How to Take Tagrisso in Relation to Meals
Tagrisso (osimertinib) can be taken without regard to food—administration with or without meals does not affect drug absorption or efficacy. 1, 2
Administration Guidance
- Take osimertinib at any time relative to meals, as food does not clinically impact osimertinib exposure 1, 2
- A formal pharmacokinetic study demonstrated that co-administration with a high-fat, high-calorie meal (containing approximately 58 grams of fat and 1000 calories) resulted in comparable Cmax and AUC to fasting conditions 1
- The geometric least-squares mean ratios for fed versus fasted states were 106.05% for AUC and 92.75% for Cmax, confirming no clinically meaningful difference 2
Dosing Schedule
- Administer 80 mg orally once daily as the standard dose for EGFR-mutated advanced NSCLC 1, 3
- Maintain consistent daily dosing at approximately the same time each day for optimal steady-state concentrations, which are achieved after 15 days 1
- The median time to peak concentration (Cmax) is 6 hours (range 3-24 hours), regardless of meal timing 1
Special Consideration for Hypomagnesemia
- Continue osimertinib at full dose (80 mg daily) while treating hypomagnesemia, as this electrolyte abnormality alone does not warrant dose modification or treatment interruption 4
- However, correct magnesium deficiency before continuing osimertinib if QTc is borderline elevated, as hypomagnesemia exacerbates QTc prolongation and increases risk of torsades de pointes 4
- Routine metabolic monitoring is required throughout treatment, as EGFR-targeted therapies can cause electrolyte disturbances 4
Critical Monitoring Requirements
- Osimertinib is contraindicated in patients with mean resting QTc >470 msec 4, 5
- Baseline and periodic ECG monitoring for QTc prolongation is recommended, especially in patients with cardiac risk factors or concurrent electrolyte abnormalities 5
- Review and minimize concurrent QT-prolonging medications before initiating therapy 5
Common Pitfall to Avoid
- Do not instruct patients to take osimertinib only with food or only on an empty stomach—this unnecessary restriction has no pharmacokinetic basis and may reduce adherence 1, 2
- Do not discontinue osimertinib for isolated hypomagnesemia without QTc prolongation, as this does not meet criteria for treatment interruption 4