Sorafenib

DEA Class; Rx

Common Brand Names; Nexavar

• Antineoplastics, Tyrosine Kinase Inhibitor; 
• Antineoplastics, VEGF Inhibitor

Indicated for advanced renal cell carcinoma

Indicated for unresectable hepatocellular carcinoma

Indicated for locally recurrent or metastatic, progressive, differentiated thyroid cancer (DTC) that is refractory to radioactive iodine treatment

Hypersensitivity

Coadministration with carboplatin and paclitaxel in patients with squamous cell lung cancer

• Thrombocytopenia (12-46%)
• Anemia (44%)
• Diarrhea (43%)
• Rash/desquamation (40%)
• Fatigue (37%)
• Abdominal pain (31%)
• Hand-foot skin reaction (30%)
• Weight loss (30%)
• Anorexia (29%)
• Alopecia (27%)
• Nausea (24%)
• Lymphopenia (23%)
• Neutropenia (18%)
• Hemorrhage (15-18%)
• Hypertension (9-17%)
• Vomiting (16%)
• Constipation (15%)
• Neuropathy (13%)
• Dry skin (11%)

Osteonecrosis of jaw reported

Increased risk of cardiac ischemia/HTN/hemorrhage; consider temporary or permanent discontinuation of therapy in patients who develop cardiovascular events

Withhold therapy for at least 10 days prior to elective surgery; do not administer for at least 2 weeks following major surgery and until adequate wound healing; safety of resumption of therapy after resolution of wound healing complications has not been established

Hepatitis reported; characterized by a hepatocellular pattern of liver damage with significant increases of transaminases which may result in hepatic failure and death

QT Prolongation: Monitor for prolonged QT intervals with CHF, bradyarrhythmias, drugs known to prolong QT interval, and electrolyte abnormalities; avoid with congenital long QT syndrome

Congestive heart failure reported; temporary or permanent discontinuation of therapy should be considered in patients who develop cardiovascular events

Monitor blood pressure weekly during first 6 weeks and periodically thereafter; consider temporary or permanent discontinuation for severe or persistent hypertension despite antihypertensive therapy

Avoid pregnancy

High incidence of skin toxicity and rash

There are no available data in pregnant women to inform a drug associated risk

There are no data on presence of drug or its metabolites in human milk, or its effects on breast-fed child or on milk production

Sorafenib 

tablet

• 200mg