Sorafenib
Cytostatic · Protein kinase inhibitor
Indications
Advanced renal carcinoma that has failed or is unsuitable for interferon alfa or interleukin-2 therapy. Treatment of unresectable hepatocellular cancer (HCC). Treatment of locally recurrent or metastatic, progressive, differentiated thyroid cancer (refractory to radioactive iodine treatment).
Dosage
Adults: 400 mg twice daily taken 1 hr before or 2 hr after a meal. Children: Not recommended.
Adverse Effects
Fatigue, weight loss, rash, hand foot skin reaction, alopecia, diarrhoea, anorexia, nausea, abdominal pain, GI upset, infections, blood dyscrasias, hypocalcaemia, hypophosphataemia, hyponatraemia, hypokalaemia, hypothyroidism, hypoglycaemia, dysphagia, depression, neuropathy, flushing, haemorrhage, hypertension, erectile dysfunction, dysgeusia, tinnitus, dysphonia, rhinorrhoea, asthenia, pain, fever, flu-like illness, mucosal inflammation, renal failure, CHF, myocardial ischaemia, MI, arthralgia, myalgia, muscle spasm, skin cancer. Increased amylase, lipase and transaminases. Reports of GI perforation (discontinue).
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Precautions: Dermatological toxicities, HTN, hemorrhage, cardiac ischaemia and/or infarction, wound healing complications, GI perforation, hepatic impairment. Electrolyte disturbances, other risk factors for QT prolongation. Withdraw before elective surgery. Monitor renal function. Diabetes. Elderly. Thyroid cancer: treat tracheal, bronchial and oesophageal infiltration before starting therapy; monitor blood calcium and TSH.
Interactions
Warfarin, irinotecan, docetaxel, rifampicin, phenytoin, carbamazepine, phenobarbitone, dexamethasone, doxorubicin, anticoagulants, ketoconazole, St John's Wort, digoxin, neomycin, carboplatin, paclitaxel, antiarrhythmics, drugs that prolong QT interval.
Advice to Patient
Take atleast 1 hour before or 2 hours after meals or with meals containing low amount of fats. Do not chew or crush tablets, swallow whole. If you miss a dose, skip this dose and take next dose at scheduled time. Do not take double dose. Contact prescriber if there is high fever, severe nausea, severe vomiting, chest pain, difficulty in breathing, light headedness, unusual bleeding or bruising, redness/pain/swelling/blisters on the palm, blistering and peeling of the skin or inside of the mouth, severe stomach pain, yellowing of skin or eyes, dark coloured urine, pale stool. Check blood pressure regularly every week during the first 6 weeks of starting therapy and inform prescriber about changes.
Pharmacokinetics
Metabolism: Hepatic. Bioavailability: 38% to 49%; reduced by 29% when administered with a high-fat meal. Half-life elimination: 25 to 48 hours. Time to peak, plasma: Approx. 3 hours. Excretion: Feces (77%, 51% of dose as unchanged drug); urine (19%, as metabolites).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.