Sutent Side Effects
Please note - some side effects for Sutent may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).
Side Effects of Sutent - for the Consumer
Sutent
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Sutent:
Seek medical attention right away if any of these SEVERE side effects occur when using Sutent:Changes in taste; constipation; decreased appetite; diarrhea; dry, thick, or cracked skin; headache; indigestion; mouth pain or irritation; nausea; nosebleed; skin or hair discoloration; stomach pain or upset; tiredness; vomiting; weakness.
TopSevere allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry, or bloody stools; blistering or rash on the palms of hands and soles of feet; calf swelling or tenderness; chest pain; dark urine; fainting; fast, slow, or irregular heartbeat; fever, chills, or sore throat; mental or mood changes (eg, confusion, decreased alertness, depression, irritability, nervousness); muscle pain, tenderness, or weakness; numbness of an arm or leg; numbness or tingling of the hands or feet; pale stools; seizures; severe or persistent headache, dizziness, stomach pain, back pain, tiredness, or weakness; shortness of breath; swelling of the hands or legs; symptoms of thyroid problems (eg, changes in menstrual period, excessive sweating, increased appetite, increased sensitivity to hot or cold conditions, sudden weight changes, tremors, trouble sleeping); unusual or severe bruising or bleeding (eg, bleeding gums, nosebleeds); vision changes or vision loss; vomit that looks like coffee grounds; yellowing of the eyes or skin.
Sutent Side Effects - for the Professional
Sutent
The data described below reflect exposure to Sutent in 577 patients who participated in a placebo-controlled trial (n=202) for the treatment of GIST or an active-controlled trial (n=375) for the treatment of MRCC. In these two studies, 225 patients were exposed to Sutent for at least 6 months and 16 were exposed for greater than one year. The population was 23 – 87 years of age and 69% male and 31% female. The race distribution was 92% White, 3% Asian, 2% Black and 3% not reported. The patients received a starting oral dose of 50 mg daily on Schedule 4/2 in repeated cycles.
The most common adverse reactions (≥20%) in patients with GIST or MRCC are fatigue, asthenia, diarrhea, nausea, mucositis/stomatitis, vomiting, dyspepsia, abdominal pain, constipation, hypertension, rash, hand-foot syndrome, skin discoloration, altered taste, anorexia, and bleeding. The potentially serious adverse reactions of left ventricular dysfunction, QT interval prolongation, hemorrhage, hypertension, and adrenal function are discussed in Warnings and Precautions (5). Other adverse reactions occurring in GIST and MRCC studies are described below.
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
6.1 Adverse Reactions in GIST Study A
Median duration of blinded study treatment was two cycles for patients on Sutent (mean 3.0, range 1–9) and one cycle (mean 1.8, range 1–6) for patients on placebo. Dose reductions occurred in 23 patients (11%) on Sutent and none on placebo. Dose interruptions occurred in 59 patients (29%) on Sutent and 31 patients (30%) on placebo. The rates of treatment-emergent, non-fatal adverse reactions resulting in permanent discontinuation were 7% and 6% in the Sutent and placebo groups, respectively.
Most treatment-emergent adverse reactions in both study arms were Grade 1 or 2 in severity. Grade 3 or 4 treatment-emergent adverse reactions were reported in 56% versus 51% of patients on Sutent versus placebo, respectively. Table 1 compares the incidence of common (≥10%) treatment-emergent adverse reactions for patients receiving Sutent and reported more commonly in patients receiving Sutent than in patients receiving placebo.
