Sunitinib

What is Sunitinib

Sunitinib is an oral, multitargeted tyrosine kinase inhibitor with anti-angiogenic and anti-tumor activities due to selective inhibition of several receptor tyrosine kinases.

Activation of gene pathways by hypoxia, such as vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), are common in solid tumors. These genes are implicated in tumor angiogenesis and proliferation. 

It is indicated for the treatment of progressive GI stromal tumor (GIST), adjuvant renal cell carcinoma (RCC) following nephrectomy in patients at high risk of recurrence, advanced RCC, and progressive pancreatic neuroendocrine tumor (pNET).

Brand Name

Sutent

Indications & Dosage

  • gastrointestinal stromal tumors (GIST)
  • malignant neuroendocrine tumor (NET)
  • renal cell cancer

For the treatment of renal cell cancer (RCC)

for the adjuvant treatment of renal cell cancer (RCC) in patients at high risk of recurrence following nephrectomy

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. alopecia
  4. anemia
  5. anemia
  6. angioedema
  7. anorexia
  8. anorexia
  9. arthralgia
  10. arthralgia
  11. asthenia
  12. asthenia
  13. back pain
  14. back pain
  15. bleeding
  16. bleeding
  17. cardiomyopathy
  18. chest pain (unspecified)
  19. chest pain (unspecified)
  20. chills
  21. chills
  22. cholecystitis
  23. constipation
  24. constipation
  25. cough
  26. cough
  27. depression
  28. diarrhea
  29. diarrhea
  30. dizziness
  31. dizziness
  32. dysgeusia
  33. dysgeusia
  34. dyspepsia
  35. dyspepsia
  36. dyspnea
  37. dyspnea
  38. edema
  39. edema
  40. elevated hepatic enzymes
  41. elevated hepatic enzymes
  42. epistaxis
  43. epistaxis
  44. erythema
  45. erythema
  46. erythema multiforme
  47. esophagitis
  48. esophagitis
  49. exfoliative dermatitis
  50. fatigue
  51. fatigue
  52. fever
  53. fever
  54. flatulence
  55. gastroesophageal reflux
  56. gastroesophageal reflux
  57. GI bleeding
  58. GI perforation
  59. gingivitis
  60. glossitis
  61. hair discoloration
  62. hair discoloration
  63. headache
  64. headache
  65. heart failure
  66. hematemesis
  67. hematoma
  68. hematuria
  69. hemolytic-uremic syndrome
  70. hemoptysis
  71. hemorrhoids
  72. hepatic failure
  73. hepatotoxicity
  74. hyperamylasemia
  75. hyperamylasemia
  76. hyperbilirubinemia
  77. hyperbilirubinemia
  78. hypercalcemia
  79. hypercalcemia
  80. hyperglycemia
  81. hyperglycemia
  82. hyperkalemia
  83. hyperkalemia
  84. hypernatremia
  85. hypertension
  86. hypertension
  87. hypertensive crisis
  88. hyperthyroidism
  89. hyperuricemia
  90. hyperuricemia
  91. hypoalbuminemia
  92. hypoalbuminemia
  93. hypocalcemia
  94. hypocalcemia
  95. hypoglycemia
  96. hypoglycemia
  97. hypokalemia
  98. hypokalemia
  99. hypomagnesemia
  100. hyponatremia
  101. hyponatremia
  102. hypophosphatemia
  103. hypophosphatemia
  104. hypothyroidism
  105. hypothyroidism
  106. impaired wound healing
  107. infection
  108. influenza
  109. insomnia
  110. insomnia
  111. insomnia
  112. leukoencephalopathy
  113. leukopenia
  114. leukopenia
  115. lymphopenia
  116. lymphopenia
  117. maculopapular rash
  118. melena
  119. myalgia
  120. myalgia
  121. myocardial infarction
  122. myopathy
  123. nausea
  124. nausea
  125. necrotizing fasciitis
  126. nephrotic syndrome
  127. neutropenia
  128. neutropenia
  129. oral ulceration
  130. osteonecrosis
  131. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  132. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  133. pancreatitis
  134. peripheral edema
  135. peripheral edema
  136. pharyngitis
  137. pleural effusion
  138. proteinuria
  139. pruritus
  140. pruritus
  141. psoriaform rash
  142. pulmonary embolism
  143. QT prolongation
  144. rash
  145. rash
  146. renal failure (unspecified)
  147. rhabdomyolysis
  148. seizures
  149. skin discoloration
  150. skin discoloration
  151. Stevens-Johnson syndrome
  152. stomatitis
  153. stomatitis
  154. stroke
  155. thrombocytopenia
  156. thrombocytopenia
  157. thromboembolism
  158. thrombosis
  159. thrombotic microangiopathy
  160. thrombotic thrombocytopenic purpura (TTP)
  161. torsade de pointes
  162. toxic epidermal necrolysis
  163. tumor lysis syndrome (TLS)
  164. vomiting
  165. vomiting
  166. weight loss
  167. weight loss
  168. xerosis
  169. xerosis
  170. xerostomia

