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Overview: Zepzelca is a medicine that is given by an infusion into a vein for certain people with a type of cancer called small cell lung cancer. Nausea and tiredness are common side effects. This medicine can cause severe side effects that may be picked up by blood testing. Keep all appointments to have your blood checked. Tell your health care provider right away if you get severe muscle pain or weakness, vomiting, stomach pain, fever, unusual bleeding or bruising, or an infection.

Uses

What is Zepzelca used for?

Zepzelca (lurbinectedin) is commonly used for the treatment of small cell lung cancer (SCLC) in certain people. Zepzelca is used with another medicine called Tecentriq or Tecentriq Hybreza in certain situations.

Zepzelca may also be used for other conditions as determined by your health care provider.

How does Zepzelca work (mechanism of action)?

Zepzelca is a type of chemotherapy. Zepzelca is known as an alkylating agent. This medicine damages DNA, which helps kill cancer cells.

How is Zepzelca supplied (dosage forms)?

Zepzelca is available in an injectable form that is given by a health care provider.

How should I store Zepzelca?

Zepzelca is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Zepzelca?

The most common side effects of Zepzelca are listed below. These side effects may vary depending on whether you are using Zepzelca with another medicine. Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of Zepzelca that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Zepzelca?

While less common, the most serious side effects of Zepzelca are described below, along with what to do if they happen.

Severe Allergic Reactions. Zepzelca may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Bone Marrow Suppression. Zepzelca may cause your bone marrow to not make enough cells. This can lead to low blood levels of important cells, such as red blood cells, white blood cells, platelets, and neutrophils. Bone marrow suppression can lead to infections or bleeding. These can be serious or even life-threatening. Keep all appointments to have your blood checked. Tell your health care provider right away if you have any of the following symptoms of bone marrow suppression.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using Zepzelca. Keep all appointments to have your blood checked. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Tissue Damage. Zepzelca is given as an infusion into a vein. If the medicine does not go into your vein, it could damage nearby tissue. Tell your health care provider right away if you see any fluid leaking where the medicine is going into your vein or if you have pain, swelling, warmth, itching, or skin color changes where the medicine is being or was given.

Warnings & Precautions

Who should not use Zepzelca?

Allergies to Ingredients. People who are allergic to any of the following should not use Zepzelca.

  • Lurbinectedin
  • Zepzelca
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Zepzelca.

What should I know about Zepzelca before using it?

Zepzelca is usually given by a health care provider in a hospital or clinic. Your health care provider may give you certain medicines to help prevent side effects.

Keep all appointments, including for blood tests, while you are using Zepzelca. This helps your health care provider make sure the medicine is safe for you. Your health care provider may adjust your dose, pause, or stop the medicine if you have certain side effects. 

If you can get your partner pregnant, use birth control such as condoms during your treatment with Zepzelca and for 4 months after your last dose.

People who are 65 years of age or older can be at greater risk of some side effects from Zepzelca. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using Zepzelca?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Zepzelca is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Kidney problems

Other Medicines and Supplements. Zepzelca may interact with other medicines and supplements. Before using Zepzelca, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Zepzelca can cause harm to an unborn baby. Your health care provider may give you a test to make sure you are not pregnant before you start Zepzelca treatment. If you can get pregnant, you should use effective birth control while using Zepzelca and for 6 months after your last dose. Tell your health care provider right away if you are pregnant, think you may be pregnant, or plan to become pregnant.

Breastfeeding. Do not breastfeed during Zepzelca treatment and for 2 weeks after your last dose. It is not known if Zepzelca passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Zepzelca?

For more information about Zepzelca, you can visit the drugmaker’s website at www.zepzelca.com or call them at 800-520-5568.

Interactions

Does Zepzelca interact with foods or drinks?

Do not eat or drink anything with grapefruit or Seville oranges while you are using Zepzelca. Both of these fruits can increase the amount of Zepzelca in your body and cause side effects.

It is unknown if drinking alcohol will affect Zepzelca, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does Zepzelca interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Zepzelca.

  • Itraconazole (Sporanox, Tolsura), which is a medicine used for fungal infections
  • Verapamil (Verelan, Verelan PM), which is a medicine used for high blood pressure or chest pain

Many other medicines may alter the blood levels of Zepzelca. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Zepzelca. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Zepzelca?

If you or someone else has used too much Zepzelca, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Zepzelca?

Zepzelca is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving Zepzelca as scheduled.

If you miss an appointment to get your Zepzelca dose, call to make another appointment as soon as possible.