Lenvatinib

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

1. abdominal pain
2. abdominal pain
3. adrenocortical insufficiency
4. alopecia
5. anemia
6. anorexia
7. anorexia
8. arthralgia
9. arthralgia
10. ascites
11. ascites
12. asthenia
13. back pain
14. bleeding
15. bleeding
16. cardiomyopathy
17. cholecystitis
18. coma
19. confusion
20. constipation
21. constipation
22. cough
23. cystitis
24. dehydration
25. dehydration
26. diarrhea
27. diarrhea
28. dizziness
29. dizziness
30. dysgeusia
31. dyspepsia
32. dyspepsia
33. dysphonia
34. dysphonia
35. dyspnea
36. dyspnea
37. elevated hepatic enzymes
38. encephalopathy
39. epistaxis
40. erythema
41. exfoliative dermatitis
42. fatigue
43. fatigue
44. fever
45. fever
46. gastroesophageal reflux
47. GI bleeding
48. GI perforation
49. gingivitis
50. glossitis
51. headache
52. headache
53. heart failure
54. hematemesis
55. hematoma
56. hematuria
57. hemoptysis
58. hepatic encephalopathy
59. hepatic encephalopathy
60. hepatic failure
61. hepatitis
62. hepatotoxicity
63. hyperamylasemia
64. hyperbilirubinemia
65. hypercalcemia
66. hypercholesterolemia
67. hypercholesterolemia
68. hyperglycemia
69. hyperkalemia
70. hyperkalemia
71. hyperkeratosis
72. hypermagnesemia
73. hypertension
74. hypertension
75. hypertensive crisis
76. hypertriglyceridemia
77. hypoalbuminemia
78. hypoalbuminemia
79. hypocalcemia
80. hypoglycemia
81. hypokalemia
82. hypomagnesemia
83. hyponatremia
84. hypophosphatemia
85. hypotension
86. hypotension
87. hypothyroidism
88. impaired wound healing
89. infection
90. infection
91. insomnia
92. insomnia
93. intracranial bleeding
94. lethargy
95. leukoencephalopathy
96. leukopenia
97. lymphopenia
98. maculopapular rash
99. malaise
100. musculoskeletal pain
101. myalgia
102. myalgia
103. myocardial infarction
104. nausea
105. nausea
106. nephrotic syndrome
107. neutropenia
108. oral ulceration
109. palmar-plantar erythrodysesthesia (hand and foot syndrome)
110. palmar-plantar erythrodysesthesia (hand and foot syndrome)
111. pancreatitis
112. parotitis
113. peripheral edema
114. peripheral edema
115. pleural effusion
116. prolonged bleeding time
117. prolonged bleeding time
118. proteinuria
119. proteinuria
120. pulmonary embolism
121. QT prolongation
122. QT prolongation
123. rash
124. rash
125. renal failure (unspecified)
126. renal failure (unspecified)
127. stomatitis
128. stomatitis
129. stroke
130. thrombocytopenia
131. thromboembolism
132. thrombosis
133. vomiting
134. vomiting
135. weakness
136. weight loss
137. weight loss
138. wound dehiscence
139. xerostomia
140. 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
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• Alfuzosin
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