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Afatinib 618 and 820

This leaflet provides information on a course of treatment called afatinib.  The leaflet will explain what this is and when and how it will be given.  It will also tell you about common side effects that you may experience.  Contact telephone numbers are given at the end of the leaflet.

What is afatinib?

Afatinib is a cancer treatment which is given as tablets.  

Why am I having afatinib?

Afatinib has been found to help some patients with your type of cancer.

How often will I see the specialist team?

You will see the specialist team every 4 weeks.  You will have regular blood tests and we will check how you are feeling and discuss any problems you may have.  This is so we can check how the treatment is affecting you.  

Can I bring relatives and friends with me? 

Currently due to the need to ensure 2m space between patients during COVID-19 we do not usually allow anyone to stay with you during your treatment. If you have any concerns about this please speak to your team before your treatment starts. We may be able to make some exceptions but we will need to be aware of this before the day of treatment.

How should I take the afatinib tablets?

Afatinib tablets should be taken once a day.  Try to take them at approximately the same time every day.  You should take the tablets on an empty stomach.  This is at least 2 hours after eating, and you should not eat food for at least 1 hour after taking the tablets.  The tablets should be swallowed whole with a glass of water.  They must not be chewed or crushed.  

How many afatinib tablets will I need to take?

It is usual to take one tablet daily but sometimes your doctor may alter the dose.  The amount you need to take will be clearly marked on the box. 

What should I do if I forget to take my tablets?

  • If it’s within 2 hours of the normal time take them now.
  • If it’s more than 2 hours late, miss this dose.

What if I take too many tablets?

Please contact Velindre Cancer Centre immediately for advice.  The telephone number is at the end of the leaflet.  Please ask for the chemotherapy pager. 

How should I store the tablets?

Your tablets should be stored in their original packaging and in a safe place away from children. They should be kept in a cool dry place (below 25oC).

Any unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.  

What are the possible side effects?

This treatment is usually well tolerated but there are some possible side effects that you need to be aware of.  The doctors, nurses and pharmacists can give you advice or answer any questions you may have.


Nausea and vomiting are uncommon with afatinib.  We will give you anti sickness tablets to take if you need them.  If you are sick more than once in 24 hours despite taking regular anti-sickness medicine, contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet. 


You may have diarrhoea with this treatment.  If this occurs it is important that you drink plenty of fluids.  We will give you loperamide tablets to control diarrhoea.  If you have four or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately.  The telephone number is at the end of the leaflet.

Skin reactions

You may experience a skin reaction with afatinib.  This is usually an acne type rash which may be dry and itchy and cause mild discomfort.  For a small number of people this reaction may be more severe.  A severe rash would affect a large part of your body, may be painful and may become infected. 

To reduce the possibility of severe skin reaction we suggest that you:

  • use non-perfumed moisturising creams on your face and upper body from the start of your treatment 
  • avoid exposure to the sun, wear a hat and use a high factor sunscreen.
  • don’t use hot water on your skin
  • don’t use soap if your skin is dry - use a soap alternative such as aqueous cream 
  • try not to rub your skin vigorously - pat gently dry 
  • wear comfortable clothes and shoes that do not rub

Your hospital doctor may prescribe antibiotic tablets to help reduce the severity of your skin rash.  You should start taking them if you develop an acne type rash.  

This skin reaction is temporary and will resolve completely after you have finished treatment.  If you develop a severe skin reaction which is causing you pain or stopping you carrying out your normal activities, please contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet.

Blood clots

A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further.  It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.  

Blood clots can be very serious.  However, most clots can usually be successfully treated with drugs to thin the blood.  Your doctor or nurse can give you more information.

Other side effects and information

It is important you do not become pregnant or father a child whilst having treatment or for at least 1 month afterwards.  This is because afatinib could damage the unborn baby.  

Very rarely some people having afatinib may experience breathing problems caused by the tablets.  If you notice new breathing problems, please contact your doctor or specialist nurse.  You will be monitored at regular clinic visits.  

Is it alright to take other medicines?

If you are taking other medicines please let your doctor, nurse or pharmacist know.  There are a small number of medicines that you may have to avoid.  These include St. John’s Wort.  

Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.

Manufacturer’s patient information leaflets

Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy

Contact telephone numbers

Velindre Cancer Centre 029 2061 5888

For urgent advice at any time of the day or night please ask for the treatment helpline

Pharmacy department 029 2061 5888 ext 6223

Monday – Friday 9am – 5pm for queries about your medicines

Macmillan freephone Helpline     0808 808 0000

Tenovus freephone 0808 808 1010

cancer helpline 


This leaflet was written by health professionals.  The information contained in this leaflet is evidence based.  It has been approved by doctors, nurses and patients.  It is reviewed and updated every 2 years.

Prepared May 2014
Reviewed May 2017