| Adverse Reaction, n (%) |
GIST | |||
|---|---|---|---|---|
| Sutent (n=202) | Placebo (n=102) | |||
| All Grades | Grade 3/4 | All Grades | Grade 3/4 | |
| Any | 114 (56) | 52 (51) | ||
| Gastrointestinal | ||||
| Diarrhea | 81 (40) | 9 (4) | 27 (27) | 0 (0) |
| Mucositis/stomatitis | 58 (29) | 2 (1) | 18 (18) | 2 (2) |
| Constipation | 41 (20) | 0 (0) | 14 (14) | 2 (2) |
| Cardiac Hypertension |
31 (15) |
9 (4) |
11 (11) |
0 (0) |
| Dermatology | ||||
| Skin discoloration | 61 (30) | 0 (0) | 23 (23) | 0 (0) |
| Rash | 28 (14) | 2 (1) | 9 (9) | 0 (0) |
| Hand-foot syndrome | 28 (14) | 9 (4) | 10 (10) | 3 (3) |
| Neurology | ||||
| Altered taste | 42 (21) | 0 (0) | 12 (12) | 0 (0) |
| Musculoskeletal | ||||
| Myalgia/limb pain | 28 (14) | 1 (1) | 9 (9) | 1 (1) |
| Metabolism/Nutrition | ||||
| Anorexia† | 67 (33) | 1 (1) | 30 (29) | 5 (5) |
| Asthenia | 45 (22) | 10 (5) | 11 (11) | 3 (3) |
Oral pain other than mucositis/stomatitis occurred in 12 patients (6%) on Sutent versus 3 (3%) on placebo. Hair color changes occurred in 15 patients (7%) on Sutent versus 4 (4%) on placebo. Alopecia was observed in 10 patients (5%) on Sutent versus 2 (2%) on placebo.
Table 2 provides common (≥10%) treatment-emergent laboratory abnormalities.
| Laboratory Parameter, n (%) |
GIST | |||
|---|---|---|---|---|
| Sutent (n=202) | Placebo (n=102) | |||
| All Grades* | Grade 3/4*† | All Grades* | Grade 3/4*‡ | |
| LVEF=Left ventricular ejection fraction | ||||
|
||||
| Any | 68 (34) | 22 (22) | ||
| Gastrointestinal | ||||
| AST / ALT | 78 (39) | 3 (2) | 23 (23) | 1 (1) |
| Lipase | 50 (25) | 20 (10) | 17 (17) | 7 (7) |
| Alkaline phosphatase | 48 (24) | 7 (4) | 21 (21) | 4 (4) |
| Amylase | 35 (17) | 10 (5) | 12 (12) | 3 (3) |
| Total bilirubin | 32 (16) | 2 (1) | 8 (8) | 0 (0) |
| Indirect bilirubin | 20 (10) | 0 (0) | 4 (4) | 0 (0) |
| Cardiac | ||||
| Decreased LVEF | 22 (11) | 2 (1) | 3 (3) | 0 (0) |
| Renal/Metabolic | ||||
| Creatinine | 25 (12) | 1 (1) | 7 (7) | 0 (0) |
| Potassium decreased | 24 (12) | 1 (1) | 4 (4) | 0 (0) |
| Sodium increased | 20 (10) | 0 (0) | 4 (4) | 1 (1) |
| Hematology | ||||
| Neutrophils | 107 (53) | 20 (10) | 4 (4) | 0 (0) |
| Lymphocytes | 76 (38) | 0 (0) | 16 (16) | 0 (0) |
| Platelets | 76 (38) | 10 (5) | 4 (4) | 0 (0) |
| Hemoglobin | 52 (26) | 6 (3) | 22 (22) | 2 (2) |
6.2 Adverse Reactions in the Treatment-Naïve MRCC Study
The as-treated patient population for the interim safety analysis of the treatment-naive MRCC study included 735 patients, 375 randomized to Sutent and 360 randomized to IFN-α. The median duration of treatment was 5.6 months (range: 0.4–15.6) for Sutent treatment and 4.1 months (range: 0.1–13.7) on IFN-α treatment. Dose reductions occurred in 121 patients (32%) on Sutent and 77 patients (21%) on IFN-α. Dose interruptions occurred in 142 patients (38%) on Sutent and 115 patients (32%) on IFN-α. The rates of treatment-emergent, non-fatal adverse reactions resulting in permanent discontinuation were 9% and 12% in the Sutent and IFN-α groups, respectively. Most treatment-emergent adverse reactions in both study arms were Grade 1 or 2 in severity. Grade 3 or 4 treatment-emergent adverse reactions were reported in 67% versus 51% of patients on Sutent versus IFN-α, respectively.
