Download - Sorafenib
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Tablets: 200 mg
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for the treatment of advanced renal cell carcinoma when treatment with interferonalfa or interleukin-2 has failed or is contra-
indicated………
for the treatment of hepatocellularcarcinoma………
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Sorafenib is a type of biological therapy called a protein tyrosine kinase inhibitor)TKI( . Tyrosine kinase is a protein which acts as a chemical messenger)an enzyme(. There are a number of different tyrosine kinases that encourage cancer cells to grow.Sorafenib blocks a number of protein kinases and is called.a multi kinase inhibitor
It works in two ways. It stops Signals that tell cancer cells
to grow Cancel cells forming blood vessels ,
which they need to grow Treatment that stops blood vessels forming is called anti angiogenesistreatment
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Sorafenib is a tablet take with a glass of water.It should take either an hr before eat or.2 hrs after
ADULT over 18 years, 400mg twice daily
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*Antibacterial:plasma conc. of sorafenib reduced by rifampicin
*Anticoagulants:sorafenib possibly enhances anticoagulanteffect of coumarins
*Antiepileptics: cytotoxics possibly reduce absorptionof phenytoin
*Antipsychotics:avoid concomitant use of cytotoxics)with clozapine )increased risk of agranulocytosis
*Cardiac Glycosides: cytotoxics reduce absorption of digoxintablets
*Cytotoxics:. sorafenib possibly increases plasma conc of doxorubicin and irinotecan, increases plasma concentration ofdocetaxel
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Fecal)77% ( and renal))19%
Excretion
25-48hoursHalf life
Hepatic oxidation and glucuronidation))CYP3A4 mediated
Metabolism
99,5%Protein binding
29-49% Bioavailability
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major surgical procedures
,cardiac ischaemia
hepatic impairment
)Pregnancy )category D
breast-feeding
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Common side effects Diarrhoea **Hand-foot syndrome** rash, or red, dry itchy skin **Fatigue** Hair thinning **Feeling sick** **Raised blood pressure )hypertension( **Increased risk of bleeding
Rare side effectsBreast tenderness and swelling because sorafenib may lower** male sex hormone )testosterone( levels Heart problems including chest pain**
**)Bleeding of the stomach lining occurs in less than )1%
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With this drug, some people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following sideeffects Increased risk of getting an infection from a drop in WBC** Tiredness and breathlessness due to a drop in RBC**
Bruising more easily due to a drop in platelets** Some of these side effects can be life threatening, particularlyinfections
Other occasional side effects includeSkin flushing, Aching joints, Constipation
sore mouth, Indigestion, Weakness , Pain Loss of appetite, Flu like symptoms A hoarse voice, Low mood
A mild effect on the liver -
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BNF September 2009 page 467,489
BNF for children 2009 page 867
http//:en.wikipedia.org/wiki/Sorafenib
http://www.rxlist.com/nexavar-drug.htm
http://www.cancerhelp.org.uk/about-cancer/treatment/cancer-drugs/sorafenib