Rapid onset of conjunctivitis associated with overdosing of erlotinib

J Clin Pharm Ther. 2018 Apr;43(2):296-298. doi: 10.1111/jcpt.12641. Epub 2017 Oct 25.

Abstract

What is known and objective: Erlotinib is one of the epidermal growth factor receptor (EGFR) inhibitors and is widely used as a targeted therapy for advanced non-small-cell lung cancer (NSCLC). There are a few reports regarding ocular adverse effects of erlotinib. Herein, we report a case of rapid onset of ocular toxicity associated with overdosing of erlotinib.

Case description: A 72-year-old male with metastatic NSCLC developed conjunctivitis after accidentally taking erlotinib at a dosage of 300 mg/day for 4 days. Before that, the patient had been taking erlotinib at the prescribed dose of 150 mg/day for 17 days. Erlotinib was discontinued for 7 days, and the conjunctivitis was successfully treated symptomatically. The adverse effect did not recur when he resumed taking erlotinib 150 mg/day, suggesting the ocular change was related to the overdosing of erlotinib.

What is new and conclusion: Awareness and close monitoring of this adverse effect are helpful for doctors and pharmacists to identify inadvertent drug overdose. Patients should be provided comprehensive education before receiving targeted therapy.

Keywords: conjunctivitis; erlotinib; ocular changes; toxicity.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Conjunctivitis / chemically induced*
  • Erlotinib Hydrochloride / adverse effects*
  • Erlotinib Hydrochloride / therapeutic use
  • Humans
  • Lung Neoplasms / drug therapy
  • Male
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / therapeutic use

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Erlotinib Hydrochloride