Halaven

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Halaven

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Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Halaven

Property Description
Active ingredient Eribulin mesylate
Form Solution for injection (intravenous)
Pharmacological class Microtubule dynamics inhibitor / Antineoplastic agent
General purpose To slow the growth of malignant cell populations
Origin Synthetic derivative (Marine macrolide analogue)

Halaven: Definition and Pharmacological Class

Halaven is a prescription-only, single-ingredient medication whose active substance is Eribulin mesylate (INN) classified as a potent microtubule dynamics inhibitor and an antineoplastic agent. This classification places it within the established therapeutic category of chemotherapy drugs used to manage cancer. Eribulin mesylate holds a unique position as a synthetic derivative—specifically, a macrocyclic ketone analogue of halichondrin B, a natural product originally isolated from a marine sponge. This distinct molecular structure supports its differentiation from older cytotoxic agents, providing an alternative mechanism for treating abnormal cell proliferation.


Eribulin's Composition, Form, and General Purpose

The medication is formulated as a sterile, clear, colorless solution for injection, contained within a single-dose vial consisting of the active Eribulin mesylate dissolved in an aqueous base. The sole route of administration is through intravenous infusion, which is required for effective systemic drug delivery. The general purpose of this therapy is directly linked to its function: by inhibiting tubulin polymerization, Eribulin disrupts the formation of the mitotic spindle, thereby arresting the cell's ability to divide. This action helps to slow the uncontrolled growth and spread of cell populations associated with malignant disease in adult patients.

Regulatory References

  1. NCI Drug Dictionary: Eribulin mesylate
  2. NIH LiverTox: Eribulin

What side effects are possible with Halaven?

Possible Side Effects and Safety Information

The official safety profile for Halaven (Eribulin mesylate) is structured around specific types and frequencies of adverse reactions, as documented by regulatory agencies. The most common effects are generally related to the drug's antineoplastic action, which targets rapidly dividing cells.


Regulatory Classification of Adverse Reactions

Adverse reactions are grouped by the body system affected and categorized by frequency:

  • Very Common Reactions (1 in 10 patients) include neutropenia (low white blood cells), anemia, fatigue/asthenia, alopecia (hair loss), and peripheral neuropathy (tingling or numbness). Common gastrointestinal effects such as nausea, constipation, and vomiting are also listed in this tier.

  • Common Reactions (1 in 100 to < 1 in 10 patients) include hypokalemia (low potassium), decreased appetite, dizziness, cough, and rash.


Serious Adverse Reactions and Constraints

Regulatory documents identify certain effects as serious, including severe or febrile neutropenia (fever with low white blood cells), which carries a risk of life-threatening infection, and sepsis. Additionally, there is a documented risk of QT prolongation, a change in the heart's electrical activity. Due to the risk of embryo-fetal toxicity, women of reproductive potential are required to use effective non-hormonal contraception during and for a specified time after treatment.


Population-Specific Safety Notes

The safety profile includes specific considerations for certain patient populations. For patients with pre-existing hepatic (liver) or renal (kidney) impairment, the regulatory labels document increased systemic drug exposure, which may lead to a higher incidence of severe neutropenia.

Overdose and Emergency Response

The official regulatory profile for Halaven (Eribulin mesylate) overdose is based on documented clinical experience following accidental over-exposure. An observed event involving a dose approximately four times the planned amount resulted in the presentation of severe toxicities. This information establishes the critical need for urgent medical care.


Documented Overdose Manifestations

The officially documented clinical outcomes following over-exposure included a Grade 3 Hypersensitivity reaction, which is classified as a severe immune response, and the subsequent development of Grade 3 Neutropenia, representing a severe decrease in white blood cells. These regulatory findings confirm that this over-exposure primarily affects the hematopoietic and immune systems.

Emergency Actions and Required Management

Immediate medical attention is required for any suspected or confirmed instance of Eribulin mesylate over-exposure. The official prescribing information mandates that the patient should be closely monitored by medical professionals due to the risk of severe complications. Management must be entirely symptomatic and rely on supportive medical interventions to address the presenting clinical manifestations. It is an official regulatory finding that no specific antidote is known for Halaven overdose. The documented Grade 3 toxicities dictate the necessity for urgent, specialized care.

Therapeutic Uses of Halaven

What Halaven Treats: Main Uses and Benefits

Treatment for Advanced, Pretreated Solid Tumors

Halaven (Eribulin mesylate) is commonly used for the therapeutic management of advanced cancer, specifically in adult patients with metastatic breast cancer and certain subtypes of unresectable liposarcoma. These are conditions characterized by periods of heightened symptoms and functional strain. The treatment is generally applied when the malignant disease has progressed following prior systemic regimens, and is used in situations involving certain distressing symptoms that are linked to organ-specific functional stress.