Table 3 compares the incidence of common (≥10%) treatment-emergent adverse reactions for patients receiving Sutent versus IFN-α.
| Adverse Reaction, n (%) | Treatment-Naïve MRCC | |||
|---|---|---|---|---|
| Sutent (n=375) | IFN-α (n=360) | |||
| All Grades | Grade 3/4† | All Grades | Grade 3/4‡ | |
|
||||
| Any | 370 (99) | 250 (67) | 354 (98) | 184(51) |
| Constitutional | ||||
| Fatigue | 218 (58) | 35 (9) | 199 (55) | 50 (14) |
| Asthenia | 79 (21) | 27 (7) | 85 (24) | 20 (6) |
| Fever | 62 (17) | 3 (1) | 129 (36) | 0 (0) |
| Weight decreased | 45 (12) | 0 (0) | 54 (15) | 2 (1) |
| Chills | 42 (11) | 3 (1) | 108 (30) | 0 (0) |
| Gastrointestinal | ||||
| Diarrhea | 218 (58) | 22 (6) | 72 (20) | 0 (0) |
| Nausea | 183 (49) | 16 (4) | 136 (38) | 5 (1) |
| Mucositis/stomatitis | 162 (43) | 12 (3) | 14 (4) | 2 (<1) |
| Vomiting | 105 (28) | 15 (4) | 51 (14) | 3 (1) |
| Dyspepsia | 105 (28) | 4 (1) | 14 (4) | 0 (0) |
| Abdominal pain§ | 83 (22) | 10 (3) | 42 (12) | 5 (1) |
| Constipation | 60 (16) | 0 (0) | 44 (12) | 1 (<1) |
| Dry mouth | 45 (12) | 0 (0) | 26 (7) | 1 (<1) |
| GERD/reflux esophagitis |
42 (11) | 0 (0) | 3 (1) | 0(0) |
| Flatulence | 39 (10) | 0 (0) | 8 (2) | 0 (0) |
| Oral pain | 38 (10) | 0 (0) | 2 (1) | 0 (0) |
| Glossodynia | 37 (10) | 0 (0) | 2 (1) | 0 (0) |
| Cardiac | ||||
| Hypertension | 111 (30) | 36 (10) | 13 (4) | 1 (<1) |
| Edema, peripheral | 42 (11) | 2 (1) | 15 (4) | 2 (1) |
| Dermatology | ||||
| Rash | 103 (27) | 3 (1) | 40 (11) | 2 (1) |
| Hand-foot syndrome | 78 (21) | 20 (5) | 3 (1) | 0 (0) |
| Skin discoloration/yellow skin | 72 (19) | 0 (0) | 0 (0) | 0 (0) |
| Dry skin | 67 (18) | 1 (<1) | 23 (6) | 0 (0) |
| Hair color changes | 56 (16) | 0 (0) | 1 (<1) | 0 (0) |
| Neurology | ||||
| Altered taste¶ | 166 (44) | 1 (<1) | 52 (14) | 0 (0) |
| Headache | 68 (18) | 3 (1) | 61 (17) | 0 (0) |
| Dizziness | 28 (7) | 1 (<1) | 42 (12) | 1 (<1) |
| Musculoskeletal | ||||
| Back pain | 70 (19) | 13 (3) | 44 (13) | 6 (2) |
| Arthralgia | 69 (18) | 5 (1) | 60 (17) | 1 (<1) |
| Pain in extremity/ limb discomfort |
65 (17) | 6 (2) | 28 (8) | 4 (1) |
| Respiratory | ||||
| Cough | 64 (18) | 2 (1) | 45 (12) | 0 (0) |
| Dyspnea | 58 (15) | 15 (4) | 65 (18) | 14 (4) |
| Metabolism/Nutrition | ||||
| Anorexia# | 142 (38) | 6 (2) | 145 (40) | 7 (2) |
| Dehydration | 30 (8) | 8 (2) | 17 (5) | 2 (1) |
| Hemorrhage/Bleeding | ||||
| Bleeding, all sites | 112 (30) | 10 (3)Þ | 27 (8) | 2 (1) |
| Psychiatric | ||||
| Insomnia | 42 (11) | 1 (<1) | 31 (9) | 0 (0) |
| Depressionß | 29 (8) | 0 (0) | 47 (12) | 5 (1) |
Treatment-emergent Grade 3/4 laboratory abnormalities are presented in Table 4.
