Eribulin

Information for patients and caregivers. Read this with your treatment calendar and the instructions from your oncology team.

On this pageAt a glanceWhat this treatment is and how it worksWhen it may be usedBefore treatmentHow treatment is given and the scheduleTests and monitoring during treatmentSide effects: what to expectWhen to seek urgent helpPractical advice for this treatmentMedicines, interactions and vaccinationsPregnancy, fertility and breastfeedingEveryday lifeWhen to contact the oncology teamAfter treatmentFrequently asked questionsSources and further reading

At a glance

Treatment
Eribulin; Halaven
Used in selected settings
Advanced breast cancer and liposarcoma
How it is given
A short intravenous administration through a checked cannula or central line.
Before you start
Save your 24-hour oncology number and have a thermometer and written medicine calendar available.

What this treatment is and how it works

It blocks the growth of structures called microtubules, which cells need to divide.

When it may be used

Eribulin may be used after previous chemotherapy for selected people with advanced breast cancer, or with liposarcoma that cannot be removed by surgery. The choice depends on prior treatment and your health. In these settings, treatment aims to control the cancer and symptoms and may help people live longer; it is not usually expected to cure the cancer.

A listed use is not a claim that every brand is licensed for that use in every country. Your oncologist will explain why this treatment is appropriate for you.

Before treatment

Before starting, tell the team about previous cancer treatment, allergies, infection symptoms, heart, lung, kidney or liver disease, hearing or nerve problems, diabetes and all medicines you take. Discuss pregnancy, contraception and fertility. Ask for a written treatment calendar, supportive-medicine instructions and a 24-hour oncology contact number. Baseline blood tests usually include a full blood count and kidney and liver function; additional tests depend on the medicine and your health. Before chemotherapy that reaches the whole body, the team should check for current or past hepatitis B infection. If a test is positive, extra monitoring or antiviral treatment may be needed to prevent the virus becoming active again. The team will coordinate testing and treatment; do not delay urgent cancer treatment yourself.

How treatment is given and the schedule

A short intravenous administration through a checked cannula or central line.

Commonly on days 1 and 8 of a 21-day cycle. The day-8 dose may be delayed or omitted if blood counts or side effects make it unsafe.

The dose is calculated for your treatment and health. Rest periods, delays or dose changes may be needed. Do not change doses or treatment dates yourself, except to follow specific instructions to stop a medicine and seek help for warning symptoms. The team will give you a revised plan when needed.

During an infusion, tell the nurse immediately about pain, burning, swelling or leaking around the cannula or line. Do not massage the area or apply heat or ice unless the team instructs you.

Tests and monitoring during treatment

Blood counts, kidney and liver function and nerve symptoms are reviewed. Blood salts and an electrocardiogram may be checked in patients at risk of a prolonged QT interval, an electrical heart-rhythm change.

At each review, describe symptoms since the previous dose, including problems that have already settled. Blood tests can detect effects before you feel them. Your team may delay, reduce, omit or stop a medicine if results or symptoms make this necessary. The decision depends on the exact protocol; a normal result does not make new symptoms safe to ignore.

Side effects: what to expect

Frequency varies with the dose, schedule, cancer and other treatments. “Common or more frequent” is a practical grouping, not a single percentage for every patient. Some serious effects appear in more than one group because severity and frequency are different.

You are unlikely to have all of these effects. This is not an exhaustive list. Tell the team about any new or troublesome symptom, including one not mentioned here.