“This therapy is considered relevant for easing the overall symptomatic burden of the advanced condition when standard therapeutic options have been utilized.”


Quick Fact: Relief for Advanced Symptom Burden This medication supports symptom management in refractory settings, which may assist with managing symptoms related to systemic imbalance and helps maintain a sense of stability when symptoms are more noticeable.


Main Benefits for Disease Management

The main therapeutic benefit of this medication is used for managing the systemic manifestations of the advanced condition, which supports achieving sustained symptom management. For patients facing advanced disease, this action contributes to easing the overall symptom load and assists with maintaining functional stability, providing supportive relief when symptoms interfere with routine activities.

Regulatory References

  1. European Medicines Agency (EMA) overview

Eligibility and Restrictions for Use

Official Eligibility Status

Halaven (eribulin mesylate) is strictly indicated for adult patients with the approved metastatic breast cancer or liposarcoma indications. Its use is contraindicated for patients with known hypersensitivity to eribulin mesylate and for breast-feeding women. Use is not recommended during pregnancy due to the expectation of fetal harm, and effective contraception is mandatory for both male and female patients of reproductive potential.

Conditional Use and Restrictions

Eligibility for treatment initiation is conditional upon meeting specific baseline clinical criteria. Regulatory documents state that treatment must only begin if the patient has corrected any pre-existing electrolyte abnormalities (e.g., hypokalemia) and meets minimum hematological counts (Absolute Neutrophil Count and platelets).

Halaven should be avoided in patients with congenital long QT syndrome. The official label specifies that use is conditional in patients with mild or moderate hepatic impairment and moderate or severe renal impairment, while use in severe hepatic impairment (Child-Pugh C) is not established as it has not been studied in trials. The medicine has no relevant use for the approved indications in the pediatric population.

What should I know about interactions with other medicines?

Interactions with Other Medicines and Products

The official regulatory profile for Halaven (Eribulin mesylate) is defined by its potential for pharmacodynamic risk and its absence of major pharmacokinetic interactions with common metabolic modifiers.

Pharmacodynamic and Organ-Based Interactions

Property Official Regulatory Statement
QT-Prolongation Risk Co-administration with drugs known to prolong the QT interval carries the risk of an additive effect on QT-interval prolongation. Pre-existing Hypokalemia or Hypomagnesemia must be corrected prior to initiation to mitigate this risk.
Organ Impairment Systemic exposure is increased in patients with mild or moderate hepatic impairment or moderate or severe renal impairment, a factor which must be considered by a healthcare professional.
Contraindicated Condition The drug is avoided in patients with congenital long QT syndrome.

Metabolic and Procedural Constraints

Property Official Regulatory Statement
CYP/Transporter Effect No clinically meaningful pharmacokinetic interaction is expected with strong CYP3A4 inhibitors, CYP3A4 inducers, or P-glycoprotein (P-gp) inhibitors.
Administration Timing Halaven must not be diluted in or administered with dextrose-containing solutions or in the same intravenous line concurrent with other medicinal products.

Mechanism of Action

Targeting Microtubule Dynamics and Cell Cycle Arrest

The core mechanism involves Eribulin's binding to beta-tubulin at the plus-ends of microtubules, specifically inhibiting their growth (polymerization). This molecular action fundamentally disrupts the formation of the mitotic spindle, forcing cells into an irreversible G2/M phase mitotic block. This prolonged arrest activates the intrinsic signaling cascade that leads to apoptosis, or programmed cell death, resulting in the physiological effect of reducing the number of dividing cells.


Modulation of Tumor Microenvironment and Phenotype

Eribulin also exerts non-cytotoxic effects by modulating the surrounding tissue environment. It influences the reversal of the Epithelial-Mesenchymal Transition (EMT) phenotype, which is associated with increased cell mobility. This mechanistic influence suppresses cellular migration and limits the acquisition of the invasive cellular phenotype. Furthermore, the drug induces vascular remodeling within the tissue, which enhances tumor perfusion and mitigates hypoxia, thereby influencing the cell's phenotype and modulating the local physiological environment.

Dosage and Administration Information

How to Use Halaven: Official Administration Guidelines

Halaven (Eribulin mesylate) is administered following a precise 21-day cyclical regimen. The medication is formulated as a sterile solution, and its administration requires specific procedural adherence to ensure proper use, as detailed in prescribing information.


