Zykadia
Zykadia (ceritinib) is an oral anticancer medication that treats non-small cell lung cancer (NSCLC) that has spread to other parts of the body. It specifically treats NSCLC that’s anaplastic lymphoma kinase (ALK) positive. Zykadia (ceritinib) is taken by mouth once a day with food. It commonly causes stomach-related side effects, such as nausea and diarrhea. But your provider can recommend ways to manage them with lifestyle changes or medications.
What is Zykadia (ceritinib)?
What is Zykadia (ceritinib) used for?
Anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) that has spread to other areas of the body
How Zykadia (ceritinib) works
Zykadia (ceritinib) is a kinase inhibitor. It blocks the activity of a specific protein called anaplastic lymphoma kinase (ALK). The ALK protein, which is found in both normal and cancer cells, signals cells to grow. Cancer cells sometimes have more ALK than normal cells. This can cause cancer cells to grow more quickly than normal cells. Zykadia (ceritinib) works to block ALK, so cancer cells can’t grow and spread as well.
Drug Facts
What are the side effects of Zykadia (ceritinib)?
Common Side Effects
- Abnormal liver labs (up to 91%)
- Diarrhea (up to 86%)
- Low red blood cell levels (84%)
- Nausea (up to 80%)
- Abnormal kidney labs (up to 77%)
- Vomiting (up to 67%)
- Stomach pain (up to 54%)
- Higher blood sugar levels (up to 53%)
- Tiredness (up to 52%)
- Lower phosphate levels (up to 38%)
- Abnormal pancreas labs (up to 37%)
- Loss of appetite (up to 34%)
Other Side Effects
- Constipation
- Cough
- Weight loss
- Rash
- Chest pain
- Back pain
- Headache
- Fever
- Heartburn, stomach reflux, or trouble swallowing
Serious Side Effects
- Serious heart rhythm problems: blurry vision, feeling light-headed, weakness, pounding heart
- Lung problems: cough, fever, trouble breathing, shortness of breath, chest pain
- Pancreas problems: upper stomach or back that gets worse when you eat, unexplained weight loss, nausea, or vomiting
- Liver problems: nausea, vomiting stomach pain or swelling, itchy skin, dark-colored urine, pale-colored stool, yellowing of the whites of the eyes or skin
- Severe stomach problems: diarrhea, nausea, vomiting, or stomach pain
Source: DailyMed
The following 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
- Dry cough, shortness of breath or trouble breathing
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Diarrhea
- Fatigue
- Loss of appetite with weight loss
- Nausea
- Stomach pain
- Vomiting
Pros and cons of Zykadia (ceritinib)
Pros
Take by mouth
Taken once a day
Can be used alone to treat lung cancer
Cons
Must be taken with food
Commonly causes stomach problems, like diarrhea and vomiting
Requires regular lab work to check for certain side effects, such as those related to the liver or pancreas
Pharmacist tips for Zykadia (ceritinib)
Take Zykadia (ceritinib) with food at the same time every day. Taking it with food will help lower your risk of developing side effects.
Swallow the tablet whole so that the medication works properly. Don’t cut, chew, or crush the tablet.
Nausea and vomiting are common side effects of Zykadia (ceritinib). If you vomit soon after you take this medication, don’t take another dose to make it up. Just take your next dose at the next scheduled time.
If you miss a dose of Zykadia (ceritinib) and it’s less than 12 hours until your next dose, you can take your missed dose. If it’s less than 12 hours until your next dose, don’t take another dose. In this case, take your next dose at the normally scheduled time.
Taking Zykadia (ceritinib) can make your skin become more sensitive to the sun. Where possible, limit the amount of time you spend in the sunlight. If you need to be outside, try to minimize your time in direct sunlight or wear sunscreen or clothes that cover your skin.
Zykadia (ceritinib) commonly causes diarrhea. Let your provider know right away if you experience diarrhea. It’s important to stay hydrated if you experience diarrhea so you don’t lose too much body fluids.
Ask your provider or pharmacist about the best way to handle and throw away Zykadia (ceritinib) safely. Anticancer medications can be very harmful to people who handle or come into contact with them.
Frequently asked questions about Zykadia (ceritinib)
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What are the risks and warnings for Zykadia (ceritinib)?
Zykadia (ceritinib) 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.
Stomach problems
Risk factors: Taking Zykadia (ceritinib) on empty stomach
Zykadia (ceritinib) commonly causes stomach problems like diarrhea, nausea, and vomiting, but most cases aren’t serious. You should take Zykadia (ceritinib) with food to lower your risk of stomach problems. Let your provider know if you experience any stomach problems. If so, they can recommend medications to help control diarrhea or ease nausea. They might also ask you to drink more fluids to replace what you’ve lost. Depending on how serious your symptoms are, your provider might ask you to stop taking Zykadia (ceritinib) for a little while. If your symptoms get better, your provider might ask you to start Zykadia (ceritinib) again, but at a lower dose.