Monitoring Parameters

  • blood glucose
  • CBC with differential
  • ECG
  • ejection fraction
  • LFTs
  • pregnancy testing
  • serum electrolytes
  • urinalysis

Contraindications

  • alcoholism
  • angina
  • bleeding
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • cardiomyopathy
  • children
  • contraception requirements
  • coronary artery bypass graft surgery (CABG)
  • coronary artery disease
  • dental disease
  • dental work
  • diabetes mellitus
  • females
  • geriatric
  • heart failure
  • hepatic disease
  • hypertension
  • hyperthyroidism
  • hypocalcemia
  • hypoglycemia
  • hypokalemia
  • hypomagnesemia
  • hypothyroidism
  • infertility
  • long QT syndrome
  • malnutrition
  • myocardial infarction
  • pregnancy
  • pregnancy testing
  • proteinuria
  • QT prolongation
  • radiation therapy
  • renal failure
  • reproductive risk
  • stroke
  • surgery
  • thyroid disease
  • tumor lysis syndrome (TLS)

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Aclidinium; Formoterol
  • Albuterol
  • Albuterol; Ipratropium
  • Alfuzosin
  • Amiodarone
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
  • Apalutamide
  • Apomorphine
  • Arformoterol
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atomoxetine
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azithromycin
  • Bedaquiline
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bexarotene
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bosentan
  • Budesonide; Formoterol
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Butabarbital
  • Carbamazepine
  • Cenobamate
  • Ceritinib
  • Chloramphenicol
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clofazimine
  • Clozapine
  • Cobicistat
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Conivaptan
  • Crizotinib
  • Dabrafenib
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Dasatinib
  • Degarelix
  • Delavirdine
  • Desflurane
  • Deutetrabenazine
  • Dexamethasone
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Dronedarone
  • Droperidol
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Eliglustat
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Enflurane
  • Entrectinib
  • Enzalutamide
  • Eribulin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Eslicarbazepine
  • Etravirine
  • Ezogabine
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fluvoxamine
  • Formoterol
  • Formoterol; Mometasone
  • Fosamprenavir
  • Foscarnet
  • Fosphenytoin
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Glycopyrrolate; Formoterol
  • Goserelin
  • Granisetron
  • grapefruit juice
  • Halogenated Anesthetics
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Idelalisib
  • Iloperidone
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Indinavir
  • Inotuzumab Ozogamicin
  • Isoflurane
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ivosidenib
  • Ketoconazole
  • Lapatinib
  • Lefamulin
  • Lenvatinib
  • Letermovir
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levalbuterol
  • Levofloxacin
  • Lithium
  • Lofexidine
  • Long-acting beta-agonists
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Lumacaftor; Ivacaftor
  • Macimorelin
  • Maprotiline
  • Mefloquine
  • Meperidine; Promethazine
  • Mephobarbital
  • Metaproterenol
  • Methadone
  • Methohexital
  • Metronidazole
  • Midostaurin
  • Mifepristone
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Moxifloxacin
  • Nafcillin
  • Nefazodone
  • Nelfinavir
  • Nevirapine
  • Nilotinib
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Olodaterol
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Ondansetron
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Oxcarbazepine
  • Ozanimod
  • Paliperidone
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenobarbital
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pirbuterol
  • Pitolisant
  • Posaconazole
  • Primaquine
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Romidepsin
  • Salmeterol
  • Saquinavir
  • Selpercatinib
  • Sertraline
  • Sevoflurane
  • Short-acting beta-agonists
  • Siponimod
  • Solifenacin
  • Sorafenib
  • Sotalol
  • St. John’s Wort, Hypericum perforatum
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Temsirolimus
  • Terbutaline
  • Tetrabenazine
  • Thioridazine
  • Tiotropium; Olodaterol
  • Tipranavir
  • Tolterodine
  • Toremifene
  • Trazodone
  • Tricyclic antidepressants
  • Trifluoperazine
  • Triptorelin
  • Tucatinib
  • Umeclidinium; Vilanterol
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Voriconazole
  • Vorinostat
  • Ziprasidone
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