Tyverb
lapatinib
lapatinib
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you only. Don’t pass it on to others. It may harm them, even if their signs of illness seem the same as yours.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What Tyverb is and what it is used for
What you need to know before you take Tyverb
How to take Tyverb
Possible side effects
How to store Tyverb
Contents of the pack and other information
Tyverb is used to treat certain types of breast cancer (HER2-overexpressing) which have spread beyond the original tumour or to other organs (advanced or metastatic breast cancer). It may slow or stop cancer cells from growing, or may kill them.
Tyverb is prescribed to be taken in combination with another anti-cancer medicine.
Tyverb is prescribed in combination with capecitabine, for patients who have had treatment for advanced or metastatic breast cancer before. This previous treatment for metastatic breast cancer must have included trastuzumab.
Tyverb is prescribed in combination with trastuzumab, for patients who have hormone receptor- negative metastatic breast cancer and have had other treatment for advanced or metastatic breast cancer before.
Tyverb is prescribed in combination with an aromatase inhibitor, for patients with hormone sensitive metastatic breast cancer (breast cancer that is more likely to grow in the presence of hormones), who are not currently intended for chemotherapy.
Information about these medicines is described in separate patient information leaflets. Ask your doctor to give you information about these other medicines.
if you are allergic to lapatinib or any of the other ingredients of this medicine (listed in Section 6).
if you have lung disease
if you have inflammation of the lung
if you have any liver problems
if you have any kidney problems
if you have diarrhoea (see section 4).
Serious skin reactions have been seen with Tyverb. Symptoms may include skin rash, blisters and skin peeling.
Tell your doctor as soon as possible if you get any of these symptoms.
St John’s Wort – a herb extract used to treat depression
erythromycin, ketoconazole, itraconazole, posaconazole, voriconazole, rifabutin, rifampicin, telithromycin – medicines used to treat infections
cyclosporine – a medicine used to suppress the immune system for example after organ transplantations
ritonavir, saquinavir – medicines used to treat HIV
phenytoin, carbamazepine – medicines used to treat seizures
cisapride – a medicine used to treat certain digestive system problems
pimozide – a medicine used to treat certain mental health problems
quinidine, digoxin – medicines used to treat certain heart problems
repaglinide – a medicine used to treat diabetes
verapamil – a medicine used to treat high blood pressure or heart problems (angina)
nefazodone – a medicine used to treat depression
topotecan, paclitaxel, irinotecan, docetaxel – medicines used to treat certain types of cancer
rosuvastatin – a medicine used to treat high cholesterol
medicines that decrease stomach acidity - used to treat stomach ulcers or indigestion
Your doctor will review the medicines you are currently taking to make sure you are not taking something that can’t be taken with the Tyverb. Your doctor will advise you whether an alternative is available.
It is not known whether Tyverb passes into breast-milk. Do not breast-feed while taking Tyverb and for at least 5 days after the last dose.
You are responsible to decide if you are able to drive a motor vehicle or perform other tasks that require increased concentration. Because of the possible side effects of Tyverb, your ability to drive or operate machines could be affected. These effects are described in section 4, ‘Possible side effects’.
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium- free’.
Your doctor will decide on the correct dose of Tyverb depending on the type of breast cancer being treated.
If you are prescribed Tyverb in combination with capecitabine, the usual dose is 5 Tyverb tablets a day, as a single dose.
If you are prescribed Tyverb in combination with trastuzumab, the usual dose is 4 Tyverb tablets a day, as a single dose.
If you are prescribed Tyverb in combination with an aromatase inhibitor, the usual dose is
Take the prescribed dose every day for as long as your doctor tells you to.
Your doctor will advise you about the dose of your other anti-cancer medicine, and how to take it.
Depending on the side effects you experience, your doctor may recommend lowering your dose or temporarily stopping your treatment.
Your doctor will also carry out tests to check your heart and liver function before and during treatment with Tyverb.