Liver problems
Some people taking Zykadia (ceritinib) developed severe liver problems. Because of this, your provider will monitor your liver health through lab work while you’re taking this medication. If you already have liver problems, Zykadia (ceritinib), your provider might also lower your dose. Let your provider know if you develop any symptoms of liver problems. These can include itchy skin, yellowing of skin or whites of your eyes, dark-colored urine, and pain or discomfort in the right upper stomach area. If a severe reaction occurs, your provider might lower your dose or have you stop taking Zykadia (ceritinib).
Lung problems
While not common, Zykadia (ceritinib) can cause serious lung problems, like inflammation of your lungs or interstitial lung disease. If you develop lung problems, your provider might tell you to stop taking Zykadia (ceritinib) while they figure out what’s causing these problems. Let your provider know if you start to have any new or worsening breathing problems (e.g., chest pain, coughing, or trouble breathing).
Heart rhythm or heartbeat problems
Risk factors: Taking other medications that can affect your heart rhythm or heartbeat | Heart failure | Heart rhythm problems | Having electrolyte levels that are out of range
In clinical trials, some people taking Zykadia (ceritinib) experienced a change in their heart rhythm. Because of this, while you’re taking Zykadia (ceritinib) your provider will monitor how your heart is working through ordering lab work to check your electrolyte levels or by performing an electrocardiogram (ECG). Your provider will also ask you to check your heart rate and blood pressure regularly at home. If you develop heart problems, your provider might need to lower your dose of Zykadia (ceritinib) or switch you to a different medication. Let your provider know right away if you have symptoms of a heart rhythm problem, such as dizziness, feeling faint, blurry vision, or a pounding heart.
High blood sugars
Risk factors: Having high blood sugar | Taking other medications that can raise your blood sugar
Taking Zykadia (ceritinib) can raise your blood sugar levels. Your provider will monitor your blood sugars when your start Zykadia (ceritinib) and throughout treatment. If your blood sugars get too high, your provider might have you take medication to control your blood sugar. They might also ask you to stop taking Zykadia (ceritinib) until your blood sugar levels return to a safe level or lower your dose of Zykadia (ceritinib). Let your provider know if you experience any symptoms of dangerously high blood sugar, such as feeling more thirsty, urinating more often, blurry vision, headaches, feeling tired, or breath that smells fruity.
Pancreas damage
Some people taking Zykadia (ceritinib) experience inflammation of the pancreas (pancreatitis), which can be serious. Your provider will order lab work regularly while you’re taking Zykadia (ceritinib) to make sure your pancreas is healthy. Depending on the results of your labs, your provider might ask you to temporarily stop taking Zykadia (ceritinib), then restart treatment at a lower dose. Let your provider know if you experience symptoms of inflammation with your pancreas, such as pain in your upper stomach or back that gets worse when you eat, unexplained weight loss, nausea, or vomiting.
Harm to unborn baby
Let your provider know right away if you become pregnant while taking Zykadia (ceritinib). Zykadia (ceritinib) might cause harm to an unborn baby. If you're female, your provider might check to see if you’re pregnant before you start treatment. If you’re able to become pregnant, you should use birth control while taking Zykadia (ceritinib) and for at least 6 months after your last dose. Males with female partners who are able to become pregnant should also use birth control while you’re taking the medication and for at least 3 months after your last dose.
Zykadia (ceritinib) dosage forms
Typical dosing for Zykadia (ceritinib)
The typical starting dose is 450 mg taken by mouth once a day.
Your dose might be different if you have severe liver problems.
What are alternatives to Zykadia (ceritinib)?
Anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) that has spread to other areas of the body
Anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) in adults
Early stage ALK-positive NSCLC in adults after surgery
Anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer that has spread to other parts of the body
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References
Best studies we foundAmerican Cancer Society. (n.d.). Chemotherapy.
American Cancer Society. (2023). If you have non-small cell lung cancer.
American Cancer Society. (2023). Targeted drug therapy for non-small cell lung cancer.
Cancer.net. (2019). Safe storage and disposal of cancer medications.
National Cancer Institute. (n.d.). ALK gene.
National Cancer Institute. (n.d.). Anaplastic lymphoma kinase.
National Cancer Institute. (2022). Targeted therapy to treat cancer.
National Comprehensive Cancer Network. (2023). Early and locally advanced non-small cell lung cancer.
Novartis Pharmaceuticals Corporation. (2023). Zykadia- ceritinib tablet, film coated [package insert]. DailyMed.
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