Should Crizotinib be taken before or after meals?

According to the pharmacokinetics of Crizotinib (Crizotinib), after taking 250 mg of Crizotinib Capsules twice daily, steady state is reached within 15 days, with a median accumulation ratio of 4.8. Over the dose range of 200 mg to 300 mg twice daily, the steady-state minimum concentration (Cmin.ss) and AUC increased in a greater than dose-proportional manner (0.8 to 1.2 times the approved recommended dose).

High-fat meals, reducedAUC0-INF and maximum plasma concentration (Cmax) of crizotinib each decreased by 14% for capsule formulations; AUC0-INF and Cmax for granular formulations of crizotinib decreased by 15% and 23%, respectively, compared with fasting conditions. Crizotinib is usually recommended to be taken after meals to reduce the irritation of the drug to the gastrointestinal tract and reduce the occurrence of adverse reactions. If the patient needs to take the medicine on an empty stomach (such as before taking the medicine), it is recommended to wait for a period of time (such as half an hour to an hour) after taking the medicine to ensure that the medicine has been completely absorbed by the body before eating.

The original drug Crizotinib has been launched in China and is covered by medical insurance, but it is only reimbursed for patients who meet the indications. The price per box may be around RMB 15,000. The price of the original Turkish version of Crizotinib sold overseas may be more than RMB 10,000 per box (the price may fluctuate due to exchange rates), which is expensive. There are also cheaper generic crizotinib drugs available overseas. The ingredients are basically similar to those of the original drugs sold domestically and abroad. For example, the price of 250mg*60 tablets produced by a Bangladesh pharmaceutical factory may be more than 2,000 yuan per box (the price may fluctuate due to exchange rates).