Administration Scope

Feature Guideline
Route of administration Intravenous (IV) injection or short infusion only.
Dosing schedule Standard dose is 1.4 mg/m^2 (mesylate) given on Day 1 and Day 8 of a 21-day cycle.
Infusion Duration Administered over 2 to 5 minutes per dose.
Preparation May be administered undiluted or diluted in up to 100 mL of 0.9% Sodium Chloride. Must not be mixed with dextrose solutions.

Usage Patterns and Adjustments

Treatment follows the intermittent 21-day cycle until disease progression or predetermined toxicity requires cessation. The dosing is body surface area-based to ensure precise delivery. Administration must be supervised by a qualified healthcare professional.

The protocol dictates specific dose adjustments for certain patient populations. A reduced starting dose, such as 1.1 mg/m^2 (mesylate), is required for adult patients diagnosed with moderate to severe renal impairment or mild hepatic impairment (Child-Pugh A). Administration on Day 1 or Day 8 must be delayed if pre-dose assessments indicate specific toxicity levels, and any subsequent resumption of treatment must be at a permanently reduced dose.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Halaven

The evidence supporting the use of Halaven (Eribulin mesylate) was observed in official clinical trials and observational studies that have been reviewed by health regulatory bodies. This section describes the types of research conducted, the outcomes measured, and the areas where evidence remains limited or uncertain.


Evidence for use in Metastatic Breast Cancer

The primary clinical research supporting Halaven in metastatic breast cancer (mBC) involved large, randomized controlled trials (RCTs). These studies were applied in research contexts involving fluctuating or unstable symptoms in adult patients whose disease had already progressed after receiving a number of prior chemotherapy treatments. Halaven was evaluated against control groups that received other existing treatments.

Trial Design and Measured Outcomes

The trials monitored outcomes related to disease progression, focusing primarily on Overall Survival (OS)—a measurement of the duration of life—and Progression-Free Survival (PFS)—a measurement of time before disease progression or death. The primary registration trial (EMBRACE) reported that the median Overall Survival measurement was greater in the Eribulin group when compared to the control group (Treatment of Physician's Choice). However, another large Phase 3 trial where Eribulin was compared directly against capecitabine reported comparable measurements for both OS and PFS in the observed populations. Research provides context but not individual predictions.


Evidence for use in Advanced Liposarcoma

Halaven was studied for the management of locally advanced or metastatic liposarcoma, a subtype of soft tissue sarcoma. This research primarily involved a large Phase 3 RCT that evaluated Halaven against another chemotherapy called dacarbazine in adult patients.

Subgroup Analysis and Focus on Specific Sarcoma Types

The study reported patterns observed in the liposarcoma subgroup related to the median Overall Survival measurement being greater in the Eribulin group when compared to the dacarbazine group. The evidence for regulatory clearance was primarily informed by the results from this specific liposarcoma subgroup analysis.


Research Gaps and Areas of Uncertainty

Clinical trials for advanced conditions typically focus on intermediate-term outcomes. For Halaven, the key regulatory studies had median follow-up durations ranging from approximately 10 to 14 months. Long-term effects are not fully established, and data are still emerging from real-world observational settings. Data for certain groups, such as children or individuals with severe co-existing health conditions, remain insufficient.

Frequently Asked Questions (FAQ)

Common questions about Halaven (FAQ)


Q: Is Halaven approved for early-stage breast cancer or only for advanced disease?

A: Official regulatory documents indicate that Halaven is approved for the treatment of patients with metastatic breast cancer who have already received certain prior chemotherapy regimens, and for locally advanced or metastatic liposarcoma. The approved indications are for these advanced stages of disease, not for early-stage conditions.


Q: Can the nerve problems (neuropathy) caused by Halaven become permanent?

A: Peripheral neuropathy, which is tingling or numbness, is a common side effect of Halaven. Regulatory patient information indicates that the symptoms may resolve slowly after treatment is stopped. However, for some individuals, the complete disappearance of the condition may not occur.


Q: Are there specific symptoms that indicate a serious infection while on Halaven?

A: Low white blood cell count (neutropenia) is a risk with Halaven and can lead to serious infection. Official safety information describes specific symptoms that should be reported to the healthcare provider immediately, such as a fever (temperature above 100.5 F or 38 C), chills, cough, or burning/pain when urinating, as these may be signs of infection.


Q: Are there any specific vitamins, supplements, or herbal products that should be avoided?

