Sorafenib

In November 2007, sorafenib was approved by the FDA for the treatment of unresectable hepatocellular carcinoma, and in November 2013, it was approved by the FDA for the treatment of metastatic differentiated thyroid cancer.

1. Drug name

1. Generic name: Sorafenib (Sorafenib)

2. Trade name: NEXAVAR

2. Indications

1. Unresectable hepatocellular carcinoma (HCC).

2. Advanced renal cell carcinoma (RCC).

3. Locally recurrent or metastatic differentiated thyroid cancer (DTC) that is ineffective in radioactive iodine therapy.

3. Specifications and properties

200mg film-coated tablets.

IV. Main ingredient

Each tablet contains 200mg sorafenib.

V. Usage and Dosage

1. Recommended dose: 400 mg orally, twice a day (about 12 hours apart), taken on an empty stomach (1 hour before a meal or 2 hours after a meal).

2. Continue taking the drug until there is no clinical benefit or intolerable toxicity occurs.

VI. Dose adjustment of

1. First dose reduction of : HCC/RCC patients reduce to 400mg once a day; DTC patients adjust to 400mg morning dose + 200mg evening dose.

2. Secondary dose reduction of : HCC/RCC patients reduce to 200 mg once a day or 200 mg twice a day; DTC patients reduce to 200 mg once a day.

3. Serious adverse reactions (such as cardiac ischemia, hypertension, bleeding, etc.) require permanent discontinuation of the drug.

7. Medication precautions

1. Medication time : must be taken on an empty stomach to avoid food affecting absorption.

2. Missed dose of : If you miss a dose, there is no need to take it again. Take the next dose according to the original plan.

3. Vomiting : If you vomit after taking the medicine, there is no need to take a supplement. Take it according to the planned dose next time.

4. Wound healing : Stop medication for at least 10 days before elective surgery, and resume medication at least 2 weeks after surgery and after the wound has healed.

8. Medication for special groups

1. Pregnant women : Contraindicated, may cause fetal damage, effective contraception is required during medication and within 6 months after discontinuation.

2. During the lactation period : Breastfeeding is prohibited.

3. Children : safety has not been established.

4. U200c for the elderly: No dose adjustment is required, but adverse reactions need to be closely monitored.

9. Adverse reactions

1. Common (≥20%):

Diarrhea, fatigue, infection, hair loss, hand-foot skin reaction, rash, weight loss, decreased appetite, nausea, abdominal pain, high blood pressure, and bleeding.

2. Serious adverse reactions:

Cardiovascular events (myocardial ischemia/infarction), bleeding, hypertensive crisis, gastrointestinal perforation, QT interval prolongation, liver damage, etc.

10. Contraindications

1. Those who are severely allergic to sorafenib or excipients.

2. Patients with squamous cell lung cancer are prohibited from taking carboplatin/paclitaxel in combination.

11. Drug interactions

1. Strong CYP3A4 inducer (such as rifampicin): Avoid combined use, which may reduce the efficacy of sorafenib.

2. Warfarin : Increases the risk of bleeding and requires close monitoring of INR.

3. QT prolonging drug : Caution is required when used together, and electrocardiogram and electrolytes should be monitored.

12. Storage method

If it is not clearly stated, it is recommended to refer to the packaging label. It usually needs to be protected from light and moisture and stored at room temperature.