
Lenvatinib is used to treat the following conditions:
Advanced thyroid cancer
Advanced liver cancer
Renal cell carcinoma (kidney cancer) when combined with Everolimus (Afinitor®) or Pembrolizumab (Keytruda®)
Endometrial cancer when combined with Pembrolizumab (Keytruda®)
Dose and Schedule
To ensure that Lenvatinib is as effective as possible, it is essential to take it as prescribed. Please follow these key points:
- Dose may vary, but the usual doses are as follows:
- 24 mg for thyroid cancer
- 20 mg for endometrial cancer
- 18 mg or 20 mg for kidney cancer
- 8 mg or 12 mg for liver cancer
- Take Lenvatinib by mouth once a day at the same scheduled time for 4 weeks.
- It can be taken with or without food, but aim to take it at the same time each day.
- Swallow the tablets whole. Do not crush, cut, or dissolve them. If you have difficulty swallowing, consult your doctor for alternative options.
- If you miss a dose:
- Only take the missed dose if it has been less than 12 hours since the scheduled time.
- Do not take an extra dose. Simply resume your regular schedule.
- Write down any missed doses and inform your doctor.
- If you are undergoing a surgical or dental procedure, inform your doctor that you are taking Lenvatinib, as it may need to be paused until your wound heals.
Drug and Food Interactions
- Lenvatinib can interact with several drugs. Inform your doctor of all prescription medications, over-the-counter drugs, vitamins, and herbal products you are taking.
- Before taking any new medications or supplements, or receiving vaccines, consult your doctor or pharmacist.
Storage and Handling
- Handle Lenvatinib with care, as it can be toxic, similar to chemotherapy drugs. Limit exposure to others.
- Store Lenvatinib at room temperature (below 25°C), in a dry place, away from light.
- Keep the medication out of reach of children and pets.
- Leave Lenvatinib in its original packaging until you are ready to take it.
- Administer the medication to yourself whenever possible.
- If a caregiver, friend, or family member must administer it, they should wear gloves when handling the tablets.
- Take Lenvatinib immediately with water.
- If you have any unused Lenvatinib, do not throw it away or flush it down the toilet. Instead, return it to the practice for proper disposal.
- If travelling, place the packaging in a sealed plastic bag and ask your pharmacist if additional precautions are needed.
Side Effects of Lenvatinib
Common side effects are known to affect about one-third of patients taking Lenvatinib. However, you may not experience these side effects. Below is a list of potential side effects and management advice.
Changes in liver, kidney, and thyroid function | Blood tests will be done before each cycle to monitor your liver, kidney, and thyroid function. |
Changes in electrolytes and laboratory values | These may include changes in glucose, amylase, lipase, triglycerides, cholesterol, potassium, alkaline phosphatase, albumin, and calcium. |
Yellowing of the skin or whites of the eyes | Call us immediately. |
Dark or brown urine | Call us immediately. |
Unusual bleeding or bruising | Use caution to avoid cuts, bruises, and burns. Gently blow your nose and use a soft toothbrush. For cuts, apply pressure until bleeding stops. Contact us if bleeding persists. |
Fatigue | Stay as active as possible, but allow yourself time to rest. Plan activities for when you feel more energetic. |
Diarrhoea (loose or urgent bowel movements) | Drink plenty of water (8-10 glasses per day). Eat small, frequent meals, and avoid high-fibre foods. Use Loperamide (Imodium) or Smecta for symptom relief. Contact your doctor if diarrhoea persists. |
Mouth irritation or sores | Maintain good oral hygiene. Use salt and bicarbonate mouth rinse, and avoid spicy or hard foods. Apply lip balm and use prescribed medications for sores. |
Decreased appetite or weight loss | Eat small, frequent meals. Consider liquid nutritional supplements. If weight loss is significant, inform your doctor. |
Increased blood pressure | Monitor your blood pressure regularly and record it. Contact your doctor if you experience any of the following: headache, dizziness, chest pain, shortness of breath, swelling, or weight gain. |
Abdominal pain | Report any serious pain immediately. |
Voice changes or hoarseness | These should resolve when you stop taking the medication. |
Headaches | Consult your doctor for advice on managing headaches. Contact your doctor immediately if the headache is severe, persistent, or accompanied by other symptoms like vomiting, vision changes, or confusion. |
Muscle or joint pain or weakness | Stay as active as possible, but allow time to rest. Keep a pain diary and inform your doctor if pain affects your daily activities. |
Pain or discomfort in hands/feet (Hand-foot skin reaction – HFSR) | Keep hands and feet moisturised and avoid tight shoes or socks. Soak feet in Epsom salt, and use cushioning when engaging in activities that pressure your hands. |
Handling Body Fluids and Waste
Lenvatinib remains in the body for several days after it is taken, and traces of the drug may be present in urine, stool, sweat, or vomit. To protect yourself and others, follow these precautions:
- Pregnant women should avoid touching anything contaminated with body fluids.
- Use the toilet as usual, but close the lid and flush twice to dispose of waste effectively. Clean the toilet if soiled.
- Wash hands thoroughly with soap and water after using the toilet.
- For bedpans, caregivers should wear gloves and clean the bedpan daily.
- Soiled linens or clothing should be washed separately from other laundry. Wash hands after handling soiled items.
Pregnancy, Sexual Activity, and Contraception
- Women should avoid pregnancy, and men should avoid fathering a child during treatment with Lenvatinib.
- Both men and women of childbearing age should use effective contraception during therapy and for at least 1 month after the last dose of Lenvatinib.
- Do not breastfeed while taking Lenvatinib and for 1 week after the last dose.
- Inform your doctor immediately if you become pregnant.
Compiled by : Karin Mouton
Registered Oncology Nurse