First dose of Neratinib to prevent diarrhea

It is unclear why neratinib causes diarrhea; however, experts believe it may be due to epidermal growth factor receptor inhibition in intestinal cells, which may damage the protective mucosal lining. In addition, use may cause some inflammation within the gastrointestinal tract and reduce the reabsorption of bile acids in the small intestine.

In clinical studies, 93% of patients who took neratinib without antidiarrheal drugs developed diarrhea within the first month of treatment with neratinib. Grade 3 diarrhea occurred in 40% of patients and grade 4 diarrhea in 0.1% of patients. The average time to first onset of grade 3 or higher diarrhea was 8 days, and the average duration of grade 3 or higher diarrhea was 5 days. Patients are advised to take antidiarrheal prophylaxis during the first two cycles (56 days) of neratinib treatment and should start with the first dose. Titrate loperamide to 1 to 2 bowel movements per day. In weeks 1-2 (days 1-14), take 4 mg three times a day; in weeks 3-8 (days 15-56), take 4 mg twice a day; in weeks 9-52 (days 57-365), take 4 mg as needed (no more than 16 mg per day).

NeratinibThe original drug is marketed in China as neratinib maleate tablets and is covered by Class B medical insurance, but reimbursement is limited to patients who meet the indications. SpecificationsThe price of each box of 40mg*180 tablets may be around 7,000 yuan. Generic drugs of neratinib are also sold overseas. The drug ingredients are basically the same as those of the original drug. The price of 40mg*180 tablets produced by Bangladesh pharmaceutical factory may be around 4,000 yuan per box (the price may fluctuate due to the exchange rate). For more information about overseas drugs and specific prices, please consult Yaode Medical Consultant.