A: Official drug information states that Halaven is not expected to have meaningful interactions with common drug metabolism systems. Official patient counseling materials emphasize the importance of ensuring the healthcare provider is aware of all medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements, when treatment is initiated or ongoing.


Q: Does Halaven interact negatively with common over-the-counter pain medications?

A: Official warnings exist regarding co-administration with other medicines that are known to prolong the QT interval, a change in the heart’s electrical activity. While the product label does not specifically address all common over-the-counter pain medications, official guidance notes that a healthcare provider should be informed about all medications taken to allow for the checking of potential risks.


Q: How is Halaven prescribed differently for breast cancer versus liposarcoma?

A: The official dose is the same for both metastatic breast cancer (mBC) and liposarcoma indications. The key difference in regulatory approval lies in the prior treatments a patient must have already received before Halaven is considered appropriate for each specific condition.


Q: What are the regulatory guidelines regarding breastfeeding during and after Halaven treatment?

A: Official regulatory information states that breastfeeding is contraindicated during treatment with Halaven. Furthermore, the guidance specifies that patients should not breastfeed for at least 2 weeks following the final dose of the medication.


Q: How quickly does hair loss typically begin after starting Halaven?

A: Hair loss, or alopecia, is a very common side effect reported in official patient information. This information indicates that hair loss typically begins approximately two to three weeks after starting treatment with Halaven.


Q: How long after stopping Halaven does hair usually start to grow back?

A: Alopecia is listed as a temporary, expected side effect. Official patient information states that hair generally starts to regrow soon after treatment is completed.


Q: Is it common to feel unusually tired or weak (fatigue) during treatment cycles?

A: Yes, official documents classify tiredness or weakness (asthenia/fatigue) as a Very Common reaction. This means it was observed in over 50% of patients in clinical trials, making it a highly frequent side effect during treatment.


Q: Does Halaven cause nausea, and is it manageable with other medicines?

A: Nausea and vomiting are listed as Very Common reactions in the official safety profile. Official patient counseling materials indicate that the healthcare team can provide medications to help manage and control these side effects.


Q: Is it possible to become dehydrated easily while undergoing Halaven treatment?

A: Yes, according to some regulatory documents, dehydration is listed as a Common side effect, meaning it may affect up to 1 in 10 people. Patients are generally advised to consult their healthcare team if they have concerns about dehydration during therapy.


Q: Can Halaven cause changes to a patient's sense of taste or smell?

A: Yes, official regulatory documents list a 'changed sense of taste' as a Common side effect, meaning it may affect up to 1 in 10 people. Changes to taste are a known potential side effect of the medication.


Q: Does Halaven cause a change in blood pressure or heart rate?

A: Official regulatory documents list a fast heart rate, known as tachycardia, and flushing as Common side effects. These reactions may affect up to 1 in 10 people receiving Halaven.


Q: How is it determined how long a patient will continue to receive Halaven?

A: Official administration instructions state that treatment is administered in 21-day cycles and is continued until one of two events occurs: the disease progresses, or unacceptable toxicity requires the cessation of therapy.


Q: What are some less common but important side effects to be aware of, like blood clots?

A: Official safety documents list blood clots in the lungs as a Common side effect (affecting up to 1 in 10 people) and blood clots generally as an Uncommon side effect (affecting up to 1 in 100 people). These effects are part of the drug’s official safety profile and may be a topic for discussion with a healthcare provider.


Q: Does the risk of peripheral neuropathy change with the duration of Halaven treatment?

A: Official patient information indicates that the nerve problems (peripheral neuropathy) can get progressively worse with the administration of additional doses of the medication. This potential for increased severity may lead to a dose delay or dose adjustment by the healthcare team.


Q: Can Halaven impact a patient's vision or eye health?

A: Yes, official regulatory documents list an increased production of tears (lacrimation) and conjunctivitis (redness and soreness of the eye surface) as Common side effects. These effects may impact up to 1 in 10 people.


Q: Is it typical to experience joint or muscle pain while taking Halaven?

A: Official documents list pain in the joints or muscles (known as arthralgia/myalgia) as a Common adverse reaction. This type of pain was reported in approximately 20% of patients in clinical trials for metastatic breast cancer.


Q: Is Halaven ever given alongside other chemotherapy drugs or treatments?

A: While the regulatory-approved dosage is for single-agent use, the drug has been studied and is referenced in supportive literature as potentially being used in combination with other treatments. This combined use is typically under certain conditions or for specific disease types, such as HER2-positive breast cancer.


