Product Intro:
Tuccatinn is an oral targeted cancer therapy developed to treat advanced or metastatic HER2-positive breast cancer. It is commonly used in combination with trastuzumab and capecitabine for patients who have received previous anti-HER2 therapies.

1. Uses:
   Tuccatinn 150 mg is used for:
   – Treatment of HER2-positive metastatic breast cancer
   – Treatment of breast cancer that has spread to the brain (brain metastases)
   – Used in combination with trastuzumab and capecitabine in patients previously treated with anti-HER2 regimens
   – May be prescribed in cases resistant to trastuzumab alone
   – Delays disease progression and improves overall survival in HER2-positive cases
   – Helps control cancer-related symptoms such as fatigue, pain, and neurological issues in patients with brain involvement

2. Storage Instructions:
   – Store below 30°C in a dry place.
   – Keep in the original packaging to protect from moisture.
   – Do not refrigerate or freeze.
   – Keep away from children and pets.
   – Discard expired or unused tablets according to medical waste guidelines.

3. How It Works (Mechanism of Action):
   Tucatinib is a selective tyrosine kinase inhibitor that blocks the activity of the HER2 (human epidermal growth factor receptor 2) protein, which is overexpressed in some breast cancers. By inhibiting HER2 signaling, Tucatinib prevents cancer cells from growing and dividing. Unlike other HER2 inhibitors, Tucatinib is more selective and causes fewer side effects related to EGFR inhibition.

4. Side Effects:
   Common side effects:
   – Diarrhea
   – Fatigue
   – Nausea
   – Vomiting
   – Liver enzyme elevation
   – Hand-foot syndrome (when used with capecitabine)
   – Mouth sores

Severe side effects:
– Severe diarrhea leading to dehydration
– Hepatotoxicity (elevated ALT, AST, bilirubin)
– Neutropenia or anemia
– Interstitial lung disease (rare but serious)
– Severe allergic reactions

5. Dosage (Typical Recommended Dose):
   – The usual adult dose is 300 mg per day, given as 150 mg tablet twice daily (morning and evening).
   – It is used in combination with trastuzumab and capecitabine.
   – Duration and dose may vary depending on the patient's condition, tolerance, and oncologist’s decision.

6. Method of Administration (How to Take It):
   – Swallow the tablet whole with water.
   – Can be taken with or without food.
   – Do not crush, chew, or break the tablet.
   – Take doses approximately 12 hours apart (e.g., 8 AM and 8 PM).
   – Maintain consistent timing every day for optimal blood levels.

7. Precautions (Things to Consider Before Taking It):
   – Regular liver function monitoring is essential during therapy.
   – Caution in patients with pre-existing liver disease.
   – Inform your doctor if you are pregnant, breastfeeding, or planning pregnancy.
   – Effective contraception must be used during treatment and for at least 1 week after the last dose.
   – Avoid alcohol and herbal supplements unless cleared by the physician.
   – Patients with severe kidney impairment should be monitored closely.

8. Drug Interactions (Medicines That May Interact):
   – Strong CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin) – may decrease Tucatinib levels
   – Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) – may increase toxicity
   – Proton pump inhibitors – may alter absorption
   – Capecitabine and trastuzumab – co-administered, so liver toxicity may be enhanced
   – Antidiabetic medications – blood sugar monitoring advised
   – Warfarin or anticoagulants – bleeding risk monitoring required

9. Allergies (Warnings for Allergic Reactions):
   – Hypersensitivity reactions are rare but possible.
   – Signs may include rash, itching, facial swelling, difficulty breathing, or hives.
   – Stop taking the medicine and seek emergency care if any such reactions occur.

10. Overdose Information (What to Do if Overdosed):
    – Symptoms of overdose may include severe diarrhea, vomiting, liver toxicity, or confusion.
    – There is no specific antidote for Tucatinib overdose.
    – Seek immediate medical attention or contact poison control.
    – Supportive treatment and hydration are provided in case of overdose.

11. Missed Dose Instructions:
    – If a dose is missed, take it as soon as you remember.
    – If it is less than 8 hours before the next dose, skip the missed dose.
    – Do not take a double dose to make up for a missed one.

12. Additional Notes:
    – Regular blood tests for liver function, blood counts, and kidney function are required.
    – Continue therapy unless advised otherwise by your oncologist.
    – Report any new or worsening symptoms, especially diarrhea or fatigue.
    – It is a high-cost specialty medicine and should only be used under a cancer specialist's supervision.
    – Not interchangeable with other HER2-targeted drugs without medical guidance.