Lenvatinib

Lenvatinib is a prescription medication used to treat a type of thyroid cancer and kidney cancer. Lenvatinib belongs to a group of drugs called kinase inhibitors, which work by blocking certain proteins that help cancer cells grow and divide.

This medication comes in capsule form and is taken typically once a day, with or without food.

Common side effects of Lenvatinib include high blood pressure, nausea, diarrhea, muscle and joint pain, decreased appetite, fatigue, and headache.

Lenvatinib is a prescription medication used to treat people with differentiated thyroid cancer (DTC, a type of thyroid cancer) that can no longer be treated with radioactive iodine and is progressing.

Lenvima is also used in combination with everolimus in patients with advanced renal cell carcinoma who had previously received an anti-angiogenic therapy.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Lenvatinib may be found in some form under the following brand names:

• Lenvima

Serious side effects have been reported with lenvatinib. See the “lenvatinib Precautions” section.

Common side effects of lenvatinib include the following:

• high blood pressure (hypertension)
• fatigue
• diarrhea
• joint and muscle pain (arthralgia/myalgia)
• decreased appetite
• decreased weight
• nausea
• inflammation of the lining of the mouth (stomatitis)
• headache
• vomiting
• excess protein in the urine (proteinuria)
• swelling and pain in the palms, hands and/or the soles of the feet
• stomach pain
• changes in voice volume or quality

This is not a complete list of lenvatinib side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

No drug interactions have been determined by the manufacturer. However, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

Serious side effects have been reported with lenvatinib including the following:

• High blood pressure. Your healthcare provider will monitor your blood pressure. If you develop high blood pressure, your doctor may prescribe medications to lower your blood pressure. Your doctor may decide to lower your lenvatinib dose or stop lenvatinib. 
• Heart problems. Call your healthcare provider right away if you get symptoms of heart problems, such as shortness of breath or swelling of your ankles.
• Blood clots. Call your healthcare provider right away if you experience any of the following symptoms:
  • severe pain or pressure in the chest
  • pain in your arms, back, neck or jaw
  • shortness of breath
  • numbness or weakness on one side of your body
  • sudden change in vision
  • severe headaches
  • difficulty speaking
• Liver problems. Your doctor will monitor your liver function before and during treatment with lenvatinib. Call your healthcare provider right away if you experience any of the following symptoms:
  • your skin or the white part of your eyes turns yellow (jaundice)
  • dark urine
  • light-colored stools
• Kidney problems. Your doctor will monitor blood tests to check your kidneys. 
• Increased protein in the urine (proteinuria). If you develop protein in your urine, your healthcare provider may decrease your dose of lenvatinib or stop your medication.
• Diarrhea. If you get diarrhea, ask your healthcare provider about what medications you can take to treat your diarrhea. Make sure to plenty of water to remain hydrated. Tell your healthcare provider or go to the emergency room, if you are unable to drink enough liquids and your diarrhea is not able to be controlled.
• Uncontrolled bleeding (hemorrhage). Call your healthcare provider right away if you experience any of the following symptoms:
  • severe and persistent nose bleeds
  • vomiting blood
  • red or black stools
  • coughing up blood or blood clots
  • heavy or new onset vaginal bleeding
• Irregular heartbeats (QT prolongation). Your healthcare provider will monitor you. 
• Low levels of blood calcium. Your healthcare provider will check your blood calcium levels during treatment. 
• Change in thyroid hormone levels. Your healthcare provider may have to adjust your thyroid medication. 
• Tear in stomach area (gastrointestinal perforation) or abnormal connection in stomach area (gastrointestinal fistula). Seek immediate attention if you experience severe stomach pain. 
• Reversible Posterior Leukoencephalopathy Syndrome (RPLS). Call your healthcare provider right away if you experience severe headaches, seizures, weakness, confusion, or blindness or change in vision. 

Do not take lenvatinib if you are allergic to lenvatinib or to any of its ingredients.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of lenvatinib, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking lenvatinib, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to lenvatinib or to any of its ingredients
• have high blood pressure
• have or had had blood clots
• have or have had kidney problems
• have a history of a tear (perforation) or abnormal connection (fistula) in your gastrointestinal tract
• have headaches, seizures, or vision problems
• have bleeding problems
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

Lenvatinib should nto be used by pregnant women. Females who are able to become pregnant should use an effective method of birth control during treatment with Lenvima and for at leats 2 weeks after the last dose of lanvatinib. Tell your doctor right away if you become pregnant or think you have become pregnant during treatment with lenvatinib.

Do not breastfeed while taking lenvatinib.

It is not known if lenvatinib crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication.

Take lenvatinib exactly as prescribed.

Your healthcare provider will tell you how much lenvatinib to take and when to take it. Your healthcare provider may change your dose during treatment, stop treatment for some time, or completely stop treatment with lenvatinib if you have side effects.

Lenvatinib comes in a capsule form and is taken once daily, with or without food.

If you miss a dose, take the missed dose as soon as you remember. If your next dose is due within 12 hours, skip the missed dose and take the next dose at your regular time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on other medical conditions you have. 

The recommended dose of lenvatinib for the treatment of metastatic thyroid cancer is 24 mg once daily.

The  recommended dose of lenvatinib for the treatment of renal cell cancer is 18 mg once daily. It is to be given with 5 mg of everolimus. 

If you take too much lenvatinib, call your healthcare provider or local Poison Control Center or seek emergency medical attention right away.

If lenvatinib is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store lenvatinib at room temperature.
• Keep this and all medications out of the reach of children.