Brigatinib

Brigatinib Brand Name– Alunbrig

What is Brigatinib

Brigatinib is a tyrosine kinase inhibitor targeting multiple kinases, including anaplastic lymphoma kinase (ALK), ROS1, insulin-like growth factor-1 receptor (IGF-1R), and FLT-3, as well as EGFR deletion and point mutations.

It is FDA approved for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) who have progressed on or are intolerant to crizotinib.

Brigatinib has been associated with interstitial lung disease/pneumonitis, bradycardia, hypertension, visual disturbances, CPK elevations, elevated pancreatic enzymes, and hypergylcemia.

Because brigatinib can cause fetal harm and is affected by certain drug interactions, female patients of reproductive age should be advised to use nonhormonal contraception during treatment and for at least 4 months after the last dose; male patients should also use contraception during treatment and for at least 3 months after the last dose.

Indications

  • non-small cell lung cancer (NSCLC)

For the treatment of non-small cell lung cancer (NSCLC)

for the treatment of locally advanced or metastatic, ALK-positive, non-small cell lung cancer (NSCLC) in patients who have not previously received an ALK inhibitor

Side Effects

  1. abdominal pain
  2. acneiform rash
  3. anemia
  4. anemia
  5. anorexia
  6. anorexia
  7. arthralgia
  8. arthralgia
  9. asthenia
  10. asthenia
  11. back pain
  12. back pain
  13. blurred vision
  14. bradycardia
  15. cataracts
  16. constipation
  17. constipation
  18. cough
  19. diarrhea
  20. diplopia
  21. dyspnea
  22. dyspnea
  23. elevated hepatic enzymes
  24. elevated hepatic enzymes
  25. fatigue
  26. fatigue
  27. fever
  28. fever
  29. headache
  30. headache
  31. hyperamylasemia
  32. hyperamylasemia
  33. hyperglycemia
  34. hyperglycemia
  35. hypertension
  36. hypertension
  37. hypophosphatemia
  38. hypophosphatemia
  39. hypoxia
  40. hypoxia
  41. infection
  42. infection
  43. insomnia
  44. lymphopenia
  45. lymphopenia
  46. macular edema
  47. meningitis
  48. musculoskeletal pain
  49. myalgia
  50. myalgia
  51. nausea
  52. nausea
  53. paresthesias
  54. peripheral neuropathy
  55. peripheral neuropathy
  56. photophobia
  57. pneumonitis
  58. pneumonitis
  59. pulmonary embolism
  60. rash
  61. rash
  62. visual impairment
  63. visual impairment
  64. vomiting
  65. vomiting

Monitoring Parameters

  • blood glucose
  • creatine phosphokinase (CPK)
  • pregnancy testing
  • serum amylase
  • serum lipase

Contraindications

  • bradycardia
  • breast-feeding
  • cataracts
  • contraception requirements
  • diabetes mellitus
  • hyperglycemia
  • hypertension
  • infertility
  • myopathy
  • pancreatitis
  • pneumonitis
  • pregnancy
  • pregnancy testing
  • pulmonary disease
  • reproductive risk
  • visual disturbance
  • visual impairment

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abemaciclib
  • Acalabrutinib
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Tramadol
  • Afatinib
  • Alfentanil
  • Alogliptin; Metformin
  • Alpelisib
  • Amiodarone
  • Amlodipine; Atorvastatin
  • Amobarbital
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atorvastatin
  • Atorvastatin; Ezetimibe
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Avanafil
  • Avapritinib
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzhydrocodone; Acetaminophen
  • Betrixaban
  • Bexarotene
  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Bosentan
  • Bosutinib
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Budesonide
  • Budesonide; Formoterol
  • Buspirone
  • Butabarbital
  • Canagliflozin; Metformin
  • Carbamazepine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Cenobamate
  • Ceritinib
  • Chloramphenicol
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Ciprofloxacin
  • Clarithromycin
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine
  • Colchicine; Probenecid
  • Conivaptan
  • Conjugated Estrogens; Medroxyprogesterone
  • Crizotinib
  • Cyclosporine
  • Dabigatran
  • Dabrafenib
  • Danazol
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Darifenacin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Dasatinib
  • Delavirdine
  • Dexamethasone
  • Dextromethorphan; Quinidine
  • Dienogest; Estradiol valerate
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Docetaxel
  • Dolutegravir
  • Dolutegravir; Lamivudine
  • Dolutegravir; Rilpivirine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Doxorubicin
  • Dronedarone
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duvelisib
  • Edoxaban
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elexacaftor; tezacaftor; ivacaftor
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enalapril; Felodipine
  • Entrectinib
  • Enzalutamide
  • Ertugliflozin; Metformin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Eslicarbazepine
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Progesterone
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Etonogestrel
  • Etravirine
  • Everolimus
  • Fedratinib
  • Felodipine
  • Fentanyl
  • Fluconazole
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluvoxamine
  • Fosamprenavir
  • Fosphenytoin
  • Glasdegib
  • Glecaprevir; Pibrentasvir
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • grapefruit juice
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibrutinib
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Imatinib
  • Indinavir
  • Irinotecan
  • Irinotecan Liposomal
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ivacaftor
  • Ketoconazole
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Lefamulin
  • Letermovir
  • Levonorgestrel
  • Linagliptin; Metformin
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lurasidone
  • Maraviroc
  • Medroxyprogesterone
  • Mefloquine
  • Mephobarbital
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methadone
  • Midazolam
  • Midostaurin
  • Mifepristone
  • Mitotane
  • Modafinil
  • Morphine
  • Morphine; Naltrexone
  • Nafcillin
  • Naldemedine
  • Naloxegol
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Nilotinib
  • Nisoldipine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Oxycodone
  • Pazopanib
  • Pentobarbital
  • Phenobarbital
  • Phenytoin
  • Pimavanserin
  • Posaconazole
  • Primidone
  • Progesterone
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Rimegepant
  • Ritonavir
  • Romidepsin
  • Saquinavir
  • Saxagliptin
  • Secobarbital
  • Segesterone Acetate; Ethinyl Estradiol
  • Sildenafil
  • Silodosin
  • Simeprevir
  • Sirolimus
  • St. John’s Wort, Hypericum perforatum
  • Sufentanil
  • Tacrolimus
  • Talazoparib
  • Telithromycin
  • Temsirolimus
  • Tenofovir Alafenamide
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Tezacaftor; Ivacaftor
  • Thiopental
  • Ticagrelor
  • Tipranavir
  • Tolvaptan
  • Topotecan
  • Tramadol
  • Trandolapril; Verapamil
  • Triazolam
  • Ubrogepant
  • Umeclidinium
  • Umeclidinium; Vilanterol
  • Venetoclax
  • Verapamil
  • Vincristine
  • Vincristine Liposomal
  • Voriconazole
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