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Screen for hepatitis B virus in all cancer patients starting systemic treatment. Find out more about hepatitis B virus screening and management.

alectinib

( al-EK-ti-nib )
Other Name(s): Alecensaro®
Appearance: White capsule

alectinib

Pronunciation:

al-EK-ti-nib

Other Name(s):

Alecensaro®

Appearance:

White capsule

This handout gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on medication

People Talking

This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

 

Who do I contact if I have questions or need help?

 

My cancer health care provider is: _____________________________________________

During the day I should contact: _______________________________________________

Evenings, weekends and holidays: _____________________________________________

 

This page gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on this medication

People Talking

This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

What is this treatment for?

For treating certain types of non-small cell lung cancer (NSCLC)
 

What should I do before I start this treatment?

Tell your health care team if you have or had significant medical condition(s), especially if you have or had:

  • heart problems (including irregular heartbeat),

  • liver, kidney problems,

  • stomach or intestinal problems, or

  • any allergies.

This medication contains a small amount of lactose. If you cannot tolerate lactose, talk to your health care team.

 

Important Icon

Remember To:

 
  • Tell your health care team about all of the other medications you are taking.

  • Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.

You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.

How is this treatment given?
  • This medication is usually taken twice a day by mouth with food. Talk to your health care team about how and when to take your medication.

  • Swallow capsule(s) whole with a glass of water. Do not open or dissolve the capsules.

  • You may need more than 1 capsule to make up the full dose. Make sure you identify the correct number of capsules to take to get the right dose.

  • Do not eat or drink grapefruit, starfruit, Seville oranges, pomegranate or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects. 

  • If you miss a dose, skip this and take your next dose as you normally do. Do not take an extra dose to make up for the missed dose.

  • If you vomit (throw up) after taking your medication, do not take an extra dose. Take your next dose at the normal scheduled time.

 

Warning: If you take too much of this medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.

 

DO this while on treatment
  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.

  • DO protect your skin from the sun while taking alectinib and for at least 7 days after the last dose. Wear a long sleeved shirt, long pants and a hat. Apply sunscreen and lip balm with UVA and UVB protection and an SPF of at least 50. Your skin may be more sensitive to the sun and you could develop a bad sunburn or rash more easily.

DO NOT do this while on treatment

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  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

  • DO NOT eat or drink grapefruit, starfruit, Seville oranges, pomegranate or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects. 

  • DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel dizzy, or have eye problems.

DO this while on treatment

Check Mark Icon

  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.

  • DO protect your skin from the sun while taking alectinib and for at least 7 days after the last dose. Wear a long sleeved shirt, long pants and a hat. Apply sunscreen and lip balm with UVA and UVB protection and an SPF of at least 50. Your skin may be more sensitive to the sun and you could develop a bad sunburn or rash more easily.

DO NOT do this while on treatment

Stop Icon

  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

  • DO NOT eat or drink grapefruit, starfruit, Seville oranges, pomegranate or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects. 

  • DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel dizzy, or have eye problems.

Will this treatment interact with other medications or natural health products?

Yes, this medication can interact with other medications, vitamins, foods, traditional medicines and natural health products. Interactions can make this medication not work as well or cause severe side effects.

Tell your health care team about all of your:

  • prescription and over-the-counter (non-prescription) medications
  • other drugs and substances, such as cannabis/marijuana (medical or recreational)
  • natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements, or traditional medicines

Check with your health care team before starting or stopping any of them.

Medication Icon
Talk to your health care team BEFORE taking or using these :
  • Anti-inflammatory medications such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®) or Aspirin®.
  • Over-the-counter products such as dimenhydrinate (Gravol®
  • Natural health products such as St. John’s Wort
  • Traditional medicines
  • Supplements such as vitamin C
  • Grapefruit juice
  • Alcoholic drinks 
  • Tobacco 
  • All other drugs or substances, such as marijuana or cannabis (medical or recreational)
What to do if you feel unwell, have pain, a headache or a fever
  • Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).

    • Fever can be a sign of infection that may need treatment right away.

    • If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.

How to check for fever:

Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain). 

  • You have a fever if your temperature taken in your mouth (oral temperature) is:

    • 38.3°C (100.9°F) or higher at any time

  •       OR

    • 38.0°C (100.4°F) or higher for at least one hour.

Medication Icon

If you do have a fever: 

  • Try to contact your health care team.  If you are not able to talk to them for advice, you MUST get emergency medical help right away.

