Sunitinib
Indications
Sunitinib is a cancer medicine taken by mouth. It is used for:
- Gastrointestinal stromal tumour (GIST) when Imatinib has stopped working or cannot be taken.
- Advanced kidney cancer (renal cell carcinoma), and in some countries after kidney removal to lower the chance of return.
- Advanced pancreatic neuroendocrine tumours that cannot be removed by surgery.
How It Works
Sunitinib is a tyrosine kinase inhibitor. It blocks several growth signals that cancer cells use to grow and that tumours use to build new blood vessels, so the tumour is starved of blood supply and grows more slowly or shrinks.
Dosage and Administration
The dose and schedule are set by the cancer specialist, as prescribed. It is often taken in cycles, for example a few weeks on treatment followed by a break, or continuously, depending on the cancer. Swallow the capsules whole once a day at about the same time, with or without food. The dose may be changed or paused because of side effects.
Interactions
- Ketoconazole, Clarithromycin, Ritonavir and grapefruit juice raise its levels.
- Rifampicin, Carbamazepine, Phenytoin and St John's wort lower its effect.
- Medicines that affect heart rhythm (QT-prolonging medicines) need extra care.
- Blood thinners such as Warfarin may increase bleeding risk.
Contraindications
Allergy to sunitinib or any ingredient of the product.
Side Effects
Common:
- Tiredness, diarrhoea, nausea, loss of appetite and change in taste.
- Mouth sores, indigestion and high blood pressure.
- Redness, pain and peeling of the palms and soles (hand-foot skin reaction), yellow skin colour and loss of hair colour.
- Low blood counts, underactive thyroid and nosebleeds.
Get urgent medical help for chest pain, breathlessness or swollen legs; severe headache, confusion, fits or vision changes; bleeding that will not stop, black stools or vomiting blood; severe stomach pain; yellow eyes or skin or dark urine; a temperature of 38°C or more; or shakiness, sweating and confusion from low blood sugar.
Pregnancy and Lactation
Sunitinib can harm an unborn baby and should not be used in pregnancy. Women who could become pregnant and men with partners who could become pregnant should use reliable contraception during treatment and for the period the doctor advises afterwards. Do not breastfeed while taking it.
Precautions and Warnings
- Blood pressure, blood counts, liver tests, thyroid tests and heart function are checked regularly; serious liver damage has been reported.
- It slows wound healing; it is usually paused before planned surgery.
- Tell the dentist you are taking it; jaw bone problems have been reported, especially with bone-strengthening injections.
- People with diabetes should check blood sugar more often.
Overdose
Too much increases the risk of serious side effects. Seek emergency medical help at once; treatment is supportive in hospital.
Therapeutic Class
Antineoplastic (anticancer), multi-targeted tyrosine kinase inhibitor.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Sunitinib