Drug information of Sorafenib

Sorafenib

Drug group:

Sorafenib is a cancer medication that interferes with the growth and spread of cancer cells in the body. Sorafenib is used to treat liver cancer, thyroid cancer, or a type of kidney cancer called advanced renal cell carcinoma

Mechanism of effect

Sorafenib interacts with multiple intracellular (CRAF, BRAF and mutant BRAF) (and cell surface kinases (KIT, FLT-3, VEGFR-2, VEGFR-3, and PDGFR-ß)

Pharmacodynamic

Decreases tumor cell proliferation in vitro

Pharmacokinetics

Bioavailability is 38% to 49%. T max is 3 h. Steady state plasma levels occur within 7 days. Administration with high-fat meals reduced sorafenib bioavailability 29%. In vitro protein binding is 99.5%. Metabolism occurs primarily in the liver by CYP3A4 and UGT1A9-mediated glucuronidation. Eight metabolites have been identified, of which pyridine N-oxide has shown in vitro potency similar to the parent drug. Mean elimination t ½ is about 25 to 48 h. After oral administration of a sorafenib 100 mg oral solution, 96% was recovered within 14 days (77% in the feces and 19% in the urine)

Dosage

Adults PO 400 mg (two 200 mg tablets) twice daily. Continue treatment until patient is no longer clinically benefiting from therapy or until unacceptable toxicity occurs

Alerts

1-Monitor BP weekly during first 6 wk of therapy and monitor and treat thereafter if necessary
2-Caution women of childbearing potential to avoid becoming pregnant while using sorafenib and for 2 wk after stopping therapy

Points of recommendation

• Administer each dose with a full glass of water on an empty stomach, at least 1 h before or 2 h after eating.
• Caution patient not to chew, crush, or break tablets.
• If a dose is missed, skip that dose and administer the next dose at the regularly scheduled time. Never administer 2 doses at the same time to catch up.
• Advise patient to notify health care provider if rash; persistent diarrhea; persistent nausea and/or vomiting; weakness; mouth sores; or numbness, tingling, or pain in hands or feet develops
• Instruct patient to immediately notify health care provider if any of the following occur:
chest pain, chest pressure, or unexplained shortness of breath on exertion or with activity; redness, pain, swelling, or blistering of palms of hands or soles of feet; unexplained bleeding

Pregnancy level

D


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