Common or more frequent side effects

Practical care and when to ask for help
Possible effectWhat you can doWhen to contact the team
Low blood countsWhite cells fight infection, red cells carry oxygen and platelets help clotting. Treatment can lower one or more of these. Wash hands, avoid close contact with people who are unwell and keep blood-test appointments.Call immediately for fever, shaking chills or feeling suddenly unwell. Report unusual bruising, bleeding, marked tiredness or increasing breathlessness. Do not wait for a blood-test result before seeking help.
Tiredness and reduced staminaBalance rest with short periods of gentle activity. Prioritise tasks and accept help with shopping, meals or transport. Tell the team about poor sleep or pain.Report fatigue that prevents basic activities or is worsening. Sudden breathlessness, chest pain, fainting or confusion needs urgent assessment.
Tingling, numbness or altered sensationProtect hands and feet from burns and injury. Wear supportive footwear, check skin regularly and take care with balance.Report symptoms before the next dose, especially if buttons, writing, walking or sleep are affected. New weakness, marked unsteadiness or difficulty breathing needs urgent assessment.
Feeling or being sickTake preventive anti-sickness medicines at the prescribed times. Try small meals and frequent small drinks; avoid strong food smells if they worsen nausea.Contact the team the same day if medicines are not controlling symptoms. Seek urgent advice if you cannot keep fluids down, feel faint or pass much less urine.
ConstipationKeep a bowel record. Gentle movement, usual fluids and a prescribed laxative can help. Ask before using suppositories or enemas when blood counts may be low.Contact the team for worsening constipation. A swollen or painful abdomen, vomiting or inability to pass wind needs urgent assessment; do not simply add laxatives.
Hair thinning or hair lossUse gentle hair care and protect the scalp from sun and cold. Ask early about wigs, head coverings and whether scalp cooling is suitable for your particular treatment.Tell the team about a painful or inflamed scalp. Hair often regrows after treatment, but the timing, texture and completeness of regrowth vary.
Muscle, joint or general achesGentle movement, rest and pain relief approved by your team may help. Check before taking anti-inflammatory painkillers.Report pain that limits movement or sleep. Severe new pain, fever, chest pain or weakness needs prompt assessment.
Reduced appetite or changes in eatingTry smaller, frequent meals with protein and energy-rich foods you tolerate. Ask for a dietitian if your weight or intake is falling.Report ongoing weight loss or difficulty eating. Inability to drink or signs of dehydration needs same-day urgent advice.
Loose or frequent stoolsKeep a record of stools. Take frequent small drinks and use the diarrhoea medicine prescribed for your regimen. Oral rehydration solution may help if the team recommends it.Contact the team promptly for diarrhoea that continues or increases. Fever, blood, severe pain, dizziness or difficulty drinking needs urgent assessment. Drug-specific stop instructions below take priority.
Sore mouth or throatUse a soft toothbrush and the mouth-care plan from your team. Choose soft, moist foods and avoid alcohol-containing mouthwash or foods that sting.Contact the team if pain affects eating or drinking, or if white patches or ulcers develop. Inability to swallow fluids, fever or severe pain needs urgent assessment.
HeadacheUse only pain relief approved by your team and report new or persistent headaches.A sudden severe headache, repeated vomiting, weakness, confusion, a seizure or a new vision problem needs urgent assessment.

Other reported side effects (frequency varies)

These effects may be common in some treatment settings, less common in others, or have no reliable frequency estimate. Their position here does not mean they are necessarily less frequent or less serious.

Dizziness, taste changes and abnormal liver tests or blood salts can occur.

Report these at review, or sooner if worsening. Use the urgent guidance for symptoms that affect breathing, drinking, urination, walking, consciousness or bleeding.

Important serious side effects, including rare effects

Serious does not always mean rare. Where reliable incidence is unavailable, no numerical frequency is assigned. The action to take matters even when the likelihood is uncertain.

Chest pain or a heart-rhythm problem

New chest tightness, chest pain, severe breathlessness, fainting or a sustained racing heartbeat needs emergency assessment. Do not try to manage this with home remedies or wait for the next visit.

Serious infection or sepsis

Low white cells can allow an infection to become life-threatening quickly. Fever, shaking chills, rapid breathing, confusion or sudden deterioration needs immediate help. Infection is possible even with a normal temperature.

Inflammation or injury in the lungs

A new cough, breathlessness, chest discomfort or falling exercise tolerance needs urgent oncology contact. Severe or rapidly worsening breathing difficulty is an emergency. Infection and other causes must also be considered.

Severe skin reaction

A spreading painful rash, blisters, peeling skin, or sores in the mouth, eyes or genital area needs urgent medical assessment. Severe reactions may require treatment to be stopped by the team.

Practical advice for this treatment

Report numbness or weakness before each dose. Tell the team immediately about fainting or a racing heartbeat, and urgently about severe muscle pain or dark urine.

