Sunitinib (Sutent)

It is important to take Sunitinib as instructed to ensure your treatment is as effective as possible. Here are some key points to remember:

• Usual Dose:
  • For GIST and RCC: 50 milligrams (50 mg) taken orally once a day at a scheduled time, for 4 weeks on treatment followed by 2 weeks off.
  • For pNET: 37.5 milligrams (37.5 mg) taken orally once a day, continuously without a scheduled off-treatment period.
• Sunitinib can be taken with or without food, but it should be taken at the same time each day.
• Sunitinib should be swallowed whole; do not crush, cut, or dissolve the tablets. If you are unable to swallow Sunitinib, talk to your doctor about possible alternatives.
• If you miss a dose, do not take an extra dose or double dose. Simply take your next dose at the regularly scheduled time. Write down any missed doses and inform your doctor at your next appointment.
• If you require surgery, inform your doctor that you are taking Sunitinib. It may need to be stopped until your wound heals following certain surgeries.

• Sunitinib has many potential drug interactions. Inform your doctor of all medications, including prescription, over-the-counter, vitamins, and herbal products you are taking.
• Avoid grapefruit or grapefruit juice during treatment with Sunitinib, as they may interact with the drug.
• Consult your doctor or pharmacist before taking new medications, supplements, or receiving any vaccines.

• Handle Sunitinib with care, as it can be toxic, much like chemotherapy drugs. Limit exposure to others.
• Store Sunitinib at room temperature (below 25°C) in a dry place, away from light.
• Keep Sunitinib out of reach of children and pets.
• Keep Sunitinib in its provided packaging until you are ready to take it.
• Administer Sunitinib to yourself whenever possible. If someone else must give you the medication, they should wear gloves when handling the tablets.
• Administer the medicine immediately by mouth with water.
• If you have unused Sunitinib, do not dispose of it in the trash or flush it down the toilet. Return all unused medication to the practice for proper disposal.
• When travelling, place your Sunitinib packaging in a sealed plastic bag. Ask your pharmacist if any additional travel precautions are required.

The following common side effects have been reported in approximately one-third of patients taking Sunitinib. Please note that you may not experience these side effects.

If your white blood cell count is low, you may be at higher risk of infection. Take the following precautions to protect yourself:

• Wash your hands frequently.
• Avoid people with fevers, flu, or other infections.
• Maintain good personal hygiene.

Contact us immediately if you experience any of the following symptoms of infection:

• Fever (above 38°C)
• Chills
• Sore throat
• Pain or burning with urination

Fatigue and Decreased Appetite

• You may feel more tired than usual. Try to get enough rest and balance your work with breaks.
• If you notice significant weight loss, talk to your doctor.

Gastrointestinal Side Effects (Nausea, Vomiting, Diarrhoea)

• To manage nausea, try eating small, frequent meals and drinking 8–10 glasses of water daily.
• For diarrhoea, drink plenty of fluids and avoid spicy, greasy, or high-fiber foods. If necessary, take medications like Loperamide (Imodium) or Smecta.
• If diarrhoea persists, consult your doctor.

Mouth Sores and Irritation

• Practice good oral hygiene, rinse your mouth frequently, and use a soft toothbrush.
• Rinse with a mixture of salt and bicarbonate of soda in lukewarm water.
• Apply lip balm to keep lips moisturised.
• Avoid spicy or hard foods and tobacco.

Skin and Hair Colour Changes

• Some people may notice changes in skin or hair colour, such as yellowing or lightening. These changes usually return to normal after treatment ends.

• Women should not become pregnant, and men should not father a child while taking Sunitinib.
• Both men and women of childbearing potential should use effective contraception during therapy and for at least one month after the last dose.
• Do not breastfeed while taking Sunitinib and for at least one month after the last dose.
• If you become pregnant during treatment, inform your doctor immediately.

Since Sunitinib remains in your body for several days, some of the drug may be present in urine, stool, sweat, or vomit. To keep yourself, others, and the environment safe:

• Pregnant women should avoid contact with body fluids from patients taking Sunitinib.
• Use your usual toilet and flush twice to ensure all waste is discarded.
• Clean any soiled surfaces before others use the toilet.

Wash your hands thoroughly after using the toilet or handling soiled linens or clothing.