Introduction
Lenvaxen 4 is an oral receptor tyrosine kinase inhibitor used in the treatment of thyroid cancer.
Lenvaxen 4 can be taken with or without food, but try to have it at the same time every day to get the most benefits. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
The most common side effects of this medicine include tiredness, joint pain, muscle pain, nausea, and vomiting. It might also cause severe headache, confusion, problems with your eyesight, and difficult talking. If happens, your doctor may checked you for blood pressure as these might be symptom of high blood pressure. If you experience severe diarrhea, then consult with your doctor or drink plenty of fluids. Let your doctor know about severe abdominal pain or black, tarry, or bloody stools as it might be symptoms of bleeding disorder. You may be asked for some blood tests to check for liver, kidney, and level of thyroid stimulating hormones.
Before taking it, tell your doctor if have heart disease, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. Use of effective contraception by both males and females during treatment is important to avoid pregnancy.
Side effects of Lenvaxen 4
Common
- Bleeding
- Cough
- Decreased appetite
- Erythema (skin redness)
- Hoarseness of voice
- Itching
- Joint pain
- Mouth sore
- Muscle pain
- Nausea
- Peripheral edema
- Rash
- Skin peeling
- Stomach pain
- Tiredness
- Vomiting
- Weight loss
How to use Lenvaxen 4
Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Lenvaxen 4 may be taken with or without food, but it is better to take it at a fixed time.
How Lenvaxen 4 works
Lenvaxen 4 is a tyrosine kinase inhibitor. It works by blocking the oxygen and nutrient supply to cancer cells due to which they stop growing.
Indication
Patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated, thyroid cancer. In combination with everolimus for the treatment of patients with, advanced renal cell carcinoma, following 1 prior vascular endothelial growth factor-targeted therapy.
Administration
Swallow capsule whole
May take with or without food
Take at the same time each day
Adult Dose
Adult Differentiated thyroid cancer (DTC) 24 mg once daily.
Renal cell carcinoma (RCC) 18 mg in combination w/ everolimus 5 mg once daily.
Patient w/ severe hepatic impairment
Initially 14 mg once daily for DTC.
10 mg once daily for RCC.
Renal Dose
Patient w/ severe renal impairment
Initially 14 mg once daily for DTC.
10 mg once daily for RCC.
Contraindication
Hypersensitivity. Lactation.
Mode of Action
Receptor tyrosine kinase (RTK) inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4)
Also inhibits other RTKs that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1, 2, 3, and 4; the platelet-derived growth factor receptor alpha (PDGFR-alpha), KIT, and RET
Precaution
Monitor BP after 1 wk of treatment then every 2 wk for the 1st 2 month & monthly thereafter. Monitor urine protein regularly. Actively managed GI toxicity to reduce the risk of development of renal impairment/renal failure. Monitor for clinical symptoms or signs of cardiac decompensation. Posterior reversible encephalopathy syndrome/reversible posterior leucoencephalopathy syndrome. Monitor liver function tests before initiation of treatment, then every 2 wk for the 1st 2 month & monthly thereafter during treatment. Adjust initial dose in patients w/ severe renal or hepatic impairment.
Serious tumour-related bleeds including fatal haemorrhagic events, GI perforation & fistula formation may occur. Patients w/ arterial thromboembolic event w/in the previous 6 month. Consider periodic monitoring of ECG & electrolytes during treatment. Monitor TSH levels. Discontinue use in the event of persistence of GI perforation or fistula & grade 4 diarrhoea. Patients of ethnic origin other than Caucasian or Asian. Not recommended in patients w/ end-stage renal disease. May affect the ability to drive or operate machinery. Women of childbearing potential must use highly effective contraception while taking & 1 month after stopping treatment. Do not use during pregnancy. Do not use in child <2 yr. Elderly >75 yr.
Lactation
Unknown if distributed in human breast milk; advise women to discontinue breastfeeding during treatment because of the potential for serious adverse reactions in nursing infants
Lenvatinib and its metabolites are excreted in rat milk at concentrations higher than in maternal plasma (approximately 2 times higher [based on AUC] in milk compared with maternal plasma
Side Effect
>10%
Percentages are for all grades of adverse effects unless otherwise noted
Hypertension (73%),Diarrhea (67%),Fatigue (67%),Arthralgia/myalgia (62%),Decreased appetite (54%),Weight decreased (51%),Nausea (47%),Hypertension, grades 3-4 (44%),Stomatitis (41%),Headache (38%),Vomiting (36%),Proteinuria (34%),Palmar-plantar erythrodysesthesia (32%),Abdominal pain (31%),Dysphonia (31%),Constipation (29%),Oral pain (25%),Cough (24%),Peripheral edema (21%),Rash (21%),Dysgeusia (18%),Dry mouth (17%),Dizziness (15%),Dyspepsia (13%),Alopecia (12%),Epistaxis (12%),Insomnia (12%),Urinary tract infection (11%)
1-10%
Percentages are for all grades of adverse effects unless otherwise noted
Dental infections (10%)
Hypotension (9%)
Diarrhea, grades 3-4 (9%)
Dehydration (9%)
Prolonged QT interval (9%)
Hypocalcemia (9%)
Decreased appetite, grades 3-4 (7%)
Hyperkeratosis (7%)
Hypokalemia (6%)
AST increased (5%)
ALT increased (4%)
Lipase increased (4%)
Creatinine increased (3%)
Nausea, grades 3-4 (2%)
Platelet count decreased (2%)
Interaction
Decreased exposure w/ oral CYP3A4/Pgp substrates [eg, astemizole, terfenadine, cisapride, pimozide, quinidine, bepridil or ergot alkaloids (ergotamine, dihydroergotamine)]. May reduce effectiveness of oral hormonal contraceptives.