Alecensa (alectinib) is a targeted cancer medicine used to treat a specific type of lung cancer called ALK-positive non-small cell lung cancer (NSCLC). It works by blocking a protein called ALK (anaplastic lymphoma kinase), which drives the growth of cancer cells that have a mutation in the ALK gene.

How it works:

ALK is an abnormal protein found in some lung cancer cells that tells them to grow uncontrollably. Alecensa targets and blocks this protein directly, slowing or stopping cancer growth. Unlike chemotherapy, it is designed to act on the cancer cells rather than all rapidly dividing cells.

The usual dose is 600mg (four 150mg capsules) taken twice daily. Your doctor will confirm the right dose for you. Always follow their instructions.

How to take it:

• Take Alecensa with food. Eating with each dose helps your body absorb the medicine better and may reduce stomach upset
• Swallow the capsules whole. Do not open, chew, or crush them
• Take it at roughly the same times each day, such as morning and evening with meals

Before you start:

• Tell your doctor about all medicines, vitamins, and supplements you are taking
• Let your doctor know if you have any history of heart, liver, or lung problems
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Alecensa can harm an unborn baby, so effective contraception is important during and for a period after treatment

Ongoing check-ups:

Regular blood tests and scans will be arranged to check how well Alecensa is working and to look for any side effects. Liver function tests are especially important, particularly in the early months of treatment.

Before starting Alecensa, your doctor will test your tumour to confirm it has the ALK mutation. This makes Alecensa more effective for your specific cancer type.

• If you remember within 6 hours of the missed dose: take it as soon as you can, with food
• If more than 6 hours have passed: skip the missed dose and take your next dose at the usual time
• Never take a double dose to make up for one you missed

If you are not sure what to do, contact your doctor or pharmacist.

If you think you have taken more than prescribed, call 000 or go to your nearest emergency department straight away.

Signs that something might be wrong include:

• Unusual tiredness or weakness
• Nausea or vomiting that is more severe than usual
• Signs of liver problems: yellowing of the skin or eyes, dark urine, stomach pain

Bring your medicine packet with you so medical staff know exactly what you took.

• Store at room temperature, below 30°C
• Keep in the original packaging, away from moisture and light
• Do not store in the bathroom
• Keep out of reach of children and pets
  

Side effects are common but many people manage them well. Key ones to know about:

• Fatigue: Feeling tired is one of the most commonly reported side effects. Rest when needed and pace yourself
• Constipation: Drink plenty of fluids, eat high-fibre foods, and let your doctor know if it becomes a problem
• Swelling (oedema): Some people notice swelling in the ankles, legs, or hands. Tell your doctor if this occurs
• Muscle pain: Aches and pains can occur. Regular gentle activity may help. Inform your doctor if pain is severe
• Liver changes: Your liver enzymes may rise during treatment. This is usually found on blood tests rather than felt directly, which is why regular monitoring is important
• Sensitivity to sunlight: Your skin may become more sensitive to UV light. Use sunscreen, wear protective clothing, and avoid prolonged sun exposure
• Nausea: Usually mild. Taking your dose with food can help
• Slow heart rate (bradycardia): Alecensa can slow the heart rate, which may cause dizziness or faintness. Your doctor may monitor your heart rhythm during treatment

Contact your doctor or pharmacist if any side effect is troubling you, even if it is not listed here.

Tell your doctor and pharmacist about everything you are taking before starting Alecensa. Important things to know:

• CYP3A4 inhibitors and inducers: Some medicines can affect how Alecensa is processed by your body. Your doctor will check for any significant interactions before you start
• Heart medicines: Alecensa can slow the heart rate, so caution is needed alongside other medicines that affect heart rhythm
• Live vaccines: Avoid live vaccines during treatment. Speak to your doctor before any vaccinations

Never start, stop, or change any medicine without speaking to your doctor first.

What does ALK-positive mean?

ALK-positive means your lung cancer cells have a specific genetic change (a mutation or rearrangement) involving the ALK gene. This mutation drives cancer cell growth. Medicines like Alecensa are designed specifically to target and block this mutation, making them more effective for this type of cancer than general chemotherapy.

How long will I take Alecensa for?

Treatment continues as long as your cancer is responding and side effects are manageable. Your doctor will monitor your response through regular scans and blood tests and let you know if any changes are needed.

Do I have to take it with food every time?

Yes. Alecensa should always be taken with food. Taking it without food significantly reduces the amount your body absorbs, which can make it less effective.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.