Halaven
Halaven (eribulin) is a chemotherapy that’s used to treat cancers, such as metastatic breast cancer and liposarcoma (a type of soft tissue cancer). The medication is given as an infusion through the vein (IV) on days 1 and 8 of 21-day treatment cycles. It only takes about 2 to 5 minutes to infuse. Often, Halaven (eribulin) causes low blood cell counts that can lead to fatigue and a risk for infections.
What is Halaven (eribulin)?
What is Halaven (eribulin) used for?
- Metastatic breast cancer after trying at least 2 previous treatments for metastatic disease
- Advanced or metastatic liposarcoma after trying anthracycline-based chemotherapy
How Halaven (eribulin) works
Halaven (eribulin) is a microtubule inhibitor. Microtubules are small, tube-like parts in cells that help cells grow. Halaven (eribulin) works by stopping microtubules in the body’s cells from working. When the medication blocks the microtubules in cancer cells, the cells can’t grow as easily and can die off.
Drug facts
Side effects of Halaven (eribulin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Low blood cell counts (up to 82%)
- Fatigue (54%)
- Hair loss (45%)
- Feeling numbness or tingling (35%)
- Nausea (35%)
- Constipation (25%)
Less Common Side Effects
- Muscle, bone, or joint pain
- Fever
- Not feeling hungry
- Weight loss
Note: Side effect data are collected from studies with people who took this medication for metastatic breast cancer. Your side effect experience might differ depending on your cancer and specific treatment plan.
Halaven (eribulin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Infections (as a result of having low white blood cell counts): fever, chills, cough, pain or burning when urinating
- Abnormal heart rhythms: new pounding or fluttering heartbeat, lightheadedness, dizziness, chest pain
The following Halaven (eribulin) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Pain, tingling, or numbness in the hands or feet
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Constipation
- Fatigue
- Hair loss
- Headache
- Nausea
- Stomach pain
Pros and cons of Halaven (eribulin)
Pros
- Short infusion lasting 2 to 5 minutes
- Given every 1 to 2 weeks
- Recommended option for metastatic breast cancer and liposarcoma when previous treatment has stopped working
Cons
- Given as an infusion through the vein
- Can cause fatigue and hair loss
- Can put you at higher risk for infections
Pharmacist tips for Halaven (eribulin)
- Before each Halaven (eribulin) infusion, you’ll get blood tests to make sure it’s safe for you to get treatment. Your provider might lower your dose or hold treatment if your liver or kidneys aren’t working well or your blood cell counts are too low; these situations put you at risk of harm.
- Halaven (eribulin) can cause a drop in your red blood cell count, leading to anemia and fatigue. The medication can also lower your platelet counts and make it harder for blood to clot. If they drop too low, you might need blood or platelet transfusions.
- You might be at higher risk for infections because you can have fewer white blood cells than usual while you’re getting treated with Halaven (eribulin). It’s a good idea to avoid sick people, wash your hands often, and let your healthcare team know if you have a fever or are feeling ill.
- It’s common to have hair loss while you’re taking Halaven (eribulin). Some people prefer to cut their hair shorter before their hair falls out. Wigs, hats, scarves, and turbans are also options you can use as accessories.
- Pain, numbness, and tingling in your hands or feet is a common Halaven (eribulin) side effect. Talk with your provider about strategies to manage your symptoms if they start negatively impacting your daily life.
- If you can become pregnant, you’ll need to use effective birth control while you’re receiving treatment and for at least 2 weeks after your last dose. If you’re male and have partners who can become pregnant, make sure to use a condom if you have sex during treatment and at least 3.5 months after the last dose. These safety measures are important because Halaven (eribulin) can harm unborn babies.
- If you’re nursing a baby, avoid breastfeeding during treatment and for 2 weeks after the last dose. We don’t know how Halaven (eribulin) affects milk supply and whether it’s safe for your baby because there are no studies about this yet.
Common questions about Halaven (eribulin)
Yes, Halaven (eribulin) is a chemotherapy medication. Chemotherapy medications target and kill cells in the body that are rapidly growing, such as cancer cells. Halaven (eribulin) works by blocking microtubules (parts of cells that are important for cells to grow and divide). The microtubules in cancer cells are very active so that the cells can rapidly grow and divide. By interfering with how microtubules work, Halaven (eribulin) kills cancer cells and prevents them from spreading.
