Eribulin (Halaven)

Eribulin is a chemotherapy drug used to treat breast cancer. 

It’s also known by the brand name Halaven.

Eribulin is used to treat breast cancer that has:

• Spread to the chest wall or skin of the breast, or the lymph nodes around the chest, neck and under the breastbone (known as regional recurrence or locally advanced breast cancer)
• Spread to other parts of the body (secondary breast cancer)

You may be given eribulin if you have already had 1 or more chemotherapy drugs for locally advanced or secondary breast cancer.

Before starting your treatment, a member of your treatment team will discuss how and when you’ll have chemotherapy and how side effects can be managed.

You’ll have blood tests and your height and weight will be measured.

You may also have tests to check your heart function, such as:

• An ECG (electrocardiogram), a simple test that checks your heart rhythm
• An echocardiogram, an ultrasound scan of the heart

You should be given a 24-hour contact number or told who to contact if you feel unwell at any time during your treatment, including at night or at the weekends.

Eribulin is given into a vein (intravenously).

This will usually be through a cannula, a small tube that’s inserted into a vein in the back of your hand or lower arm.

You could also have eribulin through:

• A skin-tunnelled catheter (Hickman line): a tube inserted into a vein in your chest
• A peripherally inserted central catheter (PICC): a tube inserted into a vein in your arm at or above the bend in your elbow
• An implanted port: a small device with a tube that goes into a vein that’s put under the skin, usually in your chest or arm

A cycle of eribulin lasts 21 days, with treatment given on days 1 and 8 of the cycle. The time between each cycle of treatment gives your body time to recover.

How long will I have eribulin for?

You’ll have eribulin for as long as your treatment team feels you’re benefiting from it and any side effects are manageable. 

Like any treatment, eribulin can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others.

These side effects can usually be managed and those described here will not affect everyone.

If you’re worried about any side effects, regardless of whether they’re listed here, talk to your chemotherapy nurse or treatment team as soon as possible.

Common side effects of eribulin

Effects on the blood

Eribulin can temporarily affect the number of blood cells in the body. Blood is made up of red cells, white cells and platelets.

You’ll have regular blood tests. If these show the number of blood cells is too low, your next cycle of treatment may be delayed, or the dose of chemotherapy reduced.

Your treatment team may change the dose of a drug to suit you and to help manage its side effects. This may help you stay on the treatment for longer.

Risk of infection

Not having enough white blood cells can increase your risk of getting an infection. 

Sometimes your treatment team may recommend injections of drugs called growth factors. This helps the body produce more white blood cells to reduce your risk of infection.  

Anaemia

Having too few red blood cells is called anaemia. If you feel particularly tired, breathless or dizzy, let your treatment team know.

Bruising and bleeding

Eribulin can reduce the number of platelets. Platelets help the blood to clot.

If your platelets are low, you may:

• Bruise more easily
• Have nosebleeds
• Notice that your gums bleed when you brush your teeth
• Take longer to stop bleeding if you cut yourself

Tell your treatment team if you have any of these symptoms.

Hair loss

Many people will experience hair loss or hair thinning, including eyebrows, eyelashes and body hair.

Scalp cooling may stop you losing some or all of the hair on your head during chemotherapy. Not all hospitals offer scalp cooling so ask your treatment team or chemotherapy nurse if it is available and suitable for you.

Read more about hair loss, scalp cooling and looking after your hair.

Extreme tiredness (cancer-related fatigue)

Cancer-related fatigue is one of the most common symptoms in people with secondary breast cancer.

Fatigue is extreme tiredness that does not go away with rest or sleep. It has many causes, from the emotional impact of a diagnosis to side effects of treatment or growth and spread of the cancer.

Fatigue may affect how you cope with your cancer and its treatment. It can also make everyday activities harder and affect your quality of life.

Find out more about managing fatigue.

Nausea and vomiting

You may feel sick (nausea) but most people will not actually be sick (vomit).

You’ll be given anti-sickness drugs into your vein or as a tablet before the chemotherapy is given. You’ll also be prescribed anti-sickness drugs to take home to reduce nausea or stop it happening.

