Nexanib

Indications

Sorafenib is a cancer medicine used to treat advanced liver cancer (hepatocellular carcinoma), advanced kidney cancer (renal cell carcinoma) and certain types of thyroid cancer that no longer respond to radioactive iodine.

How It Works

Sorafenib is a multi-kinase inhibitor. It blocks several proteins (kinases) that cancer cells use to grow and divide, and also blocks VEGF and PDGF receptors that tumours need to build new blood vessels. This slows tumour growth and cuts off its blood supply.

Dosage and Administration

Take exactly as prescribed by your cancer specialist, usually twice a day. Swallow tablets whole with water, either without food or with a low-fat meal, as a high-fat meal reduces how well it is absorbed. The dose may be lowered or treatment paused because of side effects. Do not take a double dose to make up for a missed one.

Interactions

Enzyme inducers such as Rifampicin, Carbamazepine, Phenytoin and St John's wort can reduce its effect. It can increase bleeding risk with Warfarin, so blood clotting should be checked. Neomycin taken by mouth may reduce its levels. It may increase the effects of some chemotherapy medicines such as Docetaxel and Irinotecan. Medicines that affect heart rhythm should be used with care.

Contraindications

Do not use if you are allergic to Sorafenib. It is not used during pregnancy unless clearly necessary.

Side Effects

Common side effects include hand-foot skin reaction (redness, pain, blisters on palms and soles), rash, hair thinning, diarrhoea, tiredness, high blood pressure, weight loss, loss of appetite, nausea, stomach pain and bleeding problems such as nosebleeds. It may also affect heart rhythm, the liver and thyroid.

Get urgent medical help for chest pain, signs of a heart attack, severe bleeding or black stools, vomiting blood, yellow skin or eyes, severe stomach pain, a very high blood pressure reading with headache, or a severe skin reaction with blisters and peeling.

Pregnancy and Lactation

Sorafenib can harm an unborn baby. Use effective contraception during treatment and for at least 6 months after the last dose (men should use condoms for at least 3 months). Do not breastfeed during treatment and for 2 weeks after the last dose.

Precautions and Warnings

Blood pressure is checked weekly at first and then regularly. Liver tests, blood salts and, in some people, heart tracings are monitored. Treatment is paused before major surgery and restarted when wounds have healed. Use moisturising creams and comfortable footwear to reduce hand-foot reactions. Tell your doctor about heart disease or bleeding problems.

Overdose

Overdose mainly causes diarrhoea and skin reactions. Contact your doctor or hospital; treatment is supportive.

Therapeutic Class

Antineoplastic, multi-kinase inhibitor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.