Dose Changes to Manage Side Effects

When you are prescribed NERLYNX, your doctor may start you on a lower dose. Over time, your doctor will increase the dose until you are taking 6 tablets once a day. This can help you to adjust to NERLYNX by managing side effects so you can stay on treatment.

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Success plan checklist

Download a list of key things to have in place as you start and stay on treatment.


Working With Your Healthcare Team

As with most medicines, side effects can occur with NERLYNX. But there are steps you can take to help manage the side effect of diarrhea and commit to staying on treatment.

Working with your healthcare team from the beginning is the key to success. Here are some simple steps to help prepare you:

Before taking NERLYNX

Work with your healthcare team to have a plan for what to do in case diarrhea occurs.

When you start NERLYNX

Your doctor may prescribe antidiarrheal medicines to take with your first dose and for a couple of months afterward.

While taking NERLYNX

Continue to let your doctor know about side effects and ask for help to manage them.

You may be able to help manage diarrhea with diet and lifestyle changes

Choose foods that are low in fiber and high in protein and potassium.

Eat smaller, more frequent meals.

Stay well hydrated. Drink 8 to 10 large glasses of clear liquids every day.

Avoid dairy products (except for yogurt).

Eat bananas, rice, applesauce, and toast (the BRAT diet).

Try probiotics (found in yogurt or dietary supplements) to aid digestion.

We'll cover the cost of antidiarrheals*

To support your experience on NERLYNX, PUMA offers vouchers that include access to a free supply of these medicines.

  • Patients can receive up to a 3-month supply of products used for antidiarrheal treatment for free
  • Ask your healthcare team or a Puma network Specialty Pharmacy for a voucher

*This program benefit is offered based on the findings from the CONTROL trial, which show that using antidiarrheals can help to manage diarrhea that may be caused by NERLYNX. Limitations apply. Puma Biotechnology reserves the right to rescind, revoke, or amend this program without notice.

Common side effects

While diarrhea is the most common side effect of taking NERLYNX, you may experience others. Below are other common side effects when using NERLYNX alone to treat early-stage breast cancer:

  • nausea
  • stomach-area (abdomen) pain
  • tiredness
  • vomiting
  • rash
  • dry or inflamed mouth, or mouth sores
  • decrease appetite
  • muscle spasms
  • upset stomach
  • nail problems including color change
  • dry skin
  • swelling of your stomach-area
  • nosebleed
  • weight loss
  • urinary tract infection

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

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What is the most important information I should know about NERLYNX (ner links)?

NERLYNX® (neratinib) may cause serious side effects, including:

Your healthcare provider may change your dose of NERLYNX, temporarily stop or completely stop NERLYNX if needed to manage your diarrhea.

See "What are the possible side effects of NERLYNX?" for more information about side effects.

What is NERLYNX?

It is not known if NERLYNX is safe and effective in children.

Before taking NERLYNX, tell your healthcare provider about all of your medical conditions, including if you:

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take medicines used to decrease stomach acid, called proton pump inhibitors or PPIs. You should avoid taking these medicines during treatment with NERLYNX.

What are the possible side effects of NERLYNX?

NERLYNX may cause serious side effects, including:
See "What is the most important information I should know about NERLYNX?"

The most common side effects of NERLYNX when used alone include:

The most common side effects of NERLYNX in combination with capecitabine include:

These are not all of the possible side effects of NERLYNX. For more information, ask your Healthcare Provider.

Tell your doctor if you have any side effects that bother you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

For Patient Information, please click here.