The Halaven (eribulin) infusion takes about 2 to 5 minutes. But on the day of your infusion appointment, you’ll probably have to do blood tests before getting treatment. For this reason, it’s a good idea to be prepared to spend a few hours at your appointment.
Talk with your provider about how long you’ll need to take Halaven (eribulin). Usually, you’ll continue taking Halaven (eribulin) until it’s no longer working to treat your cancer or until side effects like low blood counts, nerve problems, or fatigue become too troublesome.
It’s common to lose your hair during Halaven (eribulin) treatment. Some strategies you can use to prevent hair loss are to use soft brushes and avoid styles that pull hair (like braids or ponytails). If you do lose your hair, scarves, wigs, turbans, or hats can be useful options. Speak with your provider if you’re concerned about hair loss from Halaven (eribulin).
Feeling very tired is a common Halaven (eribulin) side effect. To manage fatigue, you can try to stay well hydrated, eat healthy, and schedule time for rest periodically throughout the day. It can help to keep track of when you have higher energy levels, so you can plan for more strenuous activities during those times. Let your provider know if fatigue starts to have a negative impact on your daily life.
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Risks and warnings for Halaven (eribulin)
Halaven (eribulin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low white blood cell counts (neutropenia)
- Risk factors: Liver problems
Halaven (eribulin) can lower the amount of white blood cells you have and cause neutropenia. This can raise your risk for infections that could be fatal. Usually, you’re at the most risk when your infection-fighting cells are at their lowest (a time point called nadir). In studies of people taking Halaven (eribulin), the average time to nadir was about 13 days of each treatment cycle.
Let your healthcare team know if you’re feeling ill or have signs of infection such as a fever, chills, cough, or pain or burning when urinating. Your provider will check your blood cell counts before each of your Halaven (eribulin) infusions. If you have an infection or your provider notices you have a low white blood cell count, your provider might recommend injections to help boost up your white blood cells. They might also adjust your Halaven (eribulin) dose.
Nerve problems (neuropathy)
Halaven (eribulin) can cause discomfort, pain, numbness, and tingling in the hands and feet. This is a nerve problem called peripheral neuropathy. In studies, some people started having these symptoms during the first 5 months of treatment, and symptoms could linger for months. Talk with your provider if you have these nerve symptoms and they’re disrupting your daily activities. They can recommend ways to help with your symptoms. They might also lower the Halaven (eribulin) dose or give you a longer break between infusions to help relieve your side effects.
Abnormal heart rhythms
- Risk factors: Heart failure | Previous abnormal heart rhythms | Taking medications that can affect heart rhythm | Electrolyte abnormalities
Halaven (eribulin) can cause changes to your heart’s electrical activity called QT prolongation. This can affect your heart rhythm, which can sometimes be serious or life-threatening. Your risk for QT prolongation depends on your genetics, your electrolyte levels, and whether you’re taking other medications that can also affect your heart rhythm. According to a small study, this problem can occur by the time you get your second dose of Halaven (eribulin) in your treatment cycle.
Your provider will check your blood electrolyte levels before starting Halaven (eribulin) and regularly during treatment. And if you have risk factors for QT prolongation, your provider might also order an electrocardiogram (EKG) to monitor your heart’s electrical activity. Share a complete list of the medications and supplements you take with your healthcare team so they can check your risk for heart rhythm problems. Tell your provider right away if you notice new pounding or fluttering heartbeat, lightheadedness, dizziness, or chest pain during treatment.
Harm to the unborn baby
Based on findings from animal studies and the way the medication works, Halaven (eribulin) can cause harm to unborn babies. If you’re pregnant or think you might be pregnant, talk with your provider before starting treatment with Halaven (eribulin).
Use reliable birth control while you’re taking the medication and for at least 2 weeks after the last dose if you’re able to become pregnant. And if you’re male and have a partner who can have children, you must use condoms when you have sex while you’re getting treated with Halaven (eribulin) and for 3.5 months after your last dose.
Halaven (eribulin) dosage
Typical dosage for Halaven (eribulin)
The typical dose will be based on your body surface area (BSA, measured in units of m2), which takes into account your height and weight.
Usually, the dose is 1.4 mg/m2 given as an infusion through the vein (intravenously or IV). It’s given on days 1 and 8 of each 21-day cycle of treatment (in other words, once a week for 2 weeks, then repeated after a week break).
Your dose might be lower if your liver or kidneys aren’t working well. You might also need a lower dose if you have side effects from the medication.