| Laboratory Parameter, n (%) |
Treatment-Naïve MRCC | |||
|---|---|---|---|---|
| Sutent (n=375) | IFN-α (n=360) | |||
| All Grades* | Grade 3/4*† | All Grades* | Grade 3/4*‡ | |
|
||||
| Gastrointestinal | ||||
| AST | 195 (52) | 6 (2) | 124 (34) | 6 (2) |
| ALT | 171 (46) | 10 (3) | 140 (39) | 6 (2) |
| Lipase | 196 (52) | 60 (16) | 153 (43) | 23 (6) |
| Alkaline phosphatase | 156 (42) | 7 (2) | 126 (35) | 6 (2) |
| Amylase | 118 (31) | 19 (5) | 101 (28) | 8 (2) |
| Total bilirubin | 72 (19) | 3 (1) | 6 (2) | 0 (0) |
| Indirect bilirubin | 46 (12) | 4 (1) | 3 (1) | 0 (0) |
| Renal/Metabolic | ||||
| Creatinine | 246 (66) | 1 (<1) | 175 (49) | 1 (<1) |
| Uric acid | 155 (41) | 43 (12) | 112 (31) | 29 (8) |
| Creatine kinase | 152 (41) | 1 (<1) | 35 (10) | 2 (1) |
| Phosphorus | 134 (36) | 17 (5) | 115 (32) | 22 (6) |
| Calcium decreased | 132 (35) | 1 (<1) | 133 (37) | 0 (0) |
| Glucose decreased | 73 (19) | 0 (0) | 54 (15) | 1 (<1) |
| Albumin | 68 (18) | 3 (1) | 67 (19) | 0 (0) |
| Glucose increased | 58 (15) | 10 (3) | 49 (14) | 20 (6) |
| Sodium decreased | 51 (14) | 18 (5) | 41 (11) | 9 (3) |
| Potassium increased | 42 (11) | 7 (2) | 54 (15) | 13 (4) |
| Sodium increased | 40 (11) | 0 (0) | 35 (10) | 0 (0) |
| Hematology | ||||
| Neutrophils | 271 (72) | 44 (12) | 166 (46) | 24 (7) |
| Hemoglobin | 266 (71) | 11 (3) | 232 (64) | 16 (4) |
| Platelets | 244 (65) | 30 (8) | 77 (21) | 0 (0) |
| Lymphocytes | 223 (59) | 44 (12) | 227 (63) | 79 (22) |
| Leukocytes | 292 (78) | 19 (5) | 202 (56) | 8 (2) |
6.3 Venous Thromboembolic Events
Seven patients (3%) on Sutent and none on placebo in GIST Study A experienced venous thromboembolic events; five of the seven were Grade 3 deep venous thrombosis (DVT), and two were Grade 1 or 2. Four of these seven GIST patients discontinued treatment following first observation of DVT.
Eight (2%) patients receiving Sutent for treatment-naïve MRCC had venous thromboembolic events reported. Four (1%) of these patients had pulmonary embolism, one was Grade 3 and three were Grade 4, and four (1%) patients had DVT, including one Grade 3. One patient was permanently withdrawn from Sutent due to pulmonary embolism; dose interruption occurred in two patients with pulmonary embolism and one with DVT. In treatment-naïve MRCC patients receiving IFN-α, six (2%) venous thromboembolic events occurred; one patient (<1%) experienced a Grade 3 DVT and five patients (1%) had pulmonary embolism, one Grade 1 and four with Grade 4.
6.4 Reversible Posterior Leukoencephalopathy Syndrome
There have been rare (<1%) reports of subjects presenting with seizures and radiological evidence of reversible posterior leukoencephalopathy syndrome (RPLS). None of these subjects had a fatal outcome to the event. Patients with seizures and signs/symptoms consistent with RPLS, such as hypertension, headache, decreased alertness, altered mental functioning, and visual loss, including cortical blindness should be controlled with medical management including control of hypertension. Temporary suspension of Sutent is recommended; following resolution, treatment may be resumed at the discretion of the treating physician.
