Crizotinib (Xalkori)

Crizotinib is a type of targeted cancer drug. It is also known as Xalkori. 

It is a treatment for advanced non small cell lung cancer (NSCLC).

Crizotinib is for NSCLC that has changes in either a gene called anaplastic lymphoma kinase (ALK) or ROS1. Your doctor checks your cancer for these gene changes. 

You pronounce crizotinib as krih-zoh-tih-nib.

How do you take crizotinib?

Crizotinib is a capsule. You swallow it whole with a glass of water. You can have it with or without food.

Taking capsules

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug or if you miss a dose.

What are the side effects of crizotinib?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.

Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Eyesight changes

Changes to your eyesight include seeing flashes of light or moving shapes or shadows (floaters), or having blurred or double vision. These side effects often start within the first week of starting treatment and are usually mild. Call your hospital advice line if you have any changes to your eyesight.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Diarrhoea or constipation

Tell your healthcare team if you have diarrhoea or constipation. They can give you medicine to help. 

Fluid build up

A build up of fluid may cause swelling in your arms, hands, ankles, legs, face and other parts of the body. Contact your healthcare team if this happens to you.

Liver changes

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.

You have regular blood tests to check for any changes in the way your liver is working.

Fatigue

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Loss of appetite

You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Dizziness

Let your doctor know if you feel dizzy or faint. It could be a sign of changes to your heart rhythm.

Numbness or tingling in fingers or toes (peripheral neuropathy)

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons. 

Taste changes

Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually returns to normal a few weeks after your treatment finishes.

Tummy (abdominal) pain

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Breathlessness

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Call your hospital advice line if you feel short of breath.

Slow heart rate

Your doctor or nurse checks your heart rate (pulse) and rhythm regularly during treatment.

Call your hospital advice line if you feel dizzy or faint, tire easily or are short of breath.

Skin problems

Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.

Contact your advice line if the rash is red, painful or itchy or looks like acne.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• inflammation or scarring and stiffness of the lungs – tell your doctor if you have shortness of breath or a cough

• indigestion

• high levels of creatinine in the blood which may show that your kidneys are not working properly

• low phosphate levels in the blood which can cause confusion or muscle weakness

• area of fluid (cyst) or pus (abscess) in the kidney

• inflammation of the food pipe (oesophagus) which may cause pain or difficulty when swallowing

• low levels of the hormone testosterone

• heart failure – let your doctor know if you have shortness of breath and swelling in your ankles

• feeling faint or fainting

• changes to how your heart works

Rare side effects

These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• a hole (perforation) in the stomach or bowel

• liver failure

• kidney failure

• sensitivity to sunlight (burn more easily)

What else do I need to know?