For Pharmacists

Tarceva in combination with gemcitabine is indicated for the first-line treatment of patients with locally advanced, unresectable or metastatic pancreatic cancer.

• The recommended daily dose of Tarceva for the treatment of pancreatic cancer is 100 mg taken orally between meals (at least 1 hour before or 2 hours after eating), in combination with gemcitabine 1000 mg/m2 IV

Tarceva is a Human Epidermal Growth Factor Receptor Type 1/Epidermal Growth Factor Receptor (HER1/EGFR) tyrosine kinase inhibitor. Tarceva tablets are available in three dosage strengths containing erlotinib hydrochloride equivalent to 150 mg, 100 mg, or 25mg.

100 mg - NDC# 5024206301	25 mg - NDC# 5024206201
How Supplied: Each carton contains one bottle with thirty 100 mg white film-coated tablets for daily oral administration. Minimum Order: 1 carton Catalog No.: 16501 Weight: 37.506 grams/carton Dimensions: 1 5/8” x 2” x 3 7/32” per carton (10.46 cubic inches)	How Supplied: Each carton contains one bottle with thirty 25 mg white film-coated tablets for daily oral administration. Minimum Order: 1 carton Catalog No.: 16500 Weight: 31.306 grams/carton Dimensions: 1 5/8” x 2” x 3 7/32” per carton (10.46 cubic inches)

Shipping

Per agreement with customer's wholesaler.

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). See USP Controlled Room Temperature.

Important Safety Information:

There have been infrequent reports of serious Interstitial Lung Disease (ILD)-like events, including fatalities, in patients receiving Tarceva for treatment of NSCLC, pancreatic cancer or other advanced solid tumors. In the event of an acute onset of new or progressive, unexplained pulmonary symptoms such as dyspnea, cough and fever, Tarceva therapy should be interrupted pending diagnostic evaluation. If ILD is diagnosed, Tarceva should be discontinued and appropriate treatment instituted as needed.

Cases of hepatic failure, hepatorenal syndrome, acute renal failure (all including fatalities), and renal insufficiency have been reported during use of Tarceva. Treatment with Tarceva should be used with extra caution in patients with total bilirubin > 3 x ULN. Tarceva dosing should be interrupted or discontinued if changes in liver function are severe. Patients should be closely monitored during therapy with Tarceva.

Gastrointestinal perforation (including fatalities) has been reported in patients receiving Tarceva. Permanently discontinue Tarceva in patients who develop gastrointestinal perforation.

Bullous, blistering and exfoliative skin conditions have been reported including cases suggestive of Stevens-Johnson syndrome/toxic epidermal necrolysis, which in some cases were fatal. Interrupt or discontinue Tarceva treatment if the patient develops severe bullous, blistering or exfoliating conditions.

In the pancreatic cancer trial, other serious adverse reactions associated with Tarceva plus gemcitabine and which may have included fatalities, were myocardial infarction/ischemia, cerebrovascular accident and microangiopathic hemolytic anemia with thrombocytopenia.

Corneal perforation and ulceration have been reported during use of Tarceva. Interrupt or discontinue Tarceva therapy if patients present with acute/worsening ocular disorders such as eye pain.

When receiving Tarceva therapy, women should be advised against becoming pregnant or breastfeeding. Tarceva is pregnancy category D.

The most common adverse reactions in patients with pancreatic cancer receiving Tarceva 100 mg plus gemcitabine were fatigue, rash, nausea, anorexia and diarrhea. Severe rash and diarrhea (5% and 5% NCI-CTC Grades 3-4, respectively) were reported. Rash and diarrhea each resulted in dose reductions in 2% of patients, and discontinuation in up to 1% of patients receiving Tarceva plus gemcitabine.

• Please see the Tarceva full prescribing information for complete safety information.