Axitinib

When should one not use Axitinib

Common side effects of this drug are:

• Metabolism and Nutrition:
• Decreased appetite
• Nervous System:
• Headache
• Altered taste (Dysgeusia)
• Vascular:
• High blood pressure (Hypertension)
• Bleeding (Haemorrhage)
• Respiratory:
• Shortness of breath (Dyspnoea)
• Cough
• Hoarseness or voice changes (Dysphonia)
• Gastrointestinal:
• Diarrhoea
• Vomiting
• Nausea
• Abdominal pain
• Constipation
• Inflammation of the mouth (Stomatitis)
• Indigestion (Dyspepsia)
• Skin and Tissue:
• Hand-foot syndrome (Palmar-plantar erythrodysaesthesia)
• Rash
• Dry skin
• Musculoskeletal:
• Joint pain (Arthralgia)
• Pain in the extremities (arms, legs, hands, feet)
• Renal:
• Protein in the urine (Proteinuria)
• General:
• Fatigue
• Weakness (Asthaenia)
• Inflammation of mucous membranes (Mucosal inflammation)
• Weight loss (Weight decreased)

Other General Warnings

• You have a history of cardiac failure events.
• You develop signs or symptoms of cardiac failure.
• Your blood pressure is not well-controlled.
• You experience persistent hypertension despite using antihypertensive medication.
• You develop severe hypertension.
• You experience severe or persistent arterial hypertension along with symptoms suggestive of posterior reversible encephalopathy syndrome (PRES) (e.g., headache, seizure, confusion, blindness).
• You have a history of thyroid dysfunction (hypothyroidism or hyperthyroidism).
• You are at risk for or have a history of arterial embolic and thrombotic events (e.g., transient ischemic attack, myocardial infarction, stroke, retinal artery occlusion).
• You had an arterial embolic or thrombotic event within the previous 12 months.
• You are at risk for or have a history of venous embolic and thrombotic events (e.g., pulmonary embolism, deep vein thrombosis, retinal vein occlusion/thrombosis).
• You had a venous embolic or thrombotic event within the previous 6 months.
• You experience elevated haemoglobin or haematocrit levels.
• You have evidence of untreated brain metastasis.
• You have experienced recent active gastrointestinal bleeding.
• You have any bleeding that requires medical intervention.
• You have risk factors for aneurysms or artery dissections, such as hypertension or a history of aneurysm.
• You develop symptoms of gastrointestinal perforation or fistula.
• You have scheduled surgery (as axitinib should be stopped at least 24 hours prior).
• You experience signs or symptoms of posterior reversible encephalopathy syndrome (PRES) (e.g., headache, seizure, lethargy, confusion, blindness).
• You develop moderate to severe proteinuria (protein in your urine).
• You develop nephrotic syndrome.
• You experience liver-related adverse reactions, such as increased liver enzymes or bilirubin.
• You have moderate hepatic impairment (Child-Pugh class B).
• You have severe hepatic impairment (Child-Pugh class C) (as axitinib should not be used in this population).

How Does It Work?

Interactions with other medicines

• Strong CYP3A4/5 inhibitors (e.g., ketoconazole, clarithromycin) significantly increase axitinib blood levels. Dose adjustment of axitinib may be necessary; avoid if possible.
• Grapefruit may also increase axitinib blood levels.
• Strong CYP1A2 and CYP2C19 inhibitors may potentially elevate axitinib blood levels; caution is advised.

Overdose

Missed a Dose