration of some drugs that include hormonal contraceptives, resulting in reduced effectiveness.
• St. John’s Wort may reduce the concentrations of brigatinib while grapefruit juice increases the concentration of brigatinib when administered together.

What are the storage conditions for Brigatinib?

• Store the brigatinib tablets in their original and labeled container at a room temperature of 20°C to 25°C.
• Keep away from excess heat and moisture.
• Keep out of reach of children and pets.