Erbitux (Cetuximab)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Erbitux Used For?
Erbitux contains cetuximab, a monoclonal antibody that specifically targets cancer cells by blocking growth signals that help tumors grow and spread.
Primary Uses
Erbitux is used to treat metastatic colorectal cancer (cancer of the colon or large intestine and rectum that has spread to other parts of the body), locally advanced head and neck cancer in combination with radiation therapy, and recurrent/metastatic head and neck cancer in combination with certain types of chemotherapy.
How It Works
Erbitux works by attaching to epidermal growth factor receptors (EGFR) on cancer cells more tightly than natural growth factors. This blocks the signals that tell cancer cells to grow and divide, helping to slow or stop tumor growth. Many human tumors have overactive EGFR receptors, which leads to uncontrolled cancer cell growth.
Good to know: Erbitux is specifically designed to target cancer cells while leaving healthy cells relatively unaffected.
How to Take Erbitux
Erbitux is given as an intravenous infusion (slow injection into a vein) by trained healthcare professionals in a medical facility. You will receive anti-allergy medicines at least 1 hour before each dose.
Dosage Instructions
Your doctor will calculate the correct dose based on your body surface area (height and weight). The first dose takes approximately 2 hours via infusion. Following doses are given weekly (1 hour infusion) or every 2 weeks (2 hours infusion). Your doctor will determine how long you need treatment based on your response and type of cancer.
What If You Miss a Dose?
If you miss an appointment for your Erbitux infusion, call your healthcare provider immediately to reschedule. It’s important to maintain your treatment schedule as prescribed by your doctor.
Important: You must receive anti-allergy medicines (antihistamine and corticosteroid) at least 1 hour before each Erbitux infusion to minimize allergic reactions.
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Headache
- Red, watery eyes (conjunctivitis)
- Diarrhea
- Nausea and vomiting
- Acne-like skin rash
- Itchy, dry, scaling skin
- Low magnesium/calcium levels in blood
- Dehydration
- Loss of appetite and weight loss
- Infusion-related reactions (fever, chills, shortness of breath, dizziness)
- Sore, red mouth
- Tiredness
- Increased infections when combined with chemotherapy
- Increased liver enzyme levels
Seek immediate medical attention if you experience:
- Severe breathing difficulties with wheezing, hoarseness, hives
- Severe blistering or peeling of skin (Stevens-Johnson syndrome)
- Inflammation of brain lining (aseptic meningitis)
- Blood clots in legs or lungs
- Lung inflammation
- Skin infections
- Heart failure or heart attack
- Low white blood cell count
- Reduced white blood cell count leading to fever, pneumonia, blood infections
Important Warnings
There are several important conditions and situations where Erbitux should not be used or requires special monitoring.
Who Should Not Take Erbitux
Do not use Erbitux if you are allergic to cetuximab or any ingredients, if your cancer cells contain a mutated form of the RAS gene, or if your RAS status is unknown (particularly when combined with oxaliplatin-containing treatments).
Medical Conditions to Discuss
Tell your doctor if you have abnormal blood test results, liver problems, kidney problems, heart problems (especially if you’re 65 or older), lung problems or breathing difficulties, eye problems, or a history of allergy to red meat, tick bites, or α-1-galactose.
Pregnancy and Breastfeeding
Erbitux is not recommended during pregnancy. Use adequate contraception during treatment and for two months after your last dose. Do not breastfeed during treatment and for 2 months after your last dose. The effectiveness in children under 18 has not been established.
RAS Gene Testing Required: For metastatic colorectal cancer, you must have RAS gene testing before starting Erbitux. The medication only works in patients with normal (wild-type) RAS genes.
Drug Interactions
Some medicines may interfere with Erbitux and affect how it works. Your doctor will carefully manage any combination treatments.
Treatment Timing: If receiving chemotherapy with Erbitux, the chemotherapy can only start 1 hour after the Erbitux infusion ends.
- Chemotherapy medicines (timing must be coordinated)
- Radiation therapy (increased radiation-related effects possible)
- Other anticancer medicines (especially with heart problems and age 65+)
Alcohol & Driving
Treatment-related symptoms can affect your concentration and ability to react, so special precautions are needed.
Alcohol
No specific alcohol interactions are mentioned in the prescribing information, but discuss alcohol use with your doctor as it may worsen certain side effects.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Erbitux affects you. Treatment-related symptoms can affect your concentration and ability to react.
Sun Exposure
Limit sun exposure by wearing a hat, protective clothing, and SPF 30+ sunscreen when outdoors. Sun exposure may worsen skin reactions.
Storage
Erbitux is stored and handled by healthcare professionals in medical facilities. It comes as a clear to slightly cloudy, colorless to yellowish solution in glass vials that are kept under proper medical storage conditions.
Overdose Information
Since Erbitux is given under medical supervision, overdose is very unlikely. However, if you think you’ve received too much, immediately call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital emergency department, even if you feel fine.
Frequently Asked Questions
Your doctor will determine how long you need Erbitux treatment based on your response to the medicine and the type of cancer you have. Treatment duration varies for each patient.
Yes, Erbitux can be used alone or in combination with chemotherapy or radiation therapy. Your doctor will discuss the benefits and risks of combination treatments with you.
Your first dose takes approximately 2 hours and you’ll receive anti-allergy medicines at least 1 hour beforehand. You’ll be monitored closely during the infusion and for at least 1 hour afterward for any reactions.
For metastatic colorectal cancer, Erbitux only works in patients whose cancer cells have normal (wild-type) RAS genes. If your cancer has mutated RAS genes, Erbitux will not be effective.
Skin reactions like acne-like rash and dry, scaling skin are common and usually develop within the first three weeks. Your doctor may prescribe antibiotics or topical steroid cream to help prevent or minimize these reactions.
You should limit sun exposure and always wear a hat, protective clothing, and SPF 30+ sunscreen when outdoors, as sun exposure may worsen skin reactions caused by Erbitux.
You’ll receive anti-allergy medicines before each infusion to minimize reactions. If you do have a reaction, your doctor will decide whether you can continue treatment based on the severity of your reaction and may adjust the infusion rate or stop treatment if necessary.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.