Pan-HER tyrosine-kinase inhibitor
Neratinib (Specialist drug)
Brand names: Nerlynx
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC; severe diarrhoea requires loperamide prophylaxis cycle 1
Route: PO
Frequency: OD
Clinical pearls
- Extended adjuvant in HER2+ early breast cancer post-trastuzumab
- Specialist breast oncology
Contraindications
- Severe hepatic impairment
- Concurrent strong CYP3A4 inducers
Side effects
- Severe diarrhoea (mandatory loperamide prophylaxis for 8 weeks)
- Hepatotoxicity
- Nausea/vomiting
- Rash
Interactions
- Strong CYP3A4 modulators
- P-gp substrates
- Drugs raising gastric pH
Monitoring
- LFTs
- Diarrhoea management
- Weight
Reference: BNF; NICE TA612; SmPC; https://bnf.nice.org.uk/drugs/neratinib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy