Sunitinib

Sunitinib

What is Sunitinib?

Sunitinib is an anti-cancer medication prescribed to treat Metastatic Renal Cell Carcinoma or Kidney Cancer. This medication is advised to use under medical supervision only. Not advised to use for patients less than 18 years old.

Type of drug

Sunitinib belongs to tyrosine kinase inhibitor group of drugs.

Use in brief

Sunitinib is prescribed to use in the treatment of kidney cancer.

Constituents

Sunitinib itself is an active ingredient in branded medicine like Suninat and Sutent Capsules.

Indications

Sunitinib is prescribed in the treatment of below mentioned health conditions.

  • Metastatic Renal cell carcinoma (Kidney Cancer)
  • Gastrointestinal Stromal Tumor (GIST) after disease progression on or intolerance to imatinib mesylate.
  • Advanced Pancreatic Neuroendocrine Tumors (pNET).

How does Sunitinib work?

Cancer tumours need active blood supply in order to grow further. Sunitinib basically belongs to anti-cancer type of drugs called tyrosine kinase inhibitor and works by stopping the formation of new blood vessels that supply blood to the tumours and also block the proteins called tyrosine kinases.

How to Take Sunitinib?

Form of medicine – Sunitinib medicine is available in the form of capsules.

When and How to use?

Follow the instructions as mentioned in the prescription. Generally used with or without food. Never crush or chew the capsules but swallow the whole medicine along with some water or liquids. In general this medicine is advised to use with food.

Common Dosage:

Recommended Dose for GIST and RCC:

The recommended dose of Sunitinib for gastrointestinal stromal tumor (GIST) and Advanced Renal Cell Carcinoma (RCC) is one 50 mg oral dose taken once daily, on a schedule of 4 weeks on treatment followed by 2 weeks off. SUTENT may be taken with or without food.

Recommended Dose for pNET:

The recommended dose of Sunitinib for pancreatic neuroendocrine tumors (pNET) is 37.5 mg taken orally once daily continuously without a scheduled off-treatment period. Sunitinib may be taken with or without food.  

However dosage depends on the type of cancer been treated and is decided by the doctor. Follow the instructions by your doctor. Never miss a dose or take excess dose. Consult your doctor immediately if any excess dosage happens by mistake.

When to Avoid Sunitinib?

Sunitinib is not advised to use in some health conditions such as:

  • Allergic reaction towards the Sunitinib medication
  • Pregnancy
  • Breastfeeding
  • Not recommended in patients aged below 18 years.

Advised to use with precautions and medical supervision in below mentioned health conditions

  • Cardiac disorders
  • Thyroid Disorder
  • Hypertension
  • Invasive dental procedures are also an identified risk factor. Prior to treatment with Sunitinib, a dental examination and appropriate preventive dentistry should be considered. In patients who have previously received or are receiving intravenous bisphosphonates, invasive dental procedures should be avoided if possible
  • Gastrointestinal disorders
  • Skin disorders
  • Liver Impairment
  • Hypoglycemia
  • Kidney Disease
  • Bleeding complications

Side-effects of Sunitinib

Sunitinib may possibly show some side effects in some patients. It is advised to consult your doctor if any of such side effects are noticed and if they are prolonged. Below mentioned are some possible side effects by Sunitinib. It may show side effects that are not mentioned here in this list.

  • Nausea
  • Vomiting
  • Weakness
  • Edema
  • Rash
  • Abdominal pain
  • Pain in extremity
  • Back pain
  • Headache
  • Joint pain
  • Discoloration of skin and hair
  • Tiredness and fatigue
  • Hypothyreosis
  • Fever
  • Dry skin
  • Bleeding-epistaxis(nose bleed is the common adverse reaction)
  • High BP
  • Diarrhea
  • Constipation
  • Painful blisters on hands and feet
  • Stomatitis
  • Hair discolouration
  • Weight loss
  • Cough
  • Taste change
  • Indigestion
  • Shortness of breath

Effects on organs

This medicine may possibly show adverse effects on the organs like heart, liver, kidney, thyroid, GI tract and skin.

