Pronunciation:

soe-toe-RAS-ib

Brand Names:

• Lumakras

Dosage Forms:

• Tablet

Classifications:

Therapeutic—

Antineoplastic Agent

Uses of This Medicine:

Sotorasib is used to treat metastatic (cancer that has already spread) or locally advanced (cannot be removed by surgery) non-small cell lung cancer (NSCLC) in patients who have received at least one previous treatment and whose tumors have an abnormal KRAS G12C gene. Your doctor will perform a test before you use this medicine.

Sotorasib belongs to the group of medicines called antineoplastics (cancer medicines). It works by interfering with the growth of cancer cells, which are eventually destroyed.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of sotorasib in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sotorasib in the elderly.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil
• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Apalutamide
• Calcium Carbonate
• Calcium Silicate
• Carbamazepine
• Cimetidine
• Cyclosporine
• Dexlansoprazole
• Digoxin
• Dihydroergotamine
• Dihydroxyaluminum Aminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Dofetilide
• Ebrotidine
• Enzalutamide
• Ergotamine
• Esomeprazole
• Famotidine
• Fentanyl
• Flibanserin
• Fosphenytoin
• Lansoprazole
• Lumacaftor
• Magaldrate
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Peroxide
• Magnesium Trisilicate
• Mitotane
• Nizatidine
• Omeprazole
• Oxycodone
• Pantoprazole
• Phenytoin
• Pimavanserin
• Pimozide
• Quinidine
• Rabeprazole
• Ranitidine
• Ranitidine Bismuth Citrate
• Rifampin
• Roxatidine
• Sirolimus
• Sodium Bicarbonate
• St John's Wort
• Tacrolimus
• Temsirolimus

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Liver disease or
• Lung or breathing problems (eg, interstitial lung disease, pneumonitis)—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

You may take this medicine with or without food. Take the medicine at the same time each day.

Swallow the tablet whole. Do not crush, break, or chew it.

If you cannot swallow the tablets:

• Put the tablets in a glass with 120 milliliters (mL) of non-carbonated, room temperature water without crushing the tablets. Do not use any other liquids.
• Stir until the tablets are in small pieces. The tablets will not completely dissolve. The color of the mixture may be pale to bright yellow.
• Drink the mixture right away or within 2 hours of preparing. Do not chew the small pieces of tablets.
• Add another 120 mL of water to the same glass and drink to make sure get the full dose.
• Stir the mixture again before drinking, if you do not drink the mixture right away.

Tell your doctor if you are also taking a stomach medicine (eg, famotidine, omeprazole, or other H2 blockers or PPIs). Take Lumakras™ at least 4 hours before of 10 hours after taking an antacid.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For non-small cell lung cancer:
    • Adults—960 milligrams (mg) (three 320 mg tablets or eight 120 mg tablets) once a day. Your doctor may adjust your dose as needed and tolerated.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If a dose is missed by more than 6 hours, do not take an extra dose. Take the next dose at the regular scheduled time. Do not take extra medicine to make up for the missed dose.

If you vomit after taking a dose, do not take an extra dose. Take the next dose at the regular time.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause swelling of the lungs (pneumonitis) or interstitial lung disease. These are life-threatening conditions and require immediate medical attention. The symptoms may be similar to the symptoms from lung cancer. Check with your doctor right away if you have new or worsening cough, fever, or trouble breathing.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Chest pain or tightness

cough

dark urine

fever or chills

light-colored stools

loss of appetite

nausea or vomiting

sneezing

sore throat

stomach pain

trouble breathing

unusual tiredness or weakness

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Blistering, crusting, irritation, itching, or reddening of the skin

constipation

cracked, dry, scaly skin

diarrhea

difficulty in moving

joint or bone pain

lack or loss of strength

muscle aches, cramps, pain, or stiffness

rash with flat lesions or small raised lesions on the skin

swelling of the hands, ankles, feet, or lower legs

swelling of the testes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.