regorafenib
Other Name: Stivarga®
- For treating colorectal cancer, gastrointestinal stromal tumours (GIST) or liver cancer in patients who have received treatment(s) before.
- Tell your doctor and pharmacist if you have or had significant medical condition(s), such as:
- heart problems (including heart rhythm),
- high blood pressure,
- liver or kidney problems,
- bleeding problems,
- recent or upcoming surgery,
- taking blood thinners or
- have any allergies.
- People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
- The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, become(s) pregnant during treatment, or if you are breastfeeding.
- If there is ANY chance that you or your partner may become pregnant, you and your partner together must:
- ► Use 2 different forms of birth control while on treatment and for at least 8 weeks after the last dose.
- ► Use 2 different forms of birth control while on treatment and for at least 8 weeks after the last dose.
- Do not breastfeed while taking this drug and for 2 weeks after the last dose.
- This medication may affect fertility (ability to get pregnant).
- Regorafenib is usually taken by mouth daily for 21 days, followed by 7 days of rest (3 weeks on, 1 week off).
- Take regorafenib exactly how your doctor told you to take it.
- Swallow tablets whole with a glass of water, after a low-fat and low-calorie (300-550 calorie) meal. Example meal: 2 slices of white toast with 1 tablespoon of low-fat margarine, 1 tablespoon of jelly and one glass (8 ounces) of skim milk.
- A missed dose should be taken as soon as remembered on the same day. Otherwise, skip this and take the next dose on the following day. Do not take two doses on the same day.
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Do not eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. They may increase side effects.
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This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.
- Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements), such as antibiotics, antifungals, seizure medications and St. John's Wort. Check with your health care team before starting or stopping any of them.
- For mild aches and pain:
- You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you.
- Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding.
- Talk to your health care team before you start or stop these medications.
- If you feel unwell, take your temperature before taking any of these medications. They may hide a fever.
- Talk to your health care team or go to the closest emergency room right away if you have a fever. See the Fever pamphlet for more information.
- Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.
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Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
- Keep the desiccant in the bottle after the first opening. Keep the bottle tightly closed. Do not eat the desiccant.
- The tablets can be used for up to 7 weeks after the bottle has been opened.
You may not have all of the side effects below. You may have side effects that are not listed.
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Abnormal liver lab tests (may be severe)
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Contact your health care team if no improvement or if severe | ||||
Fatigue (tiredness)
See our Fatigue pamphlet for more information. |
Contact your health care team if no improvement or if severe | ||||
Salt imbalances It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat. |
Get emergency medical help right away |
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Low appetite
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Contact your health care team if no improvement or if severe | ||||
Hand-foot syndrome (may be severe) You may have pain, thinning, reddening, tingling, numbness and peeling of the skin on your palms or the soles of your feet. This may occur days to weeks after the dose is given or after you start treatment. To help prevent Hand-foot syndrome :
Also see Hand-Foot Syndrome pamphlet for more information. |
Contact your health care team if no improvement or if severe | ||||
Abnormal levels of pancreas tests (lipase, amylase) Your doctor may monitor these regularly. |
Contact your health care team if no improvement or if severe | ||||
Diarrhea May happen days to weeks after you get your treatment. If you have diarrhea :
See the Diarrhea pamphlet for more information. |
Contact your health care team if no improvement or if severe | ||||
Unusual bleeding or bruising (may be severe)
You have a fever if your temperature taken in your mouth (oral temperature) is:
While you are getting treatment:
If you have a fever, talk to your health care team or go to the closest emergency room. |
Get emergency medical help right away | ||||
Hoarseness (raspy voice) |
Contact your health care team if no improvement or if severe | ||||
High blood pressure (may be severe)
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Contact your health care team if no improvement or if severe | ||||
Rash; dry, itchy skin Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away. To prevent and treat dry skin,
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Contact your health care team if no improvement or if severe |
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Mouth sores You may have round, painful, white or gray sores inside your mouth. They can occur on the tongue, lips, gums, or inside your cheeks. In more severe cases they may make it hard swallow, eat or to brush your teeth. They usually last 1 to 2 weeks. To help prevent mouth sores:
If you have mouth sores:
See the Mouth Care pamphlet for more information.
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Contact your health care team as soon as possible | ||||
Headache; mild joint, muscle pain or stiffness
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Contact your health care team if no improvement or if severe |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
- new cough, difficulty breathing, or coughing up blood
- chest pain and/or swelling of arms or legs
- sudden severe pain in your upper back, that moves up your neck or down your back, when you didn’t hurt yourself
- weakness on one side of your body
- trouble speaking, seeing, swallowing or difficulty using your arms or legs
- irregular heartbeat and/or fainting spells
- severe headache, confusion, changes in your vision or seizures
- severe belly pain, sudden changes in your bowel movements or digestion
- unusual pulsating or throbbing feeling in your chest or belly
- peeing much less than usual, unusual weight gain
- new growths on your skin
- wounds that have trouble healing or do not heal well
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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November 2023 Modified Breastfeeding and Side effects sections
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.