Prophylaxis:
Current diarrhea prophylaxis recommendations are 4 mg with the first dose of neratinib, then 4 mg 3 times on day 1 (for a total of 16 mg on day 1), 4 mg 3-times daily (for a total of 12 mg/day) on days 2 and 3, reducing to 2 mg 3- or 4-times daily (for a total of 6-8 mg/day) for the remainder of the first cycle. Nonpharmacologic interventions, including dietetic changes and increased fluid intake, are recommended for new-onset uncomplicated diarrhea.
1. Activated charcoal62 and oral alkalinization63 may be beneficial for irinotecan-associated diarrhea
2. Probiotics may have a role in preventing 5-fluorouracil (5-FU)-related diarrhea. However, studies of prophylactic octreotide and an intestinal adsorbent did not show benefit.
Reference:
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