lenvatinib
Other Name: Lenvima
in various strengths, shapes and colours
- For treating certain types of thyroid, kidney or liver cancers, and may be used to treat other types of cancer
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Tell your health care team if you have or had significant medical condition(s), especially if you have or had:
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high blood pressure
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liver, kidney or heart problems (including an irregular heartbeat)
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diabetes or nerve problems,
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headaches, seizures, or vision problems
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any bleeding problems
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a history of blood clots, including stroke
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a history of a tear in your stomach or intestine
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previous radiotherapy or
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any allergies.
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Tell your health care team if you have an eating disorder, are following a strict diet, or have conditions that may change salt levels in your blood such as severe vomiting or diarrhea.
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Tell your health care team if you have recently had or will have surgery.
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Your blood pressure should be well controlled before starting lenvatinib. Your health care team will check your blood pressure regularly when you start treatment.
Remember to:
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Tell your health care team about all of the other medications you are taking.
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Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.
Talk to your health care team about:
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How this medication may affect your sexual health.
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How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
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If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time for at least 1 month after your last dose. Talk to your health care team about which birth control options are best for you.
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Do not breastfeed while using this medication.
- This medication may affect fertility (ability to get pregnant).
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This medication is usually taken once daily by mouth, with or without food. Talk to your health care team about how and when to take your medication.
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Swallow lenvatinib capsules whole with a glass of water. Do NOT open, chew, crush, or split the capsules.
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If you have trouble swallowing capsules, talk to your health care team about how to make a lenvatinib mixture in a small glass of water or apple juice without crushing or breaking the capsules.
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You may be given this treatment along with other medication(s) to prevent nausea and vomiting. Make sure you take them as directed by your doctor
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If you miss a dose of lenvatinib, take it if it is within 12 hours of the missed dose. Do not take lenvatinib if it has been more than 12 hours since you missed your dose. Take your next dose as scheduled. Do not double the dose to make up for the forgotten one.
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If you vomit (throw up) after taking your medication, talk to your health care team about what to do.
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If you take too much of your medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away.
Will this medication interact with other medications or natural health products?
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This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
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Tell your health care team about all of your:
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prescription and over-the-counter (non-prescription) medications and all other drugs, such as marijuana (medical or recreational)
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natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
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Check with your health care team before starting or stopping any of them.
If you take medication(s) to help with your blood pressure, your health care team may monitor your blood pressure and may change your dose.
What should I do if I feel unwell, have pain, a headache or a fever?
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol) or ibuprofen (Advil)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
- You have a fever if your temperature taken in your mouth (oral temperature) is:
- 38.3°C (100.9°F) or higher at any time
OR
- 38.0°C (100.4°F) or higher for at least one hour.
- 38.3°C (100.9°F) or higher at any time
If you do have a fever:
- Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
- Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
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Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
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Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
What to DO while on this medication:
- DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures. You may need to stop this drug before surgery (lenvatinib might affect how your wounds heal). Only take it again after surgery once you have been told to do so by your health care team.
- DO talk to your health care team about your risk of getting other cancers and heart problems after this treatment.
What NOT to DO while on this medication:
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
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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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How to safely touch oral anti-cancer medications
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
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Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
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What to do if oral anti-cancer medication gets on your skin or in your eyes
If medication gets on your skin:
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Wash your skin with a lot of soap and water.
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If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:-
Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
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The following table lists side effects that you may have when getting lenvatinib. The table is set up to list the most common side effects first and the least common last.
It is unlikely that you will have all of the side effects listed and you may have some that are not listed. Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Abnormal kidney lab tests (Rarely may be severe) Your health care team may check your kidney function regularly with a blood test What to look for?
What to do?
|
Talk to your health care team if it does not improve or if it is severe |
High blood pressure (may be severe) What to look for?
What to do?
If you have a severe headache get emergency help right away as it may be a sign your blood pressure is too high. |
Talk to your health care team if it does not improve or if it is severe |
Diarrhea (may be severe) What to look for?
What to do? If you have diarrhea:
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Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day) |
Changes in thyroid activity Thyroid changes may happen weeks to months after you receive your treatment. Your health care team may check your thyroid activity regularly with a blood test. What to look for? Underactive thyroid (uncommon):
What to do? Your health care team may give you prescription medication to treat your underactive thyroid. If you have weight changes along with any of the other symptoms listed, talk to your health care team as soon as possible. |
Talk to your health care team as soon as possible. |
Low appetite What to look for?
