Tucatinib

What is Tucatinib

Tucatinib is an oral tyrosine kinase inhibitor of HER2. It is indicated, in combination with trastuzumab and capecitabine, for treatment of patients with advanced unresectable or metastatic HER2-positive breast cancer, including patients with brain metastases, who have received one or more prior anti-HER2-based regimens in the metastatic setting.

Severe diarrhea and hepatotoxicity have been reported. Monitor liver function tests during therapy.

Advise patients to contact their health care provider if diarrhea occurs.

Brand Name

TUKYSA

Indications

  • breast cancer

Side Effects

  1. abdominal pain
  2. acneiform rash
  3. anemia
  4. anorexia
  5. arthralgia
  6. diarrhea
  7. dysesthesia
  8. elevated hepatic enzymes
  9. epistaxis
  10. erythema
  11. exfoliative dermatitis
  12. hepatotoxicity
  13. hyperbilirubinemia
  14. hypokalemia
  15. hypomagnesemia
  16. hyponatremia
  17. hypophosphatemia
  18. maculopapular rash
  19. nausea
  20. oral ulceration
  21. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  22. peripheral neuropathy
  23. rash
  24. seizures
  25. stomatitis
  26. urticaria
  27. vomiting
  28. weight loss

Monitoring Parameters

  • LFTs
  • pregnancy testing

Contraindications

  • breast-feeding
  • contraception requirements
  • hepatic disease
  • hepatotoxicity
  • infertility
  • male-mediated teratogenicity
  • pregnancy
  • pregnancy testing
  • renal impairment
  • reproductive risk