If you have nausea or vomiting, contact your treatment team. They can adjust your anti-sickness medication or prescribe a different anti-sickness drug for the next chemotherapy treatment.

Diarrhoea or constipation

You may have diarrhoea or constipation. Your treatment team can prescribe medicine to help control it and can give you information about diet.

Contact your treatment team if you have diarrhoea 3 or more times in 24 hours, compared to what’s usual for you.

Also let your treatment team know if you have constipation.

Joint or muscle pain

You may have pain in your jaw, joints or muscles. Let your treatment team know if this happens. They can prescribe medication for pain relief.

Headaches

Eribulin may cause headaches. Your treatment team can tell you how to manage these or prescribe pain relief to help.

Damage to the lungs

Eribulin can affect the lungs.

Contact your treatment team straight away if you have:

• Shortness of breath
• A cough, with or without a high temperature
• Any new or worsening breathing problems, such as chest tightness or wheezing

These symptoms could be due to scarring or inflammation of the lungs caused by eribulin. Or they may have another cause, such as a lung infection.

You may need a chest x-ray or CT scan to check what’s causing your symptoms.

If eribulin has caused inflammation to your lungs, you may need to stop treatment temporarily and have steroids to treat the inflammation. 

Numbness and tingling in the hands or feet

You may have pain, numbness or tingling in your hands and feet after you have your treatment. This is due to the effect of eribulin on the nerves and is known as peripheral neuropathy.

Other symptoms of peripheral neuropathy can include difficulty doing “fiddly” tasks like doing up buttons, a feeling of warmth or cold in your hands and feet, or loss of balance.

Symptoms are often mild to start with and can gradually get worse.

For some people the symptoms stay mild and go away soon after treatment stops. However, for most people, the symptoms will gradually improve over the weeks and months after treatment has finished.

Symptoms may take longer to improve and, in some cases, may not go away completely.

If you have symptoms of peripheral neuropathy, tell your treatment team so they can monitor them.

Loss of appetite

You may lose your appetite while having eribulin, which could lead to weight loss.

Talk to your treatment team about this. They can give you information to help deal with loss of appetite or refer you to a dietitian if needed. 

Less common side effects of eribulin

Sore mouth

Looking after your mouth, including your teeth and gums, is very important during treatment. 
You may be given a mouthwash to reduce soreness and prevent mouth ulcers developing. It’s a good idea to use a small, soft toothbrush during this time.

See your dentist for a check-up before chemotherapy begins. Avoid dental work during these treatments if possible.

If you need any dental work during treatment, speak to your treatment team about the best time to have this.

If you’re having difficulty registering with a dentist, let your treatment team know.

Taste changes

Eribulin can make some food taste different, for example more salty, bitter or metallic. This usually returns to normal once you have finished treatment, although this may take some time.

Our information on diet during breast cancer treatment includes tips on dealing with taste changes.

Indigestion and heartburn

If you have indigestion or heartburn, it can usually be treated with medication from your treatment team or GP.

Heart changes

Eribulin can affect the way your heart works and may not be suitable if you have an existing heart condition.

You may have a heart (cardiac) function test called an ECG (electrocardiogram) to see if your heart is working normally both before and during your treatment.

If you have palpitations, where your heart feels like it's pounding, fluttering, beating irregularly or fast, or chest pain, tell your treatment team immediately or go to A&E straight away.

Menopausal symptoms

If you haven’t been through the menopause, eribulin can cause menopausal symptoms. This is because it affects the ovaries, which produce oestrogen.

Common menopausal symptoms can include:

• Hot flushes
• Night sweats
• Mood changes
• Joint aches and pains
• Vaginal dryness

You can talk to your breast care nurse or treatment team about the ways of coping with any of these symptoms.

Find out more about managing menopausal symptoms.

Skin and nail changes

You may develop a rash anywhere on your body or your skin might change colour. It could be red and itchy or you may feel flushed. Your treatment team might prescribe medicine to help.

