Sunitinib

Welcome to Dwaey, specifically on Sunitinib page.
This medicine contains important and useful components, as it consists of
Sunitinib is available in the market in concentration.

Generic Name of Sunitinib - Learn More

Sunitinib

Sunitinib Precaution - What You Need to Know

Before starting Sunitinib, it is essential for patients to consult their healthcare provider, especially given its potential for severe side effects and interactions:

- Cardiovascular Issues: Sunitinib can cause hypertension (high blood pressure), heart failure, and QT interval prolongation (a potential arrhythmia), so regular monitoring of blood pressure and cardiovascular health is recommended. Patients with pre-existing cardiovascular conditions should be closely monitored while taking Sunitinib.
- Liver Function: Sunitinib is metabolized in the liver, and it may elevate liver enzymes. Liver function should be assessed before and during treatment, especially for patients with a history of liver disease or those who develop abnormal liver tests during therapy.
- Thyroid Dysfunction: Hypothyroidism is a known side effect of Sunitinib. Thyroid function should be monitored regularly, and levothyroxine may be required if thyroid levels fall.
- Gastrointestinal Bleeding: Patients with a history of gastric ulcers or gastrointestinal bleeding should use Sunitinib cautiously. Hemorrhagic events, including gastrointestinal bleeding, can occur during treatment, requiring close monitoring.
- Pregnancy and Breastfeeding: Sunitinib is a Category D drug during pregnancy, meaning it can harm the fetus. It should not be used during pregnancy unless the potential benefits outweigh the risks. Sunitinib is also excreted in breast milk, so breastfeeding should be avoided during treatment.
- Immunosuppression: Sunitinib may impair the immune system's ability to fight infections, so patients should be monitored for signs of infection during treatment.

Sunitinib Indication - Uses and Benefits

Sunitinib is primarily used for the treatment of various cancers, particularly those that involve vascular endothelial growth factor (VEGF) and platelet-derived growth factor receptor (PDGFR). The major indications for Sunitinib include:

- Renal Cell Carcinoma (RCC): Sunitinib is approved for the treatment of advanced renal cell carcinoma in patients who are not amenable to surgery. It works by inhibiting tumor growth through angiogenesis (the growth of new blood vessels).
- Gastrointestinal Stromal Tumor (GIST): Sunitinib is used in patients with GISTs that are resistant to imatinib, a common treatment for these tumors. It targets the KIT and PDGF receptors, key drivers of GIST.
- Pancreatic Neuroendocrine Tumors (PNETs): Sunitinib is indicated for the treatment of progressive pancreatic neuroendocrine tumors to improve overall survival.
- Other Tumors: It may also be used off-label for other cancers, particularly those involving vascular endothelial growth factor (VEGF) signaling.

Sunitinib Contraindications - Important Warnings

Sunitinib should be avoided in the following conditions:

- Severe Hypersensitivity: Contraindicated in patients who have a known hypersensitivity to Sunitinib or any of its excipients.
- Severe Liver Impairment: Patients with severe hepatic dysfunction (e.g., cirrhosis) should not receive Sunitinib, as the drug is metabolized by the liver and can accumulate to dangerous levels.
- Pregnancy: Sunitinib is contraindicated in pregnancy due to the risk of fetal harm. It is classified as a Category D drug.
- Active Bleeding: Active bleeding disorders or a history of gastrointestinal bleeding or hemorrhage can make Sunitinib dangerous, as it may exacerbate bleeding risks.
- Severe Cardiac Conditions: Patients with severe cardiac dysfunction (including congestive heart failure, unstable angina, or arrhythmias) should avoid Sunitinib due to its potential to worsen these conditions.