6.5 Pancreatic and Hepatic Function
If symptoms of pancreatitis or hepatic failure are present, patients should have Sutent discontinued. Pancreatitis was observed in 5 (1%) patients receiving Sutent for treatment-naïve MRCC compared to 1 (<1%) patient receiving IFN-α. Hepatic failure was observed in <1% of solid tumor patients treated with Sutent.
6.6 Post-marketing Experience
The following adverse reactions have been identified during post-approval use of Sutent. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Cases of serious infection (with or without neutropenia), in some cases with fatal outcome, have been reported.
Cases of myopathy and/or rhabdomyolysis, some with acute renal failure, have been reported. Patients with signs or symptoms of muscle toxicity should be managed as per standard medical practice.
Thrombotic microangiopathy has been reported in patients on Sutent. Suspension of Sutent is recommended; following resolution, treatment may be resumed at the discretion of the treating physician.
Cases of proteinuria and rare cases of nephrotic syndrome have been reported. Baseline urinalysis is recommended, and patients should be monitored for the development or worsening of proteinuria. The safety of continued Sutent treatment in patients with moderate to severe proteinuria has not been systematically evaluated. Discontinue Sutent in patients with nephrotic syndrome.
TopSide Effects by Body System
General
General side effects including fatigue (up to 74%), anorexia (up to 33%), asthenia (up to 22%), fever (up to 18%), and dehydration (up to 11%) have been reported. Cases of serious infection, some with fatal outcome, have also been reported.
Gastrointestinal
Gastrointestinal side effects including diarrhea (up to 55%), nausea (up to 54%), mucositis/stomatitis (up to 53%), dyspepsia (up to 46%), vomiting (up to 37%), constipation (up to 34%), abdominal pain (up to 33%), glossodynia (up to 15%), and flatulence (up to 14%) have been reported.
Hematologic
Hematologic side effects have been reported including bleeding from all sites (up to 26%). Treatment-emergent laboratory abnormalities from Study A on gastrointestinal stromal tumor (GIST) patients have included neutropenia (up to 53%), lymphopenia (up to 38%), thrombocytopenia (up to 38%), and anemia (up to 26%). Common treatment-emergent grade 3 and 4 chemistry laboratory abnormalities in the metastatic renal cell carcinoma (MRCC) studies included increased lipase (16%), increased amylase (5%), hypophosphatemia (10%), and hyperuricemia (10%). Grade 3 leukopenia (7%) has also been reported by the MRCC studies.
Four patients (2%) in the two MRCC studies had venous thromboembolic events reported. Two of the patients had pulmonary embolism (both grade 4) and two patients had deep venous thrombosis (DVT) (both grade 3). Dose interruption occurred in one of these cases. Seven patients (3%) on sunitinib in GIST Study A experienced venous thromboembolic events. Five of the seven were grade 3 DVTs, and two were grade 1 or 2. Four of these seven GIST patients discontinued treatment following first observation of DVT. Cases of erythrocytosis and macrocytosis have also been reported.
Postmarketing reports have included reports of thrombotic microangiopathy.
Nervous system
Nervous system side effects including altered taste (up to 43%), headache (up to 25%), dizziness (up to 16%), and peripheral neuropathy (10%) have been reported.
In clinical studies of sunitinib, seizures have been observed in subjects with radiological evidence of brain metastases. There have also been rare (less than 1%) reports of subjects presenting with seizures and radiological evidence of reversible posterior leukoencephalopathy syndrome (RPLS). None of these subjects had a fatal outcome to the event. A case of transient sunitinib-induced coma has also been reported.
Patients with seizures and signs and symptoms consistent with RPLS, such as hypertension, headache, decreased alertness, altered mental functioning, and visual loss, including cortical blindness should be controlled with medical management including control of hypertension. Temporary suspension of sunitinib is recommended. Following resolution, treatment may be resumed at the discretion of the treating physician.