If you have skin reactions, mention this to your treatment team they can monitor the symptoms.

Some people have a skin reaction called hand-foot syndrome (palmar-plantar erythrodysesthesia). It usually affects the palms of the hands and soles of the feet, but you may also have symptoms in other areas like the skin on the knees or elbows.

Liver changes

Eribulin can affect how well your liver works. You’ll have regular blood tests to monitor this throughout your treatment.

This is a temporary effect and the liver usually returns to normal soon after your treatment has stopped.

Let your treatment team know if you have had any liver problems in the past caused by hepatitis or drinking excess alcohol.

Tummy (abdominal) pain

You may have tummy pain or discomfort or feel bloated. Let your treatment team or GP know so they can prescribe medication to help.

Eye problems

Eribulin can cause eyesight changes such as blurred vision. It can also make your eyes sore, itchy, dry and cause an infection.

Contact your treatment team as soon as possible if you have any of these symptoms.

Other less common side effect

Other less common side effects include:
•   Difficulty sleeping
•   Low mood and depression

Driving and using machinery

Eribulin can make you feel sleepy and may affect your ability to drive or operate machinery safely.

Avoid driving or using machinery until you are sure eribulin does not make you feel sleepy.

Allergic reaction

If you have an allergic reaction to eribulin, it will probably happen within the first few minutes of your treatment and is most likely the first or second time you have the drug.

Reactions can vary from mild to severe, but severe reactions are uncommon.

You’ll be monitored closely so that any reaction can be dealt with immediately.

Symptoms of an allergic reaction include:

• Flushing
• Skin rash
• Itching
• Back pain
• Lip or tongue swelling
• Shortness of breath
• Faintness
• Fever or chills

If you have a severe reaction, treatment will be stopped immediately.

Medication can be given before future treatments to reduce the risk of further reactions.

Blood clots

People with breast cancer have a higher risk of blood clots.

Having eribulin also increases the risk of blood clots such as a DVT (deep vein thrombosis).

If you have a DVT, there’s a risk part of the blood clot could break away and travel to the lung. This is known as a pulmonary embolism (PE).

Blood clots can be life-threatening and should be treated quickly. 

Taking other medications

Tell your treatment team about any prescribed or over-the-counter medicines you’re taking.

Ask their advice before taking any herbal products or supplements.

Sex, contraception and pregnancy

You can still have sex during treatment. It’s thought chemotherapy drugs cannot pass into vaginal fluids or semen, but this cannot be completely ruled out.

Most treatment teams will advise using barrier methods of contraception, such as condoms, during treatment and for a few days after chemotherapy is given.  

Women are advised not to become pregnant while having treatment because eribulin can harm a developing baby. If you have not been through the menopause, talk to your team about the most suitable method of contraception for you. It’s still possible to become pregnant even if your periods are irregular or have stopped.

Men taking eribulin should not father a child during treatment.

Speak to your treatment team about the most suitable method of contraception for you and how long to use it for after the last dose of eribulin.

Find out more about how breast cancer and its treatment can affect sex and intimacy and read our tips on how to manage these changes.

Fertility

It’s not clear whether eribulin affects fertility.

If you were diagnosed with locally advanced or secondary breast cancer before you started or completed a family, you may be concerned about your fertility.

You can talk to your treatment team about any possible fertility preservation options before starting treatment.

Breastfeeding

You’ll be advised not to breastfeed during treatment with eribulin. This is because there is a chance that your baby may absorb the drug through your breast milk, which can cause harm.

Travel and vaccinations

If you’re planning a holiday or need to travel overseas, check with your treatment team first.

You should not have any live vaccines while you’re having treatment. 

For more information about vaccines, including COVID-19 and flu vaccines, see our information on vaccines and breast cancer.

Being diagnosed with secondary breast cancer can make you feel lonely and isolated.

If you would like any further information and support about breast cancer or just want to talk things through, you can speak to one of our nurses. See the bottom of this page for ways to get in touch.

And you can visit our online forum where you can speak to people who are going through the same treatment as you.