Giotrif (Afatinib Dimaleate)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Giotrif Used For?
Giotrif is a cancer medication that targets specific proteins involved in cancer cell growth and spread.
Primary Uses
Giotrif is used to treat adult patients with non-small cell lung cancer (NSCLC). It can treat non-squamous type NSCLC with EGFR gene mutations as first treatment or after chemotherapy progression, and squamous type NSCLC after chemotherapy progression.
How It Works
Giotrif blocks the activity of proteins from the ErbB family, including Epidermal Growth Factor Receptor (EGFR). These proteins are involved in cancer cell growth and spread. By blocking these proteins, Giotrif stops cancer cells from growing and multiplying.
How to Take Giotrif
Giotrif should be taken consistently at the same time each day on an empty stomach for best results.
Dosage Instructions
The recommended dose is one 40 mg tablet daily. Your doctor may adjust your dose based on how well you tolerate the medication. Take on an empty stomach – do not eat for at least 3 hours before and 1 hour after taking. Swallow whole with water, do not crush or chew. For swallowing difficulties, the tablet can be dissolved in half a glass of non-sparkling water, stirred for up to 15 minutes, then drunk immediately.
What If You Miss a Dose?
If it’s less than 8 hours before your next dose, skip the missed dose and take your next dose as scheduled. Otherwise, take it as soon as you remember, then return to your normal schedule.
Important: Never take a double dose to make up for a missed dose, as this may increase the chance of unwanted side effects.
Available Tablet Strengths
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:
- acne-like rash, sometimes itchy with dry skin
- mouth sores and inflammation
- nail problems
- loss of appetite or weight changes
- nosebleeds
- pain, redness, swelling or peeling of hands and feet
- burning during urination and frequent, urgent need to urinate
- abnormal taste sensations
- stomach pain, indigestion, heartburn
- lip inflammation
- runny nose
- muscle spasms
- fever
- nausea
- vomiting
- diarrhea (very common, usually occurs within first 2-6 weeks)
Seek immediate medical attention if you experience:
- sudden breathing difficulty or unexplained breathing problems with cough or fever
- severe upper stomach pain spreading to the back
- severe diarrhea, dehydration, nausea, vomiting
- severe blisters and bleeding in lips, eyes, mouth, nose and genitals
- painful red areas of skin, large blisters and peeling skin
- fever and chills, aching muscles, generally feeling unwell
- eye problems such as altered vision, pain and inflammation
- signs of dehydration (headache, dizziness, tiredness, decreased urine)
- severe skin reactions (peeling or blistering)
- severe stomach pain with fever, chills, rigidity or bloating
- sudden or worsening eye problems
- breathlessness, swelling of feet/ankles/legs/stomach, feeling tired, racing heart
Important Warnings
Several medical conditions and situations require special consideration before taking Giotrif.
Who Should Not Take Giotrif
Do not take Giotrif if you are allergic to afatinib dimaleate or any ingredients in the medication. Always check the ingredient list to ensure you can safely take this medication.
Medical Conditions to Discuss
Tell your doctor if you have liver or kidney problems, heart problems, lung inflammation history, gastrointestinal problems, cancer that has spread to the bowel, eye problems or dry eyes, lactose intolerance, or if you use contact lenses. Also inform your doctor if you’re taking medicines that increase gut perforation risk like steroids, NSAIDs, or anti-angiogenic agents.
Pregnancy and Breastfeeding
Do not take Giotrif if you are pregnant, as it may harm your developing baby. Women who could become pregnant must use adequate contraception during treatment and for at least 2 weeks after the last dose. Do not breastfeed while taking Giotrif, as the medication may pass into breast milk and affect your baby.
Drug Interactions
Several medications can interfere with Giotrif and affect how it works.
- ritonavir, nelfinavir or saquinavir (HIV medicines)
- ciclosporin or tacrolimus (immune suppressants)
- ketoconazole or itraconazole (antifungals)
- erythromycin or rifampicin (antibiotics)
- verapamil (blood pressure/angina medicine)
- amiodarone (heart rhythm medicine)
- carbamazepine, phenytoin or phenobarbital (seizure medicines)
- St John’s wort herbal medicines
- quinidine (heart rhythm medicine)
- sulfasalazine (anti-inflammatory)
- rosuvastatin (cholesterol medicine)
Alcohol & Driving
Exercise caution with activities requiring alertness and protect yourself from sun exposure while taking Giotrif.
Alcohol
No specific alcohol interactions are mentioned in the prescribing information.
Driving and Operating Machinery
Be careful driving, operating machinery, or doing jobs requiring alertness until you know how Giotrif affects you. No studies have been performed on Giotrif’s effects on driving ability.
Sun Exposure
Limit sun exposure while taking Giotrif. When outdoors, wear a hat, protective clothing, and sunscreen. Giotrif may make your skin much more sensitive to sunlight than normal, and rash or acne may occur or worsen in sun-exposed areas.
Storage
Keep tablets in the blister pack until time to take them to protect from moisture and light. Store in a cool, dry place below 30°C. Do not store in the bathroom, near a sink, in the car, or on window sills. Keep out of reach of children in a locked cupboard at least 1.5 meters above ground.
Overdose Information
If you think you have taken too much Giotrif, seek urgent medical attention immediately. Phone the Poisons Information Centre (Australia: 13 11 26; New Zealand: 0800 764 766), contact your doctor, or go to the nearest hospital Emergency Department, even if you feel fine.
Frequently Asked Questions
The timeframe for Giotrif to show effectiveness varies by individual and cancer type. Your doctor will monitor your progress with regular tests and assessments to determine how well the medication is working for you.
No, Giotrif must be taken on an empty stomach. Do not eat for at least 3 hours before taking your medicine and at least 1 hour after taking it, as food can interfere with the absorption of Giotrif.
Diarrhea is very common with Giotrif and can be severe. Drink plenty of fluids and take anti-diarrheal medicine as prescribed. Contact your doctor immediately if you have more than 4 bowel movements per day or if diarrhea isn’t controlled within 48 hours of taking anti-diarrheal medicine.
No, do not stop taking Giotrif or lower the dosage without checking with your doctor first. Continue taking Giotrif for as long as your doctor tells you, even if you feel better.
If it’s less than 8 hours before your next dose, skip the missed dose. Otherwise, take it as soon as you remember, then return to your normal schedule. Never take a double dose to make up for a missed dose.
Giotrif makes your skin much more sensitive to sunlight than normal. Rash or acne may occur or worsen in sun-exposed areas. Always wear protective clothing, a hat, and sunscreen when outdoors.
No, swallow Giotrif tablets whole with water. Do not crush or chew them. If you have trouble swallowing, the tablet can be dissolved in half a glass of non-sparkling water, stirred for up to 15 minutes, then drunk immediately.
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.