Recommended Dosage and Administration of Crizotinib

Recommended Dosage and Administration of Crizotinib

The recommended dosage for adults with non-small cell lung cancer is 250 mg (one capsule) each time, taken twice daily (morning and evening), for a total daily dose of 500 mg. The recommended dosage for children and adolescents (with ALK-positive ALCL or IMT) is 280 mg/m² body surface area each time, twice daily, with a maximum daily dose not exceeding 1000 mg, as calculated by a physician. Capsules should be swallowed whole, not crushed, dissolved, or opened. Take at approximately the same time every day. If a dose is missed: if it is ≥6 hours until the next dose, take the missed dose as soon as possible; if it is<6 hours, skip the missed dose and take the next dose at the scheduled time. Do not double the dose. If vomiting occurs after taking a dose, do not take an additional dose. Do not discontinue or adjust the dosage without medical advice.

Common and Serious Side Effects of Crizotinib

In adults, very common side effects (incidence >10%) include visual impairment (flashes, blurred vision, photophobia, floaters, or double vision), nausea, vomiting, diarrhea, edema (swelling of ankles or hands), constipation, abnormal liver function, decreased appetite, fatigue, dizziness, peripheral neuropathy (numbness or tingling in joints and extremities), taste alteration, abdominal pain, anemia, rash, and slow pulse. Common side effects (incidence ≤10%) include indigestion, elevated serum creatinine, elevated alkaline phosphatase, hypophosphatemia, renal cyst, syncope, esophagitis, decreased testosterone, and heart failure. Uncommon side effects (incidence ≤1%) include gastrointestinal perforation, photosensitivity reaction, and elevated muscle enzymes. The side effect profile in children and adolescents is similar, but thrombocytopenia is more common. Serious side effects include liver failure, pneumonitis, decreased white blood cell count, arrhythmia, and vision loss. Seek immediate medical attention if any of these occur.

Additional Precautions for Crizotinib Use in Pediatric and Adolescent Patients

For children and adolescents (age ≥1 year to<18 years) with ALK-positive ALCL or IMT, stricter requirements apply. First, dosage is calculated based on body surface area (280 mg/m² twice daily), with total daily dose not exceeding 1000 mg, and each dose must be taken under adult supervision. Second, before starting XALKORI treatment and within one month after initiation, a comprehensive eye examination by an ophthalmologist is required to assess for visual problems. During treatment, ophthalmologic examinations should be repeated every 3 months; if new visual disturbances (such as flashes, blurred vision, photophobia, floaters, or double vision) occur, the frequency of examinations should be increased. Additionally, pediatric patients are more prone to severe gastrointestinal reactions, including severe diarrhea, nausea, and vomiting, which may lead to dehydration and electrolyte imbalance. If difficulty swallowing, persistent vomiting, or diarrhea occurs, contact a physician immediately. The physician may prescribe antiemetics, antidiarrheals, oral rehydration salts, or electrolyte supplements, and adjust the dosage or temporarily discontinue treatment if necessary.