Hepatic
Hepatic side effects have included treatment-emergent laboratory abnormalities in AST/ALT (39%), lipase (25%), alkaline phosphatase (24%), amylase (17%), total bilirubin (16%), and indirect bilirubin (10%) as reported by Study A on gastrointestinal stromal tumor (GIST) patients. A case of sunitinib-related fulminant hepatic failure has also been reported.
Dermatologic
Dermatologic side effects including rash (up to 38%), skin discoloration (up to 33%), dry skin (up to 17%), hair color changes (up to 17%), hand-foot syndrome (up to 14%), alopecia (up to 12%), and blistering of the skin (up to 7%) have been reported. A case of periodic hair depigmentation has also been reported. Other possible dermatologic side effects may include thickness or cracking of the skin, blisters or occasional rash on the palms of the hands and soles of the feet.
Cardiovascular
Data from nonclinical (in vitro and in vivo) studies indicate that sunitinib has the potential to inhibit the cardiac action potential repolarization process (e.g., prolongation of QT interval). In GIST Study A, 23 patients (11%) on sunitinib versus 12 (12%) on placebo had observed QT prolongation greater than 20 milliseconds from baseline. No consistent, clinically significant QTc prolongation has been observed in completed clinical studies.
Cardiovascular side effects including hypertension (up to 28%) and peripheral edema (up to 17%) have been reported. Treatment-emergent laboratory abnormalities have included decreased left ventricular ejection fraction (up to 11%) reported by Study A on gastrointestinal stromal tumor (GIST) patients. Six cases of heart failure have been reported. Two patients with metastatic renal cell carcinoma experienced grade 3 myocardial ischemia, one had grade 2 "cardiovascular toxicity" reported as an adverse event, and one patient experienced a fatal myocardial infarction while on treatment.
Musculoskeletal
Musculoskeletal side effects including arthralgia (up to 28%), limb pain (up to 18%), back pain (up to 17%), and myalgia (up to 17%) have been reported. Cases of myopathy and/or rhabdomyolysis have also been reported.
Patients with signs or symptoms of muscle toxicity should be managed as per standard medical practice.
Respiratory
Respiratory side effects including dyspnea (up to 28%) and cough (up to 17%) have been reported.
Renal
Renal side effects have included treatment-emergent laboratory abnormalities in uric acid (15%) and creatinine (12%) reported by Study A on gastrointestinal stromal tumor (GIST) patients. Postmarketing reports have included cases of proteinuria and rare cases of nephrotic syndrome.
Baseline urinalysis is recommended, and patients should be monitored for the development or worsening of proteinuria. The safety of continued sunitinib treatment in patients with moderate to severe proteinuria has not been systematically evaluated. Sunitinib should be discontinued in patients with nephrotic syndrome.
Metabolic
Metabolic side effects have included treatment-emergent laboratory abnormalities such as hypokalemia (12%) and hypernatremia (10%) reported by Study A on gastrointestinal stromal tumor (GIST) patients.
Other
Other side effects including appetite disturbance (up to 9%) have been reported.
Ocular
Ocular side effects including periorbital edema (up to 7%) and increased lacrimation (up to 7%) have been reported.
Endocrine
Endocrine side effects including hypothyroidism (up to 4%) and TSH elevations (up to 2%) have been reported.
Severe fatigue has been reported to be a result of the onset of hypothyroidism.
Patients with symptoms suggestive of hypothyroidism should have laboratory monitoring of thyroid function performed and be treated as per standard medical practice.
Three medical doctors stated in a letter to the New England Journal of Medicine that for their group of 65 patients treated with sunitinib, the incidence of laboratory evidence of thyroid dysfunction was 60% to 70%. They made a general recommendation for monitoring thyroid dysfunction in patients receiving sunitinib or similar compounds.
More Sutent resources
- Sutent Prescribing Information (FDA)
- Sutent Concise Consumer Information (Cerner Multum)
- Sutent Advanced Consumer (Micromedex) - Includes Dosage Information
- Sutent Medfacts Consumer Leaflet (Wolters Kluwer)
Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This information does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of information provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.
