Precautions and Warnings With Eribulin
Before receiving eribulin, it's important to understand that this medication can cause problems in some cases, such as an increased risk for nerve problems, electrolyte imbalances, and severe dehydration. Other safety precautions to be aware of include warnings of potential drug interactions with eribulin, as well as allergic reactions. Before starting treatment, tell your doctor if you have low blood counts, liver disease, or kidney disease.
You should talk with your healthcare provider prior to receiving eribulin mesylate (Halaven™) if you have:
- Kidney disease, such as kidney failure (renal failure)
- Liver disease, such as liver failure, hepatitis, or cirrhosis
- Low blood counts
- Long QT syndrome (a genetic irregular heart rhythm)
- Low potassium or low magnesium levels
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Some warnings and precautions to be aware of prior to receiving this medication include the following:
- Eribulin can decrease the bone marrow's ability to produce blood cells. This can result in anemia and other serious conditions. Because your immune system depends on certain blood cells, you may be more susceptible to infections while taking eribulin (see Chemotherapy and Infections). You will need regular blood tests to make sure your blood counts are not too low. These side effects can be quite serious.
- Like most chemotherapy drugs, eribulin can cause severe nausea, vomiting, and diarrhea. Keep in close contact with your healthcare provider in order to anticipate, recognize, and treat these problems.
- In studies, eribulin was shown to potentially cause a change in heart rhythm known as QT prolongation. This is a potentially serious change that can lead to life-threatening arrhythmias. Combining eribulin with other medications that have this potential probably increases the risk. If you must combine eribulin with other QT-prolonging medications, your healthcare provider should closely monitor your heart rhythm.
- You will also need close heart rhythm monitoring if you are prone to low electrolytes (such as low blood potassium or low blood magnesium), as this increases the risk for problems due to QT prolongation. Additionally, people with congenital long QT syndrome should generally avoid using this medication.
- Like several other chemotherapy medications, eribulin has a tendency to cause nerve problems. This may show up as nerve pain, unusual sensations (such as pricking or burning), or even problems with coordination or muscle control. Let your healthcare provider know right away if you suspect such problems.
- If your kidneys or liver is not functioning properly, you may need a reduced eribulin dosage.
- Eribulin can interact with other medications (see Drug Interactions With Eribulin).
- Eribulin is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug during pregnancy (see Halaven and Pregnancy).
- It is not known if eribulin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Halaven and Breastfeeding).