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abemaciclib
  • Acalabrutinib
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Tramadol
  • Ado-Trastuzumab emtansine
  • Afatinib
  • Alfentanil
  • Alfuzosin
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Almotriptan
  • Alosetron
  • Alprazolam
  • Amiodarone
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Apalutamide
  • Apixaban
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Artemether; Lumefantrine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atazanavir; Cobicistat
  • Atorvastatin
  • Atorvastatin; Ezetimibe
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Avanafil
  • Avapritinib
  • Axitinib
  • Azelastine; Fluticasone
  • Bedaquiline
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzhydrocodone; Acetaminophen
  • Betrixaban
  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Bortezomib
  • Bosentan
  • Bosutinib
  • Brentuximab vedotin
  • Brexpiprazole
  • Brigatinib
  • Bromocriptine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Budesonide
  • Budesonide; Formoterol
  • Bupivacaine; Lidocaine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Buspirone
  • Cabazitaxel
  • Cabozantinib
  • Caffeine; Ergotamine
  • Cannabidiol
  • Capmatinib
  • Carbamazepine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Cariprazine
  • Ceritinib
  • Cevimeline
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cilostazol
  • Cinacalcet
  • Clindamycin
  • Clonazepam
  • Clopidogrel
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine
  • Colchicine; Probenecid
  • Conivaptan
  • Conjugated Estrogens; Medroxyprogesterone
  • Copanlisib
  • Crizotinib
  • Cyclosporine
  • Dabigatran
  • Dabrafenib
  • Daclatasvir
  • Dapagliflozin; Saxagliptin
  • Darifenacin
  • Darolutamide
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Dasatinib
  • Deferasirox
  • Deflazacort
  • Dexamethasone
  • Dexlansoprazole
  • Dextromethorphan; Quinidine
  • Diazepam
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Disopyramide
  • Docetaxel
  • Dofetilide
  • Dolutegravir
  • Dolutegravir; Lamivudine
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Doravirine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Doxorubicin
  • Dronabinol
  • Dronedarone
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Dutasteride
  • Dutasteride; Tamsulosin
  • Duvelisib
  • Edoxaban
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Eletriptan
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enalapril; Felodipine
  • Encorafenib
  • Enfortumab vedotin
  • Entrectinib
  • Enzalutamide
  • Eplerenone
  • Erdafitinib
  • Ergotamine
  • Erlotinib
  • Estazolam
  • Estradiol Cypionate; Medroxyprogesterone
  • Eszopiclone
  • 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
  • Ethosuximide
  • Etravirine
  • Everolimus
  • Ezetimibe; Simvastatin
  • Fedratinib
  • Felodipine
  • Fentanyl
  • Flibanserin
  • Flurazepam
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Fosamprenavir
  • Fosphenytoin
  • Fostamatinib
  • Galantamine
  • Gefitinib
  • Gemfibrozil
  • Gilteritinib
  • Glasdegib
  • Glecaprevir; Pibrentasvir
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanfacine
  • Haloperidol
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibrutinib
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Imatinib
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Indinavir
  • Irinotecan
  • Irinotecan Liposomal
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isradipine
  • Istradefylline
  • Itraconazole
  • Ivabradine
  • Ivacaftor
  • Ivosidenib
  • Ixabepilone
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Lansoprazole
  • Lansoprazole; Naproxen
  • Lapatinib
  • Larotrectinib
  • Lefamulin
  • Leflunomide
  • Lemborexant
  • Levomilnacipran
  • Lidocaine
  • Lidocaine; Prilocaine
  • Lomitapide
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Lovastatin
  • Lovastatin; Niacin
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Macitentan
  • Maraviroc
  • Medroxyprogesterone
  • Mefloquine
  • Metformin; Repaglinide
  • Metformin; Saxagliptin
  • Methadone
  • Methylprednisolone
  • Midazolam
  • Midostaurin
  • Mifepristone
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Mometasone
  • Morphine
  • Morphine; Naltrexone
  • Naldemedine
  • Naloxegol
  • Nanoparticle Albumin-Bound Paclitaxel
  • Nelfinavir
  • Neratinib
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Niacin; Simvastatin
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nintedanib
  • Nisoldipine
  • Olaparib
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Osilodrostat
  • Ospemifene
  • Oxybutynin
  • Oxycodone
  • Paclitaxel
  • Palbociclib
  • Panobinostat
  • Paricalcitol
  • Pazopanib
  • Pemigatinib
  • Perindopril; Amlodipine
  • Pexidartinib
  • Phenobarbital
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Ponatinib
  • Prednisolone
  • Prednisone
  • Primidone
  • Propafenone
  • Quetiapine
  • Quinidine
  • Quinine
  • Ramelteon
  • Ranolazine
  • Regorafenib
  • Repaglinide
  • Retapamulin
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Rilpivirine
  • Rimegepant
  • Riociguat
  • Ripretinib
  • Ritonavir
  • Rivaroxaban
  • Roflumilast
  • Romidepsin
  • Ruxolitinib
  • Saquinavir
  • Saxagliptin
  • Segesterone Acetate; Ethinyl Estradiol
  • Selpercatinib
  • Selumetinib
  • Sildenafil
  • Silodosin
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Siponimod
  • Sirolimus
  • Solifenacin
  • Sonidegib
  • St. John’s Wort, Hypericum perforatum
  • Sufentanil
  • Sunitinib
  • Suvorexant
  • Tacrolimus
  • Tadalafil
  • Talazoparib
  • Tamsulosin
  • Tazemetostat
  • Telithromycin
  • Temsirolimus
  • Tenofovir Alafenamide
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Teriflunomide
  • Tezacaftor; Ivacaftor
  • Thiotepa
  • Ticagrelor
  • Tinidazole
  • Tipranavir
  • Tofacitinib
  • Tolterodine
  • Tolvaptan
  • Topotecan
  • Toremifene
  • Trabectedin
  • Tramadol
  • Trandolapril; Verapamil
  • Trazodone
  • Triamcinolone
  • Triazolam
  • Ubrogepant
  • Ulipristal
  • Umeclidinium; Vilanterol
  • Upadacitinib
  • Valbenazine
  • Vardenafil
  • Vemurafenib
  • Venetoclax
  • Verapamil
  • Vilazodone
  • Vinblastine
  • Vincristine
  • Vincristine Liposomal
  • Vinorelbine
  • Vorapaxar
  • Voriconazole
  • Voxelotor
  • Warfarin
  • Zaleplon
  • Zanubrutinib
  • Ziprasidone
  • Zolpidem
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