Eribulin

Microtubule inhibitors
Microtubule inhibitors
High alert
An error with this medicine can cause serious harm: double checks and protocols are used.

Synthetic copy of a sea-sponge toxin that stops microtubule growth. For metastatic breast cancer and liposarcoma; causes neutropenia and neuropathy.

Updated Nov 1, 2026

Quick facts

Group: Microtubule inhibitors
Target: β-tubulin (vinca site, at the growing end of the microtubule)
Used for: Unresectable
Key effects: Neutropenia and anaemia · Tiredness and weakness
Monitor: Blood count before each dose · Signs of neuropathy
ATC: L01XX41

No doses: the clinician sets them by the current guideline.

Mechanism of action

β-tubulin (vinca site, at the growing end of the microtubule)Eribulin

The crystal shows eribulin bound to bovine α/β-tubulin at the vinca site of β-tubulin.

Target in 3D: β-tubulin (vinca site, at the growing end of the microtubule). PDB structure 5JH7 (RCSB PDB, public domain). View the structure at RCSB PDB

Eribulin is a synthetic analogue of halichondrin B, a polyether macrolide from the marine sponge Halichondria okadai. It binds the vinca site of β-tubulin and blocks only the growth phase of microtubules, without affecting their shortening, and it pulls tubulin into useless aggregates. The mitotic spindle cannot form, the cell stalls in G2/M and dies by apoptosis. It is a poor substrate for the P-glycoprotein efflux pump, so it can act in tumours resistant to other tubulin drugs.

Eribulin binds the vinca site on β-tubulin
Microtubules stop growing; tubulin forms useless clumps
No spindle: the cell arrests in G2/M and dies

Indications

Metastatic breast cancer after at least two chemotherapy regimens for metastatic disease, including an anthracycline and a taxane. Breast cancer →
Unresectable or metastatic liposarcoma after an anthracycline-containing regimen.

Adverse effects

Common

Neutropenia and anaemia
Tiredness and weakness
Hair loss
Nausea, constipation, loss of appetite
Bone, back or joint pain, headache

Contraindications

The label lists none; congenital long QT syndrome is avoided

Key interactions

Drugs that prolong the QT interval: Add to the QT prolongation; the ECG is followed.
Dextrose-containing solutions and other drugs in the same line: Not mixed or given together with eribulin.

What is monitored

Blood count before each dose
Signs of neuropathy
ECG in heart failure, slow heart rate, QT drugs or electrolyte problems
Potassium and magnesium, corrected before treatment

Administration and safety

Intravenous injection over a few minutes by a doctor or nurse.
Not mixed with other drugs and not given with dextrose-containing solutions.
The starting dose is lowered in liver impairment and in moderate or severe kidney impairment.
Hazardous drug: prepared and disposed of under cytotoxic-drug procedures.

Pregnancy and breastfeeding

Can cause fetal harm; effective contraception is used during treatment and breastfeeding is stopped.

Nursing care

Check the neutrophil count before each dose.
Ask about numbness, burning or tingling before each dose.
Ask about long QT, slow heart rate, low potassium or magnesium, and heart, liver or kidney disease.
Teach to report fever, sore throat, painful urination or an irregular heartbeat.

Pharmacokinetics

Absorption: Intravenous injection over a few minutes.
Distribution: Wide; moderately bound to plasma proteins.
Metabolism: Hardly metabolised: it circulates mostly unchanged; CYP3A4 plays a negligible role.
Elimination: Mainly unchanged in the faeces, a small part in the urine; exposure rises in liver and kidney impairment.
Half-life: About 40 hours.

Test yourself

Think of the answer, then tap the question to see it.

Where does eribulin come from, and where does it bind tubulin?

It is a synthetic analogue of halichondrin B from a marine sponge, and it binds the vinca site of β-tubulin.

Which infusion fluid must not be used with eribulin?

Dextrose-containing solutions.

Which ECG finding is watched during eribulin treatment?

QT prolongation, especially with heart failure, slow heart rate, QT drugs or electrolyte problems.

Add to my cards (3)

Connections

← Back to the class: Microtubule inhibitors

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: DailyMed - ERIBULIN MESYLATE injection (DailyMed (U.S. National Library of Medicine), 2025); Eribulin Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2011); Tubulin-Eribulin complex (RCSB Protein Data Bank, 2016).

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Representative model, for educational purposes only.