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SUTENT

SUNITINIB · by PFIZER

ANTINEOPLASTICS Protein kinase inhibitor PFIZER

Composition

Cap 12.5 mg/25 mg/50 mg: Sunitinib 12.5 mg/25 mg/50 mg.

Indications & Dosage

Treatment of advanced or metastatic renal cell carcinoma. Treatment of unresectable or metastatic gastrointestinal stromal tumours (GIST). Treatment of unresectable or metastatic malignant gastrointestinal stromal tumours, after failure of imatinib, Treatment of advanced or metastatic renal cell carcinoma: Adult: 50 mg once daily for 4 weeks, followed by a 2-week treatment-free period to complete 6-week cycle, adjusted in steps of 12.5 mg, doses adjusted according to tolerability; usual dose 25-75 mg daily. Treatment of unresectable or metastatic pancreatic Neuroendocrine tumours: Adult: 37.5 mg once daily without treatment-free period; adjusted in steps of 12.5 mg, doses adjusted according to tolerability; max. 50 mg per day.

Precautions

Risk of fatal pulmonary haemorrhage, hypertension. Perform complete blood count prior to treatment. Pre-existing cardiac disease; discontinue if congestive heart failure develops, electrolytes disturbances, monitor for thyroid dysfunction and pancreatitis, increased risk of bleeding, susceptibility to QT-interval prolongation

Interactions

Rifampicin, phenobarbital, phenytoin, carbamazepine, dexamethasone, ketoconazole, erythromycin, anticoagulants.

Pregnancy

Positive evidence of risk: Avoid

Lactation

Contraindicated. Discontinue breast-feeding

Side Effects

Abdominal pain, alopecia, anorexia, arthralgia, bone-marrow suppression, cough, GI upset, dyspnea, epistaxis, fatigue, fistula formation (discontinue),GI perforation, hair& skin discoloration, hand-foot syndrome, headache, hepatic failure, hypertension, hyperuricaemia, hypothyroidism, increased lacrimation, insomnia, myalgia, oedema, oral mucositis, osteonecrosis of the jaw, pancreatitis, paraesthesia, peripheral neuropathy, proteinuria, rash, seizures, thromboembolism, tumourlysis syndrome, urine discoloration, vomiting. Rare: Nephrotic syndrome