Lenvatinib Brand Name– LENVIMA
What is Lenvatinib
Lenvatinib is an oral kinase inhibitor against vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4).
It also inhibits other kinases that have been implicated in angiogenesis, tumor growth, and cancer progression including fibroblast growth factor (FGF) receptors 1, 2, 3, and 4, as well as platelet derived growth factor receptor (PDGFR) alpha, KIT, and RET.
Lenvatinib is FDA approved for the treatment of advanced endometrial cancer, metastatic, radioactive iodine-refractory differentiated thyroid cancer, advanced renal cell carcinoma, and unresectable hepatocellular carcinoma. It may cause QT prolongation and should be avoided with other medications that cause QT prolongation.
Indications
- endometrial cancer
- hepatocellular cancer
- renal cell cancer
- thyroid cancer
For the treatment of locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC)
Side Effects
- abdominal pain
- abdominal pain
- adrenocortical insufficiency
- alopecia
- anemia
- anorexia
- anorexia
- arthralgia
- arthralgia
- ascites
- ascites
- asthenia
- back pain
- bleeding
- bleeding
- cardiomyopathy
- cholecystitis
- coma
- confusion
- constipation
- constipation
- cough
- cystitis
- dehydration
- dehydration
- diarrhea
- diarrhea
- dizziness
- dizziness
- dysgeusia
- dyspepsia
- dyspepsia
- dysphonia
- dysphonia
- dyspnea
- dyspnea
- elevated hepatic enzymes
- encephalopathy
- epistaxis
- erythema
- exfoliative dermatitis
- fatigue
- fatigue
- fever
- fever
- gastroesophageal reflux
- GI bleeding
- GI perforation
- gingivitis
- glossitis
- headache
- headache
- heart failure
- hematemesis
- hematoma
- hematuria
- hemoptysis
- hepatic encephalopathy
- hepatic encephalopathy
- hepatic failure
- hepatitis
- hepatotoxicity
- hyperamylasemia
- hyperbilirubinemia
- hypercalcemia
- hypercholesterolemia
- hypercholesterolemia
- hyperglycemia
- hyperkalemia
- hyperkalemia
- hyperkeratosis
- hypermagnesemia
- hypertension
- hypertension
- hypertensive crisis
- hypertriglyceridemia
- hypoalbuminemia
- hypoalbuminemia
- hypocalcemia
- hypoglycemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypophosphatemia
- hypotension
- hypotension
- hypothyroidism
- impaired wound healing
- infection
- infection
- insomnia
- insomnia
- intracranial bleeding
- lethargy
- leukoencephalopathy
- leukopenia
- lymphopenia
- maculopapular rash
- malaise
- musculoskeletal pain
- myalgia
- myalgia
- myocardial infarction
- nausea
- nausea
- nephrotic syndrome
- neutropenia
- oral ulceration
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- pancreatitis
- parotitis
- peripheral edema
- peripheral edema
- pleural effusion
- prolonged bleeding time
- prolonged bleeding time
- proteinuria
- proteinuria
- pulmonary embolism
- QT prolongation
- QT prolongation
- rash
- rash
- renal failure (unspecified)
- renal failure (unspecified)
- stomatitis
- stomatitis
- stroke
- thrombocytopenia
- thromboembolism
- thrombosis
- vomiting
- vomiting
- weakness
- weight loss
- weight loss
- wound dehiscence
- xerostomia
- xerostomia
Monitoring Parameters
- blood pressure
- ECG
- LFTs
- pregnancy testing
- serum calcium
- serum creatinine/BUN
- serum electrolytes
- thyroid function tests (TFTs)
- urinalysis
Contraindications
- apheresis
- AV block
- bleeding
- bradycardia
- breast-feeding
- cardiac disease
- cardiomyopathy
- celiac disease
- contraception requirements
- coronary artery disease
- dehydration
- electrolyte imbalance
- encephalopathy
- females
- fever
- fistula
- geriatric
- GI perforation
- heart failure
- hepatic disease
- hepatotoxicity
- human immunodeficiency virus (HIV) infection
- hyperparathyroidism
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothermia
- hypothyroidism
- hypovolemia
- impaired wound healing
- infertility
- long QT syndrome
- myocardial infarction
- pheochromocytoma
- pregnancy
- pregnancy testing
- proteinuria
- QT prolongation
- renal disease
- renal failure
- renal impairment
- reproductive risk
- rheumatoid arthritis
- sickle cell disease
- sleep deprivation
- stroke
- surgery
- systemic lupus erythematosus (SLE)
- thromboembolic disease
- thyroid cancer
- thyroid disease
Interactions
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Alfuzosin
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Anagrelide
- Apomorphine
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Atomoxetine
- Azithromycin
- Bedaquiline
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Ceritinib
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Crizotinib
- Dasatinib
- Degarelix
- Desipramine
- Deutetrabenazine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronedarone
- Droperidol
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Eliglustat
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Entrectinib
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Ezogabine
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Foscarnet
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- Halogenated Anesthetics
- Haloperidol
- Histrelin
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Inotuzumab Ozogamicin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
- Levofloxacin
- Lithium
- Lofexidine
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Macimorelin
- Maprotiline
- Mefloquine
- Meperidine; Promethazine
- Metaproterenol
- Methadone
- Metronidazole
- Midostaurin
- Mifepristone
- Mirtazapine
- Moxifloxacin
- Nilotinib
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Ozanimod
- Paliperidone
- Panobinostat
- Pasireotide
- Pazopanib
- Pentamidine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenylephrine; Promethazine
- Pimavanserin
- Pimozide
- Pirbuterol
- Pitolisant
- Posaconazole
- Primaquine
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Risperidone
- Romidepsin
- Salmeterol
- Saquinavir
- Selpercatinib
- Sertraline
- Short-acting beta-agonists
- Siponimod
- Solifenacin
- Sorafenib
- Sotalol
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telavancin
- Telithromycin
- Terbutaline
- Tetrabenazine
- Thioridazine
- Tiotropium; Olodaterol
- Tolterodine
- Toremifene
- Trazodone
- Triclabendazole
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Triptorelin
- Umeclidinium; Vilanterol
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Voriconazole
- Vorinostat
- Ziprasidone