Ask your health care team for the Loss of Appetite pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
High blood sugar What to look for?
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Talk to your health care team as soon as possible |
Liver problems (may be severe) Your health care team may check your liver function with a blood test. The liver changes do not usually cause any symptoms.
If you have any symptoms of liver problems, get emergency medical help right away. |
Get emergency medical help right away |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Low amounts of protein (albumin) in your blood This may be caused by protein loss in your pee Your doctor may monitor for protein in your pee regularly What to look for?
What to do?
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Talk to your health care team as soon as possible |
Nausea and vomiting What to look for?
What to do? To help prevent nausea:
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Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if it is severe |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Mouth sores What to look for?
To help prevent mouth sores:
Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information. |
Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow |
Too much or too little salt in your body What to look for?
What to do? Get emergency medical help right away for severe symptoms. |
Get emergency medical help right away for severe symptoms |
Headache; mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Unusual bleeding or bruising (may be severe) It may be due to low platelets (a type of blood cell). When platelets are low, you are at risk for bleeding and bruising. Ask your health care team for the Low Platelet Count pamphlet for more information. What to look for?
What to do? If your health care team has told you that you have low platelets:
If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. |
Talk to your health care team if you have any signs of bleeding. If you have bleeding that doesn’t stop or is severe, you MUST get emergency medical help right away |
Proteins in Urine (may be severe) Your health care team may do urine tests to check for proteins in your pee. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe. |
Talk to your health care team if it does not improve or if it is severe |
Rash on your hands and feet (hand-foot syndrome) What to look for?
What to do? To help prevent Hand-foot syndrome:
Ask your health care team for the Hand-foot syndrome pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Pains or cramps in the belly What to look for?
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Talk to your health care team if it does not improve or if it is severe |
Hoarseness (raspy voice) What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe. |
Talk to your health care team if it does not improve or if it is severe |
Constipation What to look for?
What to do? To help prevent constipation:
To help treat constipation:
Ask your health care team for the Constipation Pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Cough and feeling short of breath (may rarely be severe) What to look for?
What to do?
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Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away |
Mild swelling What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe |
Low blood sugar What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe |
Rash; dry, itchy skin What to look for?
What to do? To prevent and treat dry 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. |
Talk to your health care team if it does not improve or if it is severe |
Taste changes What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe |
Dry mouth What to look for?
What to do?
See our Mouth Care pamphlet for more information. Talk to your health care team if your dry mouth does not improve or if it is severe. |
Talk to your health care team if it does not improve or if it is severe |
Higher than normal cholesterol or fat levels in the blood What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe |
Dizziness What to look for?
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Talk to your health care team if it does not improve or if it is severe |
Low neutrophils (white blood cells) in the blood (neutropenia) When neutrophils are low, you are at risk of getting an infection more easily. Ask your health care team for the Neutropenia (Low white blood cell count) pamphlet for more information. What to look for?
You have a fever if your temperature taken in your mouth (oral temperature) is:
What to do? If your health care team has told you that you have low neutrophils:
If you have a fever: If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you MUST get emergency medical help right away. |
Heartburn; stomach upset; bloating What to look for?
What to do?
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Talk to your health care team if it does not improve or if it is severe |
Higher than normal levels of pancreas enzymes in your blood (lipase, amylase) What to look for?
What to do?
If you have any symptoms, get emergency medical help right away. |
Talk to your health care team if it does not improve or if it is severe |
Hair thinning or loss What to look for?
What to do?
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Talk to your health care team if this bothers you |
Trouble Sleeping Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe |
Talk to your health care team if it does not improve or if it is severe |
Heart problems What to look for?
What to do? Get emergency medical help right away. |
Get emergency medical help right away |
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:
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Sudden severe pain in the neck, face, back or belly. Unusual pulsating feeling in your chest or belly
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Sudden weakness on one side of your body
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Bloating or feeling of fullness in the belly and severe constipation
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Pain, swelling or hardening of a vein in your arm or leg
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Feeling confused, severe headache, problems with your vision, trouble speaking, swallowing or using your arms or legs
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Severe or unusual bone pain especially in your back, hips and wrist
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Severe muscle pain or weakness with dark pee
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Signs of an allergy such as fever, itchiness, rash, swollen lips, face or tongue, chest and throat tightness
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Wounds that do not heal well or take too long to heal
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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March 2023 Modified "What should I do before I have this medication" section
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.