  • Ask your health care team for the Fever pamphlet for more information.

 

 

 

 

 

If you do not have a fever but have mild symptoms such as headache or mild pain:

  • Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.

Important Icon

Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.

How will this treatment affect sex, pregnancy and breastfeeding?

Talk to your health care team about:

  • How this medication may affect your sexual health.

  • How this medication may affect your ability to have a baby, if this applies to you.

This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

  • If there is any chance you may become pregnant, you and your partner together must use 2 effective forms of birth control at the same time until at least 5 weeks after your last dose. Talk to your health care team about which birth control options are best for you.
     
  • If you are a patient that can get somebody pregnant, you and your partner together must use 2 effective forms of birth control at the same time until at least 3 months after your last dose. Talk to your health care team about which birth control options are best for you.
     
  • Do not breastfeed while on this medication.
     

How to safely store and handle this medication

Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.

Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
 

How to safely touch oral anti-cancer medication


If you are a patient:

  • Wash your hands before and after touching your oral anti-cancer medication.

  • Swallow each capsule whole. Do not crush or chew your capsules.

If you are a caregiver:

  • Wear nitrile or latex gloves when touching tablets, capsules or liquids.
     

  • Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
     

  • Throw out your gloves after each use. Do not re-use gloves. 
     

  • Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
     

 

What to do if anti-cancer medication gets on your skin or in your eyes 


If medication gets on your skin:

  • Wash your skin with a lot of soap and water.

  • If your skin gets red or irritated, talk to your health care team.

If medication gets in your eyes:

  • Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.

 

What are the side effects of this treatment?

The following table lists side effects that you may have when getting alectinib. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.

Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on alectinib.


Common Side Effects (25 to 49 out of 100 people)
Side effects and what to do When to contact health care team

Constipation

What to look for?

  • Having bowel movements (going poo) less often than normal.
  • Small hard stools (poo) that look like pellets.
  • The need to push hard and strain to have any stool (poo) come out.
  • Stomach ache or cramps.
  • A bloated belly, feeling of fullness, or discomfort.
  • Leaking of watery stools (poo).
  • Lots of gas or burping.
  • Nausea or vomiting.
     

What to do?

To help prevent constipation:

  • Try to eat more fiber rich foods like fruits with skin, leafy greens and whole grains.
  • Drink at least 6 to 8 cups of liquids each day unless your health care team has told you to drink more or less.
  • Be Active. Exercise can help to keep you regular.
  • If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation:

  • If you have not had a bowel movement in 2 to 3 days you may need to take a laxative (medication to help you poo) to help you have regular bowel movements. Ask your health care team what to do.

Ask your health care team for the Constipation Pamphlet for more information.

Talk to your health care team if it does not improve or if it is severe.

Fatigue 

What to look for?

  • Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.

What to do?

  • Be active. Aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.
  • Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Ask family or friends to help you with things like housework, shopping, and child or pet care.
  • Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your health care team has told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired.

Ask your health care team for the Fatigue pamphlet for more information. 

Talk to your health care team if it does not improve or if it is severe.

 

Less Common Side Effects (10 to 24 out of 100 people)
Side effects and what to do When to contact health care team

Mild joint, muscle pain or cramps 

What to look for?

  • New pain in your muscles or joints, muscle cramps, or feeling achy.

What to do?

  • Take pain medication (acetaminophen or opioids such as codeine, morphine, hydromorphone, oxycodone) as prescribed.
  • Read the above section: "What to do if you feel unwell, have pain, a headache or a fever" before taking acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or Aspirin. These medications may hide an infection that needs treatment or they may increase your risk of bleeding.
  • Rest often and try light exercise (such as walking) as it may help.

Ask your health care team for the Pain pamphlet for more information.
 

Talk to your health care team if it does not improve or if it is severe.

Mild swelling

What to look for?

  • You may have mild swelling or puffiness in your arms and/or legs. Rarely, this may be severe.
     

What to do?

To help prevent swelling:

  • Eat a low-salt diet.


If you have swelling:

  • Wear loose-fitting clothing.
  • For swollen legs or feet, keep your feet up when sitting.
     
Talk to your health care team if it does not improve or if it is severe.

Liver problems

(May be severe)

Your health care team may check your liver function with a blood test. Liver changes do not usually cause any symptoms.


What to look for?

  • Rarely, you may develop yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. This may be severe.


What to do?