  • Serious infections, with or without neutropenia, including some with a fatal outcome, have been reported. Uncommon cases of necrotising fasciitis, including of the perineum, sometimes fatal, have been reported.
  • Hypersensitivity/angioedema, Tumour Lysis Syndrome, Seizures, Osteonecrosis of the Jaw, Impaired wound healing, Fistula were reported as adverse effects of Sunitinib.

It is advised to use with extreme precautions and medical supervision in case of severe health disorders or impairment related to these organs. It is advised to consult the doctor and share detailed information about the current health condition so that the doctor can alter the dosage depending on the patient’s health condition.

Reported Allergic Reactions?

It is not recommended in patients who have known allergic reactions towards Sunitinib. Precaution has to be taken in case of known issues of skin disorders. 

Effect on menstrual cycle

Effect on the menstrual cycle is not clinically established. You may consult your gynaecologist.

Drug Interactions to Be Careful About

Sunitinib may possibly show drug interaction with some other medication if they are used together. It is advised to share the medication details that you might be using any with your doctor before he prescribes this medicine to you.

Sunitinib has the possibility of showing drug interaction if used along with the below mentioned list of medicine.

  • Ketoconazole, Itraconazole (used to treat fungal infections)
  • Erythromycin, clarithromycin, Rifampicin (used to treat infections)
  • Ritonavir (used to treat HIV)
  • Dexamethasone (A corticosteroid used for various conditions)
  • Phenytoin, carbamazepine, phenobarbital (used to treat epilepsy and other neurological conditions)
  • Plant-based preparations that contain St. John’s Wort (used to treat depression and anxiety)

Food interactions

Consumption of grapefruit or grapefruit juice is not advised as this may affect the medicine levels in the blood and cause severe side effects such as nausea, vomiting, loss of appetite, mouth sores, diarrhea, hair loss, pain, numbness, weakness.

Interactions with laboratory procedures:

It is advised to monitor Complete Blood Count before and during the treatment with sunitinib. Limited data is available on interaction with any diagnostic test while under the medication but it is always good to share details about your current medication before attending any lab tests so that you doctor and lab technician is aware of.

Is Sunitinib Addictive?

No drug addiction is noticed in case of Sunitinib.

Can I have Sunitinib with alcohol?

Limited data is available about the effect of Sunitinib if consumed with alcohol. Consult your doctor if you have a habit of taking alcohol at regular basis.

Can I have Sunitinib When Pregnant?

Not advised to use in general in pregnant women.

Can I have Sunitinib when feeding a baby?

Not advised to use in general in breastfeeding women. But with consultation and supervision in case if unavoidable and the intended benefits are more compared to possible side effects. If this medicine is prescribed during breastfeeding, your doctor may advise you to discontinue breastfeeding until the treatment is completed.

Can I drive after taking Sunitinib?

Some patients may feel dizzy and alertness may be decreased and in such conditions it is not advised to do activities that require alertness such ad driving or operating heavy machinery.   

Effect of overdose Sunitinib

Serious adverse effects may be possible if overdosage happens in large quantities. Consult your doctor immediately in such situations.

Effect of using expired Sunitinib?

It is advised not to use any medicine that is expired to avoid any adverse effects. Consult your doctor immediately if any adverse effects are noticed by taking any expired medicine. It is advised to check the label while purchasing the medicine to verify the expiry date to be safe.

Effect of missing a dose of Sunitinib

No major adverse effects are noticed if only one dosage is missed. But if you are missing the dosages regularly, it is advised to keep a reminder so that you don’t miss the regular dosage.

Storage requirements

No specific storage requirements. Keep away from the reach of the children and pets.

Different Brands of Sunitinib medicine available

Below mentioned is the available brand of medicine that contains Sunitinib as a key ingredient, and your doctor may prescribe this to treat the condition.

  • Suninat 50mg Capsule – Manufactured by Natco Pharma Ltd
  • Sutent Capsule – Manufactured by Pfizer Ltd

Sutent is available in various dosages (available in 12.5mg/ 25mg/37.5/ 50mg) in the form of Capsules.

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