Medicines, interactions and vaccinations

Give the oncology pharmacist a complete list of prescription medicines, over-the-counter products, vitamins, herbal and Ayurvedic remedies and supplements. Ask before starting anything new. Do not stop prescribed medicines, including anticoagulants or infection-prevention medicines, without a coordinated plan. Live vaccines are generally unsuitable while immunity is suppressed; discuss vaccine type and timing with the team. Non-live vaccines may be offered, although protection can be reduced. Follow any specific stop-and-call instructions for the cancer medicine on this page or in your written treatment plan.

Medicines that prolong the QT interval, lower potassium or magnesium, or affect blood counts need review. Tell the team about heart-rhythm problems and existing neuropathy.

Pregnancy, fertility and breastfeeding

Chemotherapy can harm a developing baby and may affect fertility temporarily or permanently. Discuss sperm, egg or embryo storage before treatment when feasible. If you could become pregnant, or your partner could become pregnant, use effective contraception during treatment and for the drug-specific period afterwards. Ask for a written end date based on every medicine in your plan: the required period differs by product and can extend for months. Periods stopping does not guarantee infertility. Tell the team immediately about a suspected pregnancy. Do not breastfeed during treatment; restart only after the team confirms the interval for the exact medicine and formulation.

Everyday life

Gentle activity, regular meals and rest can help you cope. Prepare food hygienically and drink according to your individual fluid plan. Avoid smoking; ask whether alcohol is safe with your exact treatment and other medicines. Plan work, travel and driving around symptoms and monitoring visits. Do not drive if dizzy, sleepy, weak, visually affected or impaired by neuropathy. You can usually be close to family and friends: chemotherapy does not make you radioactive. Follow the unit’s instructions for handling urine, vomit, laundry and sexual precautions for the period it specifies.

When to contact the oncology team

Contact the oncology team the same day for persistent vomiting or diarrhoea, difficulty drinking, reduced urine, mouth pain affecting eating, new cough, jaundice, a painful or spreading rash, unusual bruising, worsening constipation or new nerve symptoms. Use the more urgent instructions for the particular symptom when given above. If the team cannot be reached and you are unwell, seek urgent medical care.

Write down your hospital’s daytime and out-of-hours numbers before treatment. CTI’s general contact details do not replace the emergency number provided by your treating hospital.

After treatment

Keep the planned blood tests and follow-up appointments after the last dose. Blood counts and immunity may take time to recover, and some effects can start or persist later. Contact the team about symptoms rather than waiting for a routine visit. Keep a treatment summary, including drug names, dates and any serious reactions, for future doctors. Response may be assessed with examination, scans or blood or marrow tests, depending on the cancer.

Frequently asked questions

Why might day 8 be cancelled?

Blood counts or toxicity may require more recovery time. Your team will explain how the rest of the cycle changes.

What is a QT interval?

It is a measurement of the heart’s electrical recovery between beats. Certain medicines and low blood salts can make a rhythm problem more likely.

Will I get every side effect listed?

No. Many people have only some of them. Your dose, other medicines, health and previous treatment all affect risk. Reporting symptoms early often makes them easier to manage.

Does having few side effects mean treatment is not working?

No. Side effects do not reliably show how well cancer treatment is working. The team assesses response using the appropriate tests.

Can a dose be reduced or delayed?

Yes. Blood counts, organ function or side effects may require a delay, reduction, omission or change. The team balances safety with the treatment aim; do not change doses yourself. Follow the specific instructions to stop a medicine and seek help if a warning symptom occurs.

Can I take vitamins, herbal or Ayurvedic products?

Check every product with the oncology pharmacist first. “Natural” does not mean interaction-free, and some products can affect the liver, bleeding or drug levels.

What should I have ready at home?

A thermometer, the 24-hour oncology number, a treatment calendar, your medicine list and prescribed symptom medicines. Arrange help with transport or meals if needed.

When should I call instead of waiting for the next appointment?

Use the urgent-help instructions on this page. Fever, sudden illness, uncontrolled symptoms or difficulty drinking should not wait until the next treatment visit.

Sources and further reading

Summary of Product Characteristics

Product-specific details vary by formulation and treatment protocol.

Professional reference resources. These describe the specific product, warnings, interactions, monitoring and adverse effects. For US substitutes, the document is prescribing information rather than an SmPC. Check the product actually dispensed in India.

Other authoritative references

Editorially approved by Dr (Prof) Vijay Agarwal

Professor and Lead Consultant – Medical Oncology

Review record updated: Medical Review Policy

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