Contact a doctor or pharmacist immediately. If possible, show them the pack.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Symptoms may include:
skin rash (including itchy, bumpy rash)
unusual wheezing, or difficulty in breathing
swollen eyelids, lips or tongue
pains in muscles or joints
collapse or blackout.
diarrhoea (which may make you dehydrated and lead to more severe complications)
rash, dry skin, itching
loss of appetite
feeling sick (nausea)
being sick (vomiting)
tiredness, feeling weak
indigestion
constipation
sore mouth/mouth ulcers
stomach pain
trouble sleeping
back pain
pain in hands and feet
joint or back pain
a skin reaction on the palms of the hands or soles of the feet (including tingling, numbness, pain, swelling or reddening)
cough, shortness of breath
headache
nose bleed
hot flush
unusual hair loss or thinning
an effect on how your heart works
In most cases, the effect on your heart will not have any symptoms. If you do experience symptoms associated with this side effect, these are likely to include an irregular heartbeat and shortness of breath.
liver problems, which may cause itching, yellow eyes or skin (jaundice), or dark urine or pain or discomfort in the right upper area of the stomach
nail disorders – such as a tender infection and swelling of the cuticles
skin fissures (deep cracks on the skin or chapped skin)
treatment-induced lung inflammation, which may cause shortness of breath or cough
Other uncommon side effects include:
blood tests results that show changes in liver function (usually mild and temporary)
severe allergic reactions (see the beginning of section 4)
irregular heart-beat (change in the electrical activity of the heart)
severe skin reaction that might include: rash, red skin, blistering of the lips, eyes or mouth, skin peeling, fever or any combination of these
pulmonary arterial hypertension (increased blood pressure in the arteries (blood vessels) of the lungs)
If you suffer from diarrhoea while taking Tyverb:
drink plenty of fluids (8 to 10 glasses a day), such as water, sports drinks or other clear liquids
eat low-fat, high protein foods instead of fatty or spicy foods
eat cooked vegetables instead of raw vegetables and remove the skin from fruits before eating
avoid milk and milk products (including ice cream)
avoid herbal supplements (some may cause diarrhoea).
Your doctor will check your skin before and during treatment. To care for sensitive skin:
wash with a soap-free cleanser
use fragrance free, hypoallergenic beauty products
use sunscreen (Sun Protection Factor [SPF] 30 or higher).
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects
not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of
this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the blister or bottle and the carton. Do not store above 30ºC.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
The active substance in Tyverb is lapatinib. Each film-coated tablet contains lapatinib ditosylate monohydrate, equivalent to 250 mg lapatinib.
The other ingredients are: microcrystalline cellulose, povidone (K30), sodium starch glycolate (Type A), magnesium stearate, hypromellose, titanium dioxide (E171), macrogol (400),
polysorbate 80, iron oxide yellow (E172), and iron oxide red (E172).
Tyverb film-coated tablets are oval, biconvex, yellow film-coated, with ‘GS XJG’ marked on one side. Tyverb is supplied in either blisters packs or bottles:
Each pack of Tyverb contains 70 or 84 tablets in aluminium foil blisters of 10 or 12 tablets each. Each
foil has a perforation down the middle and can be divided into two blisters with 5 or 6 tablets in each, depending on the pack size.
Tyverb is also available in multipacks containing 140 tablets that comprise 2 packs, each containing 70 tablets.
Tyverb is also available in plastic bottles containing 70, 84, 105 or 140 tablets.
Not all pack sizes may be marketed.
Novartis Europharm Limited Vista Building
Elm Park, Merrion Road Dublin 4
Ireland
Glaxo Wellcome S.A. Avenida de Extremadura 3
09400 Aranda de Duero
Burgos Spain
Novartis Pharma GmbH Roonstraße 25
D-90429 Nuremberg Germany
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:
SIA Novartis Baltics Lietuvos filialas
Tel: +370 5 269 16 50
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Novartis s.r.o.
Tel: +420 225 775 111
Novartis Healthcare A/S
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Novartis Pharma Services Inc.
Tel: +356 2122 2872
Novartis Pharma GmbH Tel: +49 911 273 0
Novartis Pharma B.V. Tel: +31 88 04 52 555
SIA Novartis Baltics Eesti filiaal
Tel: +372 66 30 810
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Tlf: +47 23 05 20 00
Novartis (Hellas) A.E.B.E.
Τηλ: +30 210 281 17 12
Novartis Pharma GmbH
Tel: +43 1 86 6570
Novartis Farmacéutica, S.A. Tel: +34 93 306 42 00
Novartis Poland Sp. z o.o. Tel.: +48 22 375 4888
Novartis Pharma S.A.S.
Tél: +33 1 55 47 66 00
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Tel: +351 21 000 8600
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Novartis Ireland Limited
Tel: +353 1 260 12 55
Novartis Pharma Services Inc.
Tel: +386 1 300 75 50
Vistor hf.
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Novartis Ireland Limited Tel: +44 1276 698370