Medically reviewed on September 5, 2018.
Applies to the following strengths: 4 mg; 10 mg; 14 mg daily-dose; 18 mg daily-dose; 24 mg daily-dose
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Thyroid Cancer
24 mg orally once a day
Duration of therapy: Until disease progression or unacceptable toxicity occurs
Use: Treatment of patient with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer.
Renal Dose Adjustments
-Mild renal impairment (CrCl 60 to 89 mL/min): No adjustment recommended.
-Moderate renal impairment (CrCl 30 to 59 mL/min): No adjustment recommended.
-Severe renal impairment (CrCl less than 30 mL/min): 14 mg orally once a day
-End stage renal disease: Data not available.
Liver Dose Adjustments
-Mild renal impairment (Child-Pugh A): No adjustment recommended.
-Moderate renal impairment (Child-Pugh B): No adjustment recommended.
-Severe hepatic impairment (Child-Pugh C): 14 mg orally once a day
Persistent and Intolerable Grade 2 to 3 Adverse Reactions or Grade 4 Lab Abnormalities:
-Interrupt therapy and resume at a lower dose once resolved to Grade 0 to 1 or baseline.
-Base dose reduction on the previous dose level (24 mg, 20 mg, or 14 mg once per day).
When initial dose level is 24 mg orally once a day;
-1st occurrence: Reduce dose to 20 mg orally once a day.
-2nd occurrence: Reduce dose to 14 mg orally once a day.
-3rd occurrence: Reduce dose to 10 mg orally once a day.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
This drug is not expected to be dialyzable due to its high plasma protein binding.
-This drug can be given with or without food.
-This drug should be taken at the same time each day.
-If a dose is missed and cannot be taken within 12 hours, skip that dose and take the next dose at the usual time of administration.
-Cardiovascular: Blood pressure (prior to treatment, after 1 week, every 2 weeks for the first 2 months, then at least monthly), signs and symptoms of cardiac decompensation, ECG, electrolytes
-Endocrine: TSH levels (monthly)
-Hepatic: ALT, AST (prior to treatment, every 2 weeks for the first 2 months, then at least monthly)
-Metabolic: Serum electrolytes, blood calcium levels (at least monthly)
-Renal: Proteinuria (prior to treatment and periodically after initiation)
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Other brands: Lenvima