Q: What specific types of breast cancer cells (like HER2-positive) has Halaven been studied in?

A: While the core regulatory label applies to metastatic breast cancer generally, official-use supporting documents mention that Halaven may be used as a single agent for HER2-negative disease. It may also be used in combination with other treatments for specific conditions like HER2-positive breast cancer.


Q: Are there any known effects of Halaven on fertility for male and female patients?

A: Regulatory nonclinical toxicology data indicates that testicular toxicity was observed in animal studies. Official patient information states that male fertility may be compromised by this drug and that male partners of childbearing potential should use effective contraception.


Q: Is it common to experience changes in appetite or weight during treatment?

A: Yes, decreased appetite (anorexia) and decreased weight are both listed in official documents as Common adverse reactions. Each occurred in approximately 20% of patients in clinical trials.


Q: Can Halaven treatment lead to changes in blood sugar or electrolyte levels?

A: Yes, official documents list hypokalemia (low potassium) as a Common laboratory abnormality. Changes in the level of sugar, phosphates, calcium, and magnesium in the blood are also listed as Common adverse reactions.


Q: Is it true that Halaven can cause difficulty with sleeping or changes in mood?

A: Yes, official regulatory documents list an inability to sleep (insomnia) and depression as Common side effects. These mood and sleep changes may affect up to 1 in 10 people.


Q: Does having diabetes affect who can receive Halaven treatment?

A: Official prescribing information does not list diabetes as a contraindication. However, regulatory documents list 'altered level of sugar' in the blood as a Common side effect, which suggests close monitoring of blood sugar levels may be necessary during treatment.


Q: Are there special precautions for dental care or minor cuts while on Halaven?

A: Due to the risk of a low white blood cell count (neutropenia), patients may have a higher risk of infection. Official information indicates that if a patient experiences a sore that does not heal, including issues on the skin or in the mouth, this is a symptom that must be reported to the healthcare team.


Q: Do patients need to be cautious about driving or operating machinery due to side effects?

A: Official documents state that Halaven may cause side effects such as tiredness and dizziness, which can affect the ability to drive or use machines. The guidance in official documents is that patients who experience tiredness or dizziness are generally cautioned about driving or using machinery.


Q: Can patients experience skin or nail changes while receiving Halaven?

A: Yes, official regulatory documents list rash, itching, and nail problems as Common side effects. These skin and nail changes may affect up to 1 in 10 people.


Q: Are there certain types of liver or kidney function tests that are monitored specifically for Halaven?

A: Yes, official documents advise monitoring blood cell counts and looking for electrolyte abnormalities. Liver and kidney function are monitored, as the dose may be reduced based on liver function tests (bilirubin, AST/ALT) and creatinine clearance (kidney function).


Q: What happens if a patient misses a scheduled treatment day?

A: The Day 8 dose in the treatment cycle may be delayed for up to one week if pre-dose assessments indicate specific toxicity levels. If those toxicities do not resolve or improve to an acceptable level by Day 15, the dose is typically omitted for that cycle.


Q: Is it true that patients on Halaven are more prone to mouth sores or stomatitis?

A: Official documents list mucosal inflammation as a Common adverse reaction. Mouth ulcers and stomatitis (inflammation of the mouth) are listed as Uncommon side effects, meaning they may affect up to 1 in 100 people in some regulatory documents.


Q: Are there any documented long-term effects of Halaven that can occur after treatment stops?

A: Due to the nature of the clinical trials, the full range of long-term effects is not completely established. However, official information does mention that the peripheral neuropathy (nerve problems) may not go away completely in some individuals after treatment is stopped.


How should Halaven be stored and disposed of?

How to Store and Dispose of Halaven?

The storage and disposal of Halaven (Eribulin mesylate) solution for injection must strictly follow regulatory requirements, as it is classified as a cytotoxic agent.


Storage Requirements

Intact vials must be stored at 25 C (77 F), with permitted excursions between 15 C and 30 C. It is mandatory to store the medication in its original carton to protect it from light. The vials must not be frozen or refrigerated.

After preparation, stability is limited: both undiluted and diluted solutions are stable for a maximum of 4 hours at room temperature or 24 hours under refrigeration at 4 C.


Handling and Disposal

Halaven is a single-use vial, and any unused portion must be discarded. Medications must be kept out of the sight and reach of children.

Patients must not throw away this medicine via wastewater or household waste. Due to its classification, disposal of the unused product must be done by asking a pharmacist for instruction on proper pharmaceutical waste handling.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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