Lenvima Dosage
Generic name: LENVATINIB 10mg
Dosage form: capsule
Medically reviewed by Drugs.com. Last updated on Nov 17, 2020.
2.1 Important Dosage Information
- Reduce the dose for certain patients with renal or hepatic impairment [see Dosage and Administration (2.7, 2.8)].
- Take LENVIMA once daily, with or without food, at the same time each day [see Clinical Pharmacology (12.3)]. 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.
2.2 Recommended Dosage for Differentiated Thyroid Cancer (DTC)
The recommended dosage of LENVIMA is 24 mg orally once daily until disease progression or until unacceptable toxicity.
2.3 Recommended Dosage for Renal Cell Carcinoma (RCC)
The recommended dosage of LENVIMA is 18 mg in combination with 5 mg everolimus orally once daily until disease progression or until unacceptable toxicity.
Refer to everolimus prescribing information for recommended everolimus dosing information.
2.4 Recommended Dosage for Hepatocellular Carcinoma (HCC)
The recommended dosage of LENVIMA is based on actual body weight:
• 12 mg for patients greater than or equal to 60 kg or
• 8 mg for patients less than 60 kg.
Take LENVIMA orally once daily until disease progression or until unacceptable toxicity.
2.5 Recommended Dosage for Endometrial Carcinoma
The recommended dosage of LENVIMA is 20 mg orally once daily, in combination with pembrolizumab 200 mg administered as an intravenous infusion over 30 minutes every 3 weeks, until unacceptable toxicity or disease progression.
Refer to the pembrolizumab prescribing information for other pembrolizumab dosing information.
2.6 Dosage Modifications for Adverse Reactions
Recommendations for LENVIMA dose interruption, reduction and discontinuation for adverse reactions are listed in Table 1. Table 2 lists the recommended dosage reductions of LENVIMA for adverse reactions.
Adverse Reaction | Severity a | Dosage Modifications for LENVIMA |
Hypertension [see Warnings and Precautions (5.1)] |
Grade 3 |
|
Grade 4 |
|
|
Cardiac Dysfunction [see Warnings and Precautions (5.2)] |
Grade 3 |
|
Grade 4 |
|
|
Arterial Thromboembolic Event [see Warnings and Precautions (5.3)] | Any Grade |
|
Hepatotoxicity [see Warnings and Precautions (5.4)] | Grade 3 or 4 |
|
Renal Failure or Impairment [see Warnings and Precautions (5.5)] | Grade 3 or 4 |
|
Proteinuria [see Warnings and Precautions (5.6)] | 2 g or greater proteinuria in 24 hours |
|
Gastrointestinal Perforation [see Warnings and Precautions (5.8)] | Any Grade |
|
Fistula Formation [see Warnings and Precautions (5.8)] | Grade 3 or 4 |
|
QT Prolongation [see Warnings and Precautions (5.9)] | Greater than 500 ms or greater than 60 ms increase from baseline |
|
Reversible Posterior Leukoencephalopathy Syndrome [see Warnings and Precautions (5.11)] | Any Grade |
|
Other Adverse Reactions [see Warnings and Precautions (5.7, 5.10, 5.12)] |
Persistent or intolerable Grade 2 or 3 adverse reaction Grade 4 laboratory abnormality |
|
Grade 4 adverse reaction |
|
|
a National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. |
Indication | First Dosage Reduction To | Second Dosage Reduction To | Third Dosage Reduction To |
DTC | 20 mg once daily |
14 mg once daily |
10 mg once daily |
RCC | 14 mg once daily |
10 mg once daily |
8 mg once daily |
Endometrial Carcinoma | 14 mg once daily |
10 mg once daily |
8 mg once daily |
HCC | |||
|
8 mg once daily |
4 mg once daily |
4 mg every other day |
|
4 mg once daily |
4 mg every other day |
Discontinue |
When administering LENVIMA in combination with everolimus for the treatment of renal cell carcinoma, reduce the LENVIMA dose first and then the everolimus dose for adverse reactions of both LENVIMA and everolimus. Refer to the everolimus prescribing information for additional dose modification information.
When administering LENVIMA in combination with pembrolizumab for the treatment of endometrial carcinoma, interrupt one or both drugs or dose reduce LENVIMA as appropriate. No dose reductions are recommended for pembrolizumab. Withhold or discontinue pembrolizumab in accordance with the instructions in the pembrolizumab prescribing information.
2.7 Dosage Modifications for Severe Renal Impairment
The recommended dosage of LENVIMA for patients with DTC, RCC, or endometrial carcinoma and severe renal impairment (creatinine clearance less than 30 mL/min calculated by Cockcroft-Gault equation using actual body weight) is [see Warnings and Precautions (5.5), Use in Specific Populations (8.6)]:
• Differentiated thyroid cancer: 14 mg orally once daily
• Renal cell carcinoma: 10 mg orally once daily
• Endometrial carcinoma: 10 mg orally once daily
2.8 Dosage Modifications for Severe Hepatic Impairment
The recommended dosage of LENVIMA for patients with DTC, RCC, or endometrial carcinoma and severe hepatic impairment (Child-Pugh C) is [see Warnings and Precautions (5.4), Use in Specific Populations (8.7)]:
• Differentiated thyroid cancer: 14 mg taken orally once daily
• Renal cell carcinoma: 10 mg taken orally once daily
• Endometrial carcinoma