If you have any symptoms of liver problems, get emergency medical help right away.
 

Get emergency medical help right away.

Anemia (low red blood cells)

What to look for?

  • You may feel more tired or weaker than normal.
  • Pale skin and cold hands and feet.
  • You may feel short of breath, dizzy or lightheaded.
  • This may occur in days to weeks after your treatment starts.


What to do?

If your health care team has told you that you have anemia (low red blood cells):

  • Rest often and eat well.
  • Light exercise, such as walking may help.
  • You may need medication or a blood transfusion.
  • If it is very bad, your doctor may need to make changes to your treatment regimen.
Talk to your health care team if it does not improve or if it is severe.

Rash; dry, itchy skin; sensitivity to sunlight

What to look for?

  • You may have cracked, rough, flaking or peeling areas of the skin.
  • Your skin may look red and feel warm, like a sunburn.
  • Your skin may itch, burn, sting or feel very tender when touched.
  • Use a lip balm with sunscreen on your lips.
     

What to do?

To prevent and treat dry skin:

  • Use fragrance-free skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen and lip balm with UVA and UVB protection and a SPF of at least 50.
  • Avoid perfumed products and lotions that contain alcohol.
  • Drink 6 to 8 cups of non-alcoholic, non-caffeinated liquids each day, unless your health care team has told you to drink more or less.

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

Talk to your health care team if it does not improve or if it is severe.

Nausea and vomiting

(Generally mild)

What to look for?

  • Nausea is feeling like you need to throw up. You may also feel light-headed.
  • You may feel nausea within hours to days after your treatment.
     

What to do?

To help prevent nausea:

  • It is easier to prevent nausea than to treat it once it happens.
  • If you were given anti-nausea medication(s), take them as prescribed, even if you do not feel like throwing up.
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (like coffee, tea) and avoid alcohol.

If you have nausea or vomiting:

  • Take your rescue (as-needed) anti-nausea medication(s) as prescribed.
  • Ask your health care team for the Nausea & Vomiting pamphlet for more information.
  • Talk to your health care team if:
    • nausea lasts more than 48 hours
    • vomiting lasts more than 24 hours or if it is severe
Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if it is severe.

Diarrhea

What to look for?

  • Loose, watery, unformed stool (poo) that may happen days to weeks after you get your treatment.

What to do?

If you have diarrhea:

  • Take anti-diarrhea medication if your health care team prescribed it or told you to take it.
  • Do not eat foods or drinks with artificial sweetener (like chewing gum or ‘diet’ drinks), coffee and alcohol, until your diarrhea has stopped.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day, unless your health care team has told you to drink more or less.
  • Talk to your health care team if you can’t drink 6 to 8 cups of liquids each day when you have diarrhea. You may need to drink special liquids with salt and sugar, called Oral Rehydration Therapy.
  • Talk to your health care team if your diarrhea does not improve after 24 hours of taking diarrhea medication or if you have diarrhea more than 7 times in one day.

Ask your health care team for the Diarrhea pamphlet for more information.

Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day).

Slow or irregular heartbeat 

What to look for?

  • You may have an irregular or slow heartbeat, or fainting spells.
     

What to do?

Get emergency medical help right away.

Get emergency medical help right away.

Weight gain

What to look for?

  • You may notice your clothes fit tighter.
  • You may gain weight even though you have not changed the way you eat or exercise.

What to do?

  • Try to eat a healthy and well balanced diet.
  • Eat small meals throughout the day.
  • Ask your health care team to see a dietician to help you control your weight if this bothers you.
  • If you notice you are gaining weight, talk to your health care team to find out what may be causing this and what to do.
Talk to your health care team if it does not improve or if it is severe 
 

Other rare, but serious side effects are possible with this treatment.

If you have any of the following, talk to your cancer health care team or get emergency medical help right away:

  • Chest pain, new cough, breathing problems, or coughing up blood

  • Sudden severe pain in your belly or stomach area, or vomiting

  • Dry or watering eyes, redness, irritation, pain, sensitivity to light, or blurred vision

  • Pain, swelling or hardening of a vein in your arm or leg

  • Severe pain or weakness in your muscles

  • Dark red or brown coloured pee

  • Pain in your lower back, changes in urination (peeing) such as less urine than usual, or recent weight gain that is not normal for you

  • New swelling in your hands, ankles, feet or other areas of your body

For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.

Notes

September 2025 Updated/Revised patient information sheet

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.