Lenvatinib

This page provides a brief overview of the drug lenvatinib, including its indications, dosage and administration guidelines, mechanism of action, available brand names with strengths, warnings, and common side effects.

Context and Approval Date

Lenvatinib contains the active ingredient lenvatinib. When radioactive iodine therapy is not beneficial, doctors prescribe this tyrosine kinase inhibitor for progressive or advanced thyroid cancer. Doctors also treat patients with previously untreated liver cancer who are not eligible for surgical treatment. Preventing allergic reactions to lenvatinib or its components is crucial. Patients should seek advice from their dentist or oral surgeon about taking this medication, as it may affect wound healing and increase the risk of bleeding.

Lenvatinib received its initial approval from the U.S. Food and Drug Administration (FDA) in February 2015 for the treatment of locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer. Since its initial approval, lenvatinib has gained additional approvals for other uses, including the treatment of hepatocellular carcinoma (liver cancer) and renal cell carcinoma (kidney cancer).

Mechanism of Action of Lenvatinib

Lenvatinib inhibits receptor tyrosine kinases (RTKs), enzymes responsible for developing new blood vessels that provide oxygen and nutrients to cells, supporting their growth. This medication inhibits the receptors that promote blood vessel growth in tumor cells. RTKs are present in cancer cells in high concentrations, and administration of this medicine slows down cancer cell growth and multiplication.

All Substitutes

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Product Packaging Size Manufacturer Price
Lenvatol 10mg capsule 10 tablets CIPLA Ltd INR 3400
Lenvat 10mg capsule 10 tablets Natco Pharma Ltd INR 1500
Bdfoie 10mg capsule 10 capsule BDR Pharmaceuticals INR 2400
Lenva 10mg capsule 10 capsule Hetero Healthcare INR 2500
Lenced 10mg capsule 10 capsule Zydus Cadila INR 2600
Lentris 10mg capsule 10 capsule Mylan Pharmaceuticals INR 2700
Lentykine 10mg capsule 10 capsule Intas Pharmaceuticals Ltd INR 3000

Uses of Lenvatinib

Lenvatinib is a medication used to treat various types of cancer, including thyroid, liver, and kidney cancers. It can slow the disease progression and reduce tumor size in patients with radioactive iodine-refractory differentiated thyroid cancer. The most common type of liver cancer, unrespectable hepatocellular carcinoma (HCC), also receives approval for its treatment.

Lenvatinib administration guidelines and available dosage options

Lenvatinib is an oral medication typically taken once daily, ideally at the same time each day, with or without food. A doctor or other healthcare provider should prescribe it. You should swallow these capsules whole, along with a glass of water. Crushing, chewing, or opening them can alter the medication's absorption process and reduce its effectiveness. You should not take a double dose to make up for the second dose.

Information about lenvatinib

Lenvatinib uses

Lenvatinib is used for treating thyroid cancer.

How lenvatinib works

Lenvatinib is a tyrosine kinase inhibitor that works by blocking the supply of oxygen and nutrients to cancer cells, thereby inhibiting their growth.

Common side effects of lenvatinib

Diarrhea, High blood pressure, Protein in urine, Anemia (low number of red blood cells) Heart failure, Liver toxicity, Decreased calcium level in blood, Thyroid disorders, Renal failure
1. Lenvatinib is used to treat thyroid cancer.
2. Take it with or without food, but preferably at the same time each day.
3. Diarrhea is a possible side effect. Drink plenty of fluids, and inform your doctor if it doesn't stop or if you find blood in your stools.
4. Use a reliable contraceptive method to prevent pregnancy while you are taking this medicine and for a month after you stop taking it.
5. Monitor your blood pressure regularly while taking this medication. Inform your doctor if you notice symptoms of very high blood pressure, such as a severe headache, confusion, problems with your eyesight, nausea, or vomiting.
6. It may cause serious bleeding problems. Inform your doctor if you get headaches, stomach pain, or if you notice blood in your urine or stools.
7. Do not take this medicine if you are pregnant, planning to conceive, or breastfeeding.

Warning, Precautions, and Side Effects Associated with Lenvatinib

Warnings

Lenvatinib can lead to elevated blood pressure and increase the risk of cardiovascular events such as heart attack and stroke. It may also increase the risk of bleeding or hemorrhage, as well as impair wound healing. Additionally, it can cause kidney damage or failure, resulting in proteinuria (an abnormal amount of protein in the urine). In some cases, it may lead to hypothyroidism or other thyroid dysfunctions. Rarely, this medication can cause reversible posterior leukoencephalopathy syndrome (RPLS), which can manifest as seizures, confusion, and other neurological symptoms.

Precautions

Lenvatinib patients should regularly monitor their blood pressure; if hypertension is not well-controlled, they may need to adjust their dose or stop their treatment. Patients with a history of cardiovascular disease, bleeding, or taking blood thinners require close monitoring. Patients should inform their healthcare provider if they intend to undergo any surgical procedures during treatment, as this medication increases the risk of bleeding. While taking this medication, you should do regular urine tests for protein checks and any signs of kidney problems. Women of reproductive age should use effective contraception while taking it, and for at least one week after the last dose. You should regularly test your thyroid function while taking it, and if you notice any signs of thyroid dysfunction, immediately inform your doctor.

Side effects

Lenvatinib can lead to several side effects, some of which may be serious. Common side effects include fatigue, decreased appetite, weight loss, muscle pain, nausea, vomiting, and diarrhea. Patients might also experience elevated blood pressure. Other potential side effects encompass liver damage, blood clotting issues, and cardiovascular problems. It is important to closely monitor for signs of liver damage, such as jaundice (yellowing of the skin or eyes), dark urine, or abdominal pain. The medication can also increase the risk of blood clots, which can be life-threatening and may cause serious heart conditions, including heart attack, stroke, and heart failure.

Word of advice

Maintain regular communication with your healthcare provider and report any concerns or side effects promptly. Avoid pregnancy and breastfeeding during treatment. Refrain from consuming grapefruits, as they can interfere with the absorption of this medication. Use sunscreen and wear protective clothing when outdoors to minimize the risk of sunburn or skin damage. Avoid strenuous activities or exercise until you understand how the medication affects you. Maintain a healthy and balanced diet to support your overall health and well-being. Staying informed and actively engaged in your treatment can help achieve the best outcomes and manage potential risks or complications effectively.

FAQ - Lenvatinib

1Can lenvatinib cause infertility?
Lenvatinib can cause menstrual periods to change and may affect fertility in some women. Patients should talk to their healthcare provider about any fertility concerns before starting this medication.
2 Can lenvatinib cause hair loss?
Yes, hair loss is a possible side effect of lenvatinib, though not all patients will experience it. Patients should discuss potential side effects with their healthcare provider before beginning treatment.
3 Can lenvatinib cause heart problems?
Lenvatinib may cause high blood pressure, which can elevate the risk of heart issues. Patients should have their blood pressure checked regularly while on this medication.
4 If I am taking Lenvatinib, can I go for a teeth extraction?
Before having any dental procedures, it is important to inform your dentist and healthcare provider that you are taking lenvatinib. This medication can increase the risk of bleeding, and procedures involving cutting or removing tissue may further elevate this risk. Your healthcare provider and dentist may advise you to take certain precautions, such as temporarily stopping this medication before the procedure or adjusting your medication dose.
5 Can lenvatinib cause vision issues?
Yes, vision problems can be a side effect of lenvatinib. Patients should report any changes in their vision to their healthcare provider right away.
6 Can lenvatinib be administered to children?
Children do not currently have approval for the use of lentinib. We have not established the safety and efficacy in children.

References

1. Eisai Inc U.S Food and Safety Drug Administration (FDA) [Last revised Aug 2018], [Accessed on 20th April 2023],https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/206947s007lbl.pdf
2. M.W.J. Strachan, J. Newell-Price, Endocrine disease, Davidson’s Principles & Practice of Medicine, 22nd Edition, 2014, 733-796.
3. Q.M. Anstee, D.E.J. Jones, Liver and Biliary Tract Disease, Davidson’s Principles and Practice of Medicine, 22nd Edition, 2014, 921-988.
4. Suyama and Iwase, Lenvatinib: A promising molecular targeted agent for multiple cancers, Cancer Control, 2018, 25, 1-5, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056795/pdf/10/1177 1073274818789361.pdf
5. Eisai Europe Limited, Electronic Medicines Compendium (EMC), [Revised on Mar 2021] [Accessed on 20th April 2023],https://www.medicines.org.uk/emc/files/pil.6840.pdf