Adult: 50 mg once daily for 4 wk followed by a 2-wk rest period to comprise a complete 6-wk cycle. May be adjusted in increments or decrements of 12.5 mg based on individual tolerability. Min: 25 mg daily. Max: 75 mg daily.
Oral Malignant tumour of endocrine pancreas, advanced
Adult: 37.5 mg once daily, given continuously. May be adjusted in increments or decrements of 12.5 mg, based on individual tolerability. Max: 50 mg daily.
Special Patient Group
Patients taking strong CYP3A4 inhibitors:
Unresectable, metastatic malignant gastrointestinal stromal tumours; Metastatic renal cell carcinoma:Reduce dose to a Min of 37.5 mg daily.
Advanced pancreatic neuroendocrine tumour Reduce dose to a Min of 25 mg daily.
Patients taking CYP3A4 inducers:
Unresectable, metastatic malignant gastrointestinal stromal tumours; Metastatic renal cell carcinoma: May increase in increments of 12.5 mg to a max of 87.5 mg daily.
Advanced pancreatic neuroendocrine tumour: May increase in increments of 12.5 mg to a max of 62.5 mg daily.
Severe: (Child-Pugh class C): Contraindicated.
May be taken with or without food.
Hypersensitivity to sunitinib. Severe hepatic (Child-Pugh class C) impairment. Lactation.
Patients w/ history of CV events (e.g. heart failure, cardiomyopathy, MI, myocardial ischaemia); history of QT interval prolongation; bradycardia, electrolyte imbalance, thyroid dysfunction, underlying or poorly controlled HTN. Patient undergoing major surgery. Hepatic and renal impairment. Pregnancy. Concomitant use w/ potent CYP3A4 enzyme inhibitors and inducers should be avoided, if not possible, consider dosage adjustment.
Monitor LVEF, BP, ECG, adrenal function, CBC w/ differential and platelet, LFTs (prior to and during each cycle of treatment), blood glucose levels, urinalysis, serum chemistries (e.g. Mg, phosphate, K); signs/symptoms of hypoglycaemia, hypothyroidism, hyperthyroidism, or thyroiditis.
Symptoms: Impaired muscle coordination, head shakes, hypoactivity, piloerection, ocular discharge, GI distress. Management: General supportive treatment. Emesis or gastric lavage may be considered to eliminate unabsorbed drug.
L01EX01 - sunitinib ; Belongs to the class of other protein kinase inhibitors. Used in the treatment of cancer.
Anon. Sunitinib. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/03/2016.Buckingham R (ed). Sunitinib Malate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/03/2016.Joint Formulary Committee. Sunitinib. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/05/2017.McEvoy GK, Snow EK, Miller J et al (eds). Sunitinib Malate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 04/03/2016.Sutent Capsule (Pfizer Laboratories Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/03/2016.