Targeted Therapy / Oncology

Alunbrig (brigatinib)

Takeda Oncology · ALK / ROS1 / EGFR Tyrosine Kinase Inhibitor

FDA Approved 2017 Oral tablet Specialty Medication
Alunbrig brigatinib 90mg 180mg tablets, Takeda Oncology, ALK-positive NSCLC targeted therapy

What is Alunbrig? Alunbrig (brigatinib) is an ALK and ROS1 inhibitor by Takeda approved for adult patients with ALK-positive metastatic non-small cell lung cancer (NSCLC) — both as first-line therapy and after crizotinib.

About Alunbrig

Brand NameAlunbrig
Generic / INNbrigatinib
Drug ClassALK / ROS1 / EGFR Tyrosine Kinase Inhibitor
ManufacturerTakeda Oncology
AdministrationOral tablet
FDA Approval2017
📦 Available in 30 mg, 90 mg, and 180 mg tablets. Standard regimen uses 90 mg (7-day lead-in) then 180 mg daily.

FDA-Approved Uses for Alunbrig

Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.

  • ALK-positive metastatic non-small cell lung cancer (NSCLC) — first-line
  • ALK-positive metastatic NSCLC — after crizotinib
Biomarker Note: ALK gene rearrangement (fusion) testing is REQUIRED using an FDA-approved companion diagnostic (e.g., FISH, IHC, or NGS) before starting brigatinib.

How Does Alunbrig Work?

Brigatinib inhibits ALK (anaplastic lymphoma kinase), ROS1, and several mutant forms of EGFR. It also inhibits EGFR mutations including T790M. Brigatinib has demonstrated activity against several ALK resistance mutations including those arising from prior crizotinib therapy, and has good CNS penetration — important for brain metastases in ALK+ NSCLC.

Dosage & Administration

90 mg orally once daily for the first 7 days (lead-in dose), then 180 mg once daily if tolerated. Tablets can be taken with or without food. Dose reductions to 120 mg or 90 mg for toxicity.

⚠️ Important

Dosing is individualized by the prescribing clinician. Never adjust your dose without consulting your healthcare provider. This information is educational only and does not replace the official prescribing information.

Warnings, Precautions & Side Effects

General Warning

Early-onset pulmonary events (pneumonitis/ILD) — monitor closely especially during the first week. Hypertension. Bradycardia. Visual disturbances. CPK elevation / myalgia. Pancreatitis. Embryo-fetal toxicity. Photosensitivity.

⛔ Serious Warnings & Precautions
  • Pulmonary toxicity (early-onset within first 7 days)
  • Hypertension
  • Bradycardia
  • Severe visual disturbances
  • Pancreatitis
  • Embryo-fetal toxicity

Common Side Effects

  • Nausea
  • Diarrhea
  • Fatigue
  • Cough
  • Headache
  • Hypertension
  • Myalgia
  • CPK elevation
  • Visual disturbances

This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.

Storage & Handling

Store at room temperature 20°C to 25°C (68°F to 77°F). Store below 30°C.

BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.

Insurance Coverage, Prior Authorization & Patient Assistance

🛡️ Commercial Insurance

Alunbrig is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.

✅ Prior Authorization

Prior authorization is required by virtually all insurance plans for Alunbrig. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.

🏥 Medicare Coverage

Medicare Part D covers this oral specialty medication. Medicaid coverage varies by state.

🆓 Patient Assistance

Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.

Prior Authorization Patient Assistance Insurance & Savings Medication Costs

Frequently Asked Questions — Alunbrig

Alunbrig (brigatinib) is an ALK inhibitor by Takeda approved for ALK-positive metastatic NSCLC, as first-line therapy and after crizotinib. It has strong CNS penetration, making it effective against brain metastases.

The 7-day lead-in at 90 mg before escalating to 180 mg helps reduce the risk of early-onset pulmonary toxicity (pneumonitis), which can occur within the first days of treatment.

ALK gene rearrangement must be confirmed by an FDA-approved test (such as FISH, IHC, or NGS) before starting brigatinib.

Alunbrig is covered by most commercial insurance and Medicare Part D with prior authorization and ALK biomarker documentation.

Related Medications

Xalkori (crizotinib)  ·  Zykadia (ceritinib)  ·  Alecensa (alectinib)  ·  Lorbrena (lorlatinib)

Related Conditions

ALK-positive NSCLC  ·  Non-small cell lung cancer  ·  NSCLC with brain metastases

Comparisons

Keytruda Rybrevant

Authoritative References

Medical Disclaimer: This page is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your oncologist, hematologist, or licensed healthcare professional before making any treatment decisions. Last reviewed: August 2026 by the BiologicHealthPlus Clinical Team.