Sunitinib Side Effects - What to Expect

Common and severe side effects associated with Sunitinib include:

- Fatigue: One of the most common side effects of Sunitinib. It can be significant and impact daily life.
- Diarrhea: Gastrointestinal symptoms like diarrhea, nausea, and vomiting are common. Patients should be monitored and managed for these symptoms.
- Hypertension: High blood pressure is a known side effect and may require antihypertensive treatment or dosage adjustments.
- Hand-Foot Syndrome: Sunitinib can cause redness, swelling, and pain on the palms of the hands and soles of the feet, which can be severe in some cases.
- Skin Rash: A common side effect, skin reactions like rash or itching may occur. These are often mild but can be bothersome.
- Liver Toxicity: Liver function should be monitored, as elevated liver enzymes can indicate liver damage.
- Thyroid Dysfunction: Hypothyroidism is frequently observed with Sunitinib treatment, which may require thyroid hormone replacement therapy.
- Bleeding and Hemorrhage: Serious bleeding events, including gastrointestinal bleeding, can occur, particularly in patients with pre-existing bleeding disorders or those on anticoagulants.
- Cardiac Toxicity: Rarely, Sunitinib can lead to congestive heart failure, arrhythmias, or QT prolongation.

Severe, rare side effects that require immediate medical attention include severe chest pain, shortness of breath, severe dizziness, or signs of an allergic reaction (e.g., rash, swelling of the face or throat, difficulty breathing).

Sunitinib Pregnancy Category ID - Safety Information

4

Sunitinib Mode of Action - How It Works

Sunitinib is a multikinase inhibitor that works by targeting several key receptor tyrosine kinases involved in the growth of blood vessels (angiogenesis) and cancer cell proliferation. Specifically, Sunitinib inhibits:

- VEGF Receptors (VEGFR): These are crucial for angiogenesis, the process by which tumors develop new blood vessels. By blocking VEGFR, Sunitinib reduces the tumor’s ability to grow and spread.
- PDGFR: By inhibiting platelet-derived growth factor receptor, Sunitinib reduces the ability of the tumor to grow and metastasize.
- KIT and RET: Sunitinib also inhibits KIT and RET receptors, which are involved in the growth of certain cancers, such as GISTs.

Inhibiting these pathways leads to reduced tumor vascularization, limiting the tumor's blood supply, and slowing its growth and spread.

Sunitinib Drug Interactions - What to Avoid

Sunitinib has several notable drug interactions, including:

- CYP3A4 Inhibitors/Inducers: Sunitinib is metabolized primarily by the CYP3A4 enzyme, so drugs that inhibit (e.g., ketoconazole, itraconazole) or induce (e.g., rifampin, carbamazepine) CYP3A4 can affect its levels. Inhibitors may increase Sunitinib levels, leading to a higher risk of toxicity, while inducers may reduce Sunitinib's effectiveness.
- Antihypertensive Drugs: Sunitinib can cause hypertension, and using it in combination with antihypertensive medications may require adjustments in dosage or more frequent monitoring of blood pressure.
- Other Cancer Treatments: When used in combination with other chemotherapy or targeted therapy (e.g., bevacizumab, imatinib), Sunitinib’s toxicity and effects on blood pressure and organ function should be closely monitored.
- Gastric Acid-Reducing Agents: Since Sunitinib is absorbed in the stomach, the use of proton pump inhibitors (PPIs) or H2 blockers may alter its absorption and efficacy. These should be used cautiously or avoided.
- Warfarin and Anticoagulants: Sunitinib may increase the risk of bleeding, and care should be taken when used alongside anticoagulants like warfarin or aspirin.

Sunitinib Adult Dose - Recommended Dosage

The typical starting dose of Sunitinib is 50 mg once daily. It is usually taken for 4 weeks, followed by a 2-week break (a treatment cycle of 6 weeks in total). This regimen may be repeated, depending on the patient's response and tolerance.

- In some cases, if adverse effects are severe, the dose may be reduced to 37.5 mg/day or 25 mg/day.
- Sunitinib can be taken with or without food, and it is recommended to take it at the same time each day.

Sunitinib Child Dose - Dosage for Children

Sunitinib is not recommended for use in pediatric patients due to insufficient safety and efficacy data in this population. Treatment in children should only be considered on a case-by-case basis if deemed absolutely necessary by a healthcare provider.

As always, consulting with a healthcare provider is crucial before starting Sunitinib, especially for patients with pre-existing medical conditions or those taking other medications.

Sunitinib Renal Dose - Dosage for Kidney Conditions

Sunitinib dosing does not typically need to be adjusted for mild to moderate renal impairment. However, for patients with severe renal impairment (creatinine clearance <30 mL/min), the use of Sunitinib should be approached with caution. Close monitoring for toxicity is recommended, and dose adjustments may be necessary.