Mechanism of action and treatment recommendations for osimertinib

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Posted by Pharmacist Ly Anh Thu - Clinical Pharmacist - Faculty of Pharmacy - Vinmec Central Park International General Hospital
Osimertinib is a drug that has a major effect in the treatment of lung cancer, in order for the drug to be effective, patients need to know information about the drug as well as its dosage and usage.

1.Composition and content of Osimertinib In terms of composition and content of Osimertinib include:
Tagrisso tablet 40mg One tablet contains 47.7mg osimertinib mesylate equivalent to osimertinib Tagrisso 80mg tablet One tablet contains 95.4mg osimertinib mesylate equivalent to osimertinib mesylate 80mg osimertinib Includes other excipients. 2. Mechanism of action of Osimertinib Osimertinib is a tyrosine kinase inhibitor (TKI). This is an irreversible inhibitor of the Epidermal Growth Factor Receptor (EGFR) with sensitive mutations (EGFRm) and TKI-resistant T790M mutations. Since then, the drug has the effect of inhibiting the proliferation, development, and metastasis of cancer cells and helping to respond to chemotherapy and radiation therapy. Tagrisso acts on T790M and may slow or prevent advanced lung cancer. Medicines can help shrink the tumor.
3. What disease does the drug work for? Tagrisso contains the active ingredient osimertinib, which belongs to the class of anticancer protein kinase inhibitors. Therefore, the drug is used to treat adult patients with non-small cell lung cancer. The drug is used when:
The test result is positive for the “T790M” mutation. The patient's cancer has progressed or worsened despite previous treatment, which may include drugs that work by inhibiting "EGFR" (epidermal growth factor receptor).

4. How should the drug be used and the dosage? In terms of dosage, the recommendation is one 80mg tablet per day. Your doctor may reduce your dose to 1 40mg tablet a day if needed.
How to use, the patient should take the tablet whole with a little water. Do not crush, break or chew the tablet. Take Tagrisso at the same time every day. The medicine can be taken with or without meals. In case the patient has difficulty swallowing the whole tablet, it can be dissolved in water by:
Put the tablet in a glass, add 50ml (about 2/3 of a glass of water), do not use any other water, especially carbonated water. This medicine will not dissolve completely, so just stir until the tablet dissolves into very small pieces. Drink this solution as soon as it dissolves.
To make sure the patient has finished taking the medicine, rinse the glass with 50ml of water and drink again. In case the patient takes the drug through the gastric tube, dissolve the drug with 15mL of filtered water, suck it into the syringe, then add another 15ml to the glass to rinse the glass and suck it into the syringe. Pump 30ml of medicine through the catheter, then use another 30ml of filtered water to rinse the tube.

5. When should Osimertinib not be taken? In the following cases, patients should not take Osimertinib or should consult a doctor or pharmacist before taking it.
Patients who are allergic (hypersensitive) to osimertinib or any of its ingredients. The patient is taking St. John's Wort (Hypericum perforatum). 6. Undesirable side effects Osimertinib Common side effects patients experience while taking Osimertinib
Diarrhea Skin and nail problems, signs may include itching, dry skin, rash, redness around the nail. Using moisturizing products on the skin and nails will solve this symptom. Gastritis, inflammation of the inner lining of the mouth. Decrease in the number of white blood cells in the blood. Decrease in the number of platelets in the blood. Be sure to tell your doctor right away if you notice any of the following serious side effects:
Sudden shortness of breath with cough or fever, which could be a sign of pneumonia. Your doctor may stop you from taking Tagrisso if you experience this side effect. If the patient experiences tearing, light sensitivity, eye pain, eye redness, or vision changes.

7. What drugs should be avoided while using Osimertinib? Inform doctor or pharmacist if patient is taking, has recently taken, or may take any other medicines. Including dietary supplements and over-the-counter drugs.
Drugs that may decrease the effectiveness of Tagrisso: Phenytoin, Carbamazepine, Phenobarbital, Rifabutin or Rifampicin, St. John's Wort Tagrisso may affect the following drugs: Warfarin, Phenytoin and S-mephenytoin, Alfentanil, Rosuvastatin Oral hormonal contraceptives: Bosentan, Efavirenz, Modafinil . However, if it is less than 12 hours to take the next dose, stop taking the missed dose and then take the next dose as usual.
In order for the use of drugs to achieve high efficiency in the course of disease treatment, patients should take the drug as directed, do not arbitrarily change the dose or add or reduce without the consent of a specialist doctor.

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