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EGFR tyrosine-kinase inhibitor

Gefitinib (Specialist drug)

Brand names: Iressa

Adult dose

Dose: Specialist initiation only — refer to BNF/SmPC; usually 250mg OD
Route: PO
Frequency: OD

Clinical pearls

  • EGFR-mutation-positive locally advanced/metastatic NSCLC

Contraindications

  • Severe hepatic impairment
  • Pregnancy

Side effects

  • ILD (potentially fatal)
  • Diarrhoea
  • Acneiform rash
  • Hepatotoxicity
  • Corneal erosion

Interactions

  • Strong CYP3A4 inhibitors/inducers
  • Drugs raising gastric pH (PPIs, H2 antagonists) reduce levels
  • Warfarin

Monitoring

  • LFTs
  • Symptoms of ILD
  • Ophthalmic if eye symptoms

Reference: BNF; NICE TA192; SmPC; https://bnf.nice.org.uk/drugs/gefitinib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.