What are the instructions for use and dosage of neratinib/neratinib?

Neratinib comes as a tablet ( 40 mg). Treatment should be started and supervised by a doctor experienced in treating cancer and is available by prescription only. Doctors will instruct patients to take neratinib at about the same time each day with a meal and to swallow it whole (the tablet should not be chewed, crushed, or split before swallowing). If a patient misses a dose, do not replace the missed dose and instruct the patient to continue taking neratinib with the next scheduled daily dose.

For extended adjuvant treatment of patients with early-stage breast cancer, the recommended dose of neratinib is 240 mg (6 tablets) taken orally once daily, with food, until disease recurrence or up to one year. For patients with advanced or metastatic breast cancer, the recommended dose is also 240 mg (6 tablets) daily with food on days 1-21 of a 21-day cycle The drug is given orally once, plus capecitabine 750 mg/m2 orally twice daily on days 1-14 of a 21-day cycle until disease progression or unacceptable toxicity occurs.

The most common side effect of using neratinib is diarrhea. Doctors will instruct patients to take antidiarrheal prevention for 56 days before treatment. The drug includes loperamide. The drug dose on days 1-14 is 4 mg three times a day; the drug dose on days 15-56 is 4 mg twice a day; after day 56 or when the drug needs to be discontinued due to illness, 4 mg is taken as needed, not exceeding 16 mg per day, and the dose is titrated to achieve 1-2 bowel movements per day. If diarrhea still occurs after prophylaxis, treat with antidiarrheal agents, fluids, and electrolytes as clinically indicated. Interruption and dose reduction of latinib may also be necessary to control diarrhea.