Dr. Cass on Managing Diarrhea in Patients Treated With EGFR TKIs

Amanda Cass, PharmD, BCPS, BCOP, clinical pharmacist, Thoracic Oncology Clinic, Vanderbilt University Medical Center, discusses strategies to manage the diarrhea that may occur as an adverse effect (AE) in patients treated with EGFR TKIs.

Instructing patients to keep imodium at home when they receive their EGFR prescription, and telling them who to call if they have issues or questions, are recommended first steps toward managing this AE, Cass says. Daily imodium may be effective in some patients, as EGFR TKIs are daily therapies, unlike intravenous chemotherapy, where patients may have AEs for a few days after they receive the therapy, and then have weeks of recovery, Cass explains.

Establishing a balance between diarrhea and constipation is important, Cass notes. For example, if a patient on adjuvant osimertinib (Tagrisso) is experiencing diarrhea, taking 1 tablet of imodium each day may result in constipation, while 1 tablet every other day may not lessen the diarrhea, Cass says. However, a more specific regimen, such as alternating between 1 tablet and half a tablet every other day, may balance out the patient’s symptoms, Cass explains.

Proactive strategies that are tailored to patients’ specific symptoms are key to managing this AE, Cass concludes.

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