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A Comprehensive Guide to Erbitux: Mechanism, Side Effects, and Cost

Doctor holding ribbon for head and neck cancer awareness

Erbitux injection is an FDA-approved cancer medication. It is used to treat certain types of head and neck cancer and cancers of the large intestine (colon) and rectum. In this article, you will learn about its mechanism of action, side effects, cost, and more. 

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Important Erbitux Warnings

Severe or Fatal Infusion Reactions

This medication can cause severe or fatal reactions during an infusion. Though these reactions can occur at any time during therapy, the risk is often highest with the first infusion. 

Your healthcare provider will watch you closely during and at least one hour after each infusion. 

Inform your provider or tell your caregiver if you experience the following reactions during or after an infusion:

  • Sudden breathing problems
  • Shortness of breath
  • Noisy breathing
  • Swelling of the eyes, face, mouth, lips or throat
  • Hoarseness
  • Hives
  • Dizziness
  • Fainting
  • Nausea
  • Fever
  • Chills
  • Chest pain

Should any of these reactions occur, your provider will slow, temporarily stop or permanently discontinue treatment. 

Cardiopulmonary Arrest and Sudden Death

If you take this medication with radiation therapy for head and neck cancer, you may be at a higher risk of cardiopulmonary arrest and sudden death during or after Erbitux therapy. Cardiopulmonary arrest is when your heart suddenly stops beating. Your healthcare provider will monitor your electrolyte levels during and after Erbitux infusions.

The risk of cardiopulmonary arrest and sudden death is also higher if you take this medication with platinum-based medicine and fluorouracil for head and neck cancer. 

Inform your provider if you have or have ever had:

  • Coronary artery disease (narrowing of the heart arteries)
  • Heart failure (heart failing to pump blood throughout the body)
  • Irregular heartbeat
  • Any heart disease
  • Low blood levels of magnesium, potassium, or calcium

Before Taking Erbitux

Before you receive your first dose, inform your provider if you:

  • Are allergic to this product, any product component, red meat, mouse protein, or galactose
  • Have or have ever had heart disease, lung disease, difficulty breathing, abnormal heart rhythm, or clogged arteries
  • Have had a tick bite
  • Are pregnant or plan to get pregnant
  • Are breastfeeding

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Erbitux Introduction and Uses

Erbitux is a brand-name prescription medication. The active ingredient in this product is cetuximab, which belongs to a class of targeted drug therapy called monoclonal antibodies (mAbs). Monoclonal antibodies are lab-created proteins that can suppress, mimic, or enhance your immune response. 

This medication is used to treat:

  • A specific type of head and neck cancer that has spread to other body parts. For this purpose, Erbitux injection may be used alone or with radiation therapy. 
  • A specific type of head and neck cancer that has spread to other parts of the body or reappears after treatment. For this purpose, this medication is used with or after chemotherapy. 
  • A specific type of colorectal cancer (cancer of the colon and rectum) that has spread to other body parts. For this purpose, Erbitux injection may be used alone or with chemotherapy.

Erbitux Mechanism of Action

Erbitux blocks the action of a protein called epidermal growth factor receptor (EGFR). In cancer cells, this protein has mutated or they are in large abundance on the cells. Erbitux works to stop EGFR from interacting with other signals in the body, thereby resulting in inhibition of growth and cell death.   

Erbitux makes cancer cells more sensitive to radiation therapy. 

Erbitux Dosage

This medication comes as a liquid to be injected slowly (infusion) into a vein. The following strengths are available in the US:

  • A single-dose 50 ml vial, which contains 100 mg of active drug (2 mg/ml). 
  • A single-dose 100 ml vial, which contains 200 mg of active drug (2 mg/ml).

A healthcare provider will inject this medication in a medical office or an infusion center. The first infusion lasts two hours, while subsequent infusions last one hour. 

Usual Adult Dose for Colorectal Cancer

(May be used alone or with other cancer drugs)

  • Weekly: Initial dose: 400 mg/m2 IV over 120 minutes; subsequent dose: 250 mg/m2 IV over 60 minutes once a week. 
  • Biweekly: 500 mg/m2 IV over 120 minutes every 2 weeks. 

With encorafenib (a cancer drug):

  • Initial Dose: 400 mg/m2 IV over 120 minutes. 
  • Subsequent dose: 250 mg/m2 IV over 60 minutes once a week. 

Usual Adult Dose for Head and Neck Cancer

With radiation therapy:

  • Initial dose: 400 mg/m2 IV over 120 minutes one week before starting radiation therapy.
  • Maintenance dose: 250 mg/m2 IV over 60 minutes once a week for 6 to 7 weeks. 

With other cancer drugs or alone:

  • Weekly: Initial dose: 400 mg/m2 IV over 120 minutes; subsequent dose: 250 mg/m2 IV over 60 minutes once a week. 
  • Biweekly: 500 mg/m2 IV over 120 minutes every 2 weeks.

Erbitux Side Effects

Common Side Effects

Call your healthcare provider if the following symptoms worsen or don’t go away: 

Cancer patient with hair loss as a side effect of taking Erbitux
  • Acne-like skin rash 
  • Dry or cracking skin
  • Itching
  • Changes in the fingernails or toenails
  • Hair loss
  • Increased hair growth on head, face, eyelashes, or chest
  • Headache
  • Tiredness
  • Confusion
  • Numbness in the arms or legs
  • Dry mouth
  • Sores on the lips, mouth, or throat
  • Sore throat
  • Nausea
  • Vomiting
  • Taste changes
  • Loss of appetite or weight
  • Constipation
  • Diarrhea
  • Heartburn
  • Joint or bone pain
  • Pain or swelling at the injection site
  • Fever
  • Chills

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Serious Side Effects

Call your healthcare provider immediately if you experience:

  • Loss of vision
  • Blistering, peeling, or shedding skin
  • Red, swollen, or infected skin
  • New or worsening cough, shortness of breath, or chest pain

Allergic Reactions

Seek emergency medical care if you experience:

  • Hives
  • Breathing difficulty
  • Swelling in the face or throat

Use During Pregnancy and Lactation 

If you are a woman of childbearing age, your provider will order a test to check if you are pregnant. This medication can harm your unborn baby. Use effective contraception during treatment and for at least 60 days after the last dose. Call your provider if you become pregnant during treatment. 

Avoid breastfeeding during treatment and for 60 days after the last dose. 

Erbitux Cost

Cost can vary depending on your insurance plan, location, and pharmacy. Contact your insurance provider to find out if your plan covers this medication or if you need prior authorization.
According to Eli Lilly and Company, the manufacturer of Erbitux, the list price of this medication is $16,081.73 per month.

Contact us if you are interested in receiving financial assistance for Erbitux.

This information is not a substitute for medical advice or treatment. Talk to your doctor or healthcare provider about your medical condition prior to starting any new treatment. AmeriPharma® Specialty Care assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content. AmeriPharma® Specialty Care does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship, or recommendation by AmeriPharma® Specialty Care. This webpage may contain references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with AmeriPharma® Specialty Care.
MEDICALLY REVIEWED BY Dr. Samantha Kaeberlein, PharmD

Dr. Samantha Kaeberlein, PharmD was born and raised in Canton, OH. She received her pharmacy degree from Northeast Ohio Medical University (NEOMED) in 2020. The most rewarding part of her job is providing medical guidance so patients can make informed, well-rounded decisions regarding their healthcare. Her areas of expertise are geriatrics and long-term care. In her free time, she enjoys spending time outdoors, reading, and hunting for the best cup of coffee in America.

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