Cetuximab

Cetuximab is used in the treatment of head and neck cancer and cancer of colon and rectum. It helps to mark the cancer cells for destruction by the body's immune system. Cetuximab is given as an injection under the supervision of doctor. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. Do not stop taking it unless your doctor tells you to. The most common side effects of this medicine include nausea, headache, vomiting, and skin rash. If these bother you or appear serious, let your doctor know. There may be ways of reducing or preventing them. Inform your doctor if you experience sudden difficulty breathing, shortness of breath, and fever, chills. Regular blood tests are required to check your blood cells along with heart, liver and electrolyte levels. It makes your skin more sun sensitive, take precaution while stepping out. Before taking it, tell your doctor if you have heart disease, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy. Cetuximab is a monoclonal antibody that specifically binds to receptors on cancer cells. Thus it flags the cancer cells for destruction by the body's immune system.

• Head and neck cancer • Cancer of colon and rectum

Cetuximab is a recombinant human/mouse chimeric monoclonal antibody. It binds specifically to the epidermal growth factor receptor (EGFR), thus competitively inhibiting the binding of epidermal growth factor (EGF) and other ligands. This blocks phosphorylation and activation of receptor-associated kinases, thus inhibiting cell growth, inducing apoptosis and decreases matrix metalloproteinase and vascular EGF production.

Adult Dose: Intravenous Advanced colorectal cancer Adult: Loading: As monotherapy or in combination with irinotecan, flourouracil, leucovorin (FOLFIRI): 400 mg/m2 via IV infusion over 120 minutes. Maintenance dose: 250 mg/m2 once weekly via IV infusion over 60 minutes. Squamous cell carcinoma of the head and neck Adult: As monotherapy or in combination with radiation therapy or platinum-based therapy and fluorouracil: Initial dose: 400 mg/m2 via IV infusion over 120 minutes 1 week prior to initiation of treatment. Maintenance dose: 250 mg/m2 infused over 60 minutes for 6-7 weeks during the duration of radiation therapy or until disease progression, or unacceptable toxicity when administered with platinum-based therapy.

Your doctor or nurse will give you this medicine. Kindly do not self-administer.

If you miss a dose of Cetuximab, please consult your doctor.

Common: • Nausea • Headache • Vomiting • Conjunctivitis • Skin rash • Diarrhea • Infusion reaction • Decreased magnesium level in blood • Increased liver enzymes

[UNSAFE] Cetuximab may cause side effects which could affect your ability to drive. Cetuximab is given as an injection into the veins under the supervision of a doctor.

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with Cetuximab. Please consult your doctor.

[CONSULT YOUR DOCTOR] Cetuximab may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[CONSULT YOUR DOCTOR] Cetuximab is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.

[SAFE IF PRESCRIBED] Cetuximab is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Cetuximab may not be needed in these patients. Please consult your doctor. [CONSULT YOUR DOCTOR] There is limited information available on the use of Cetuximab in patients with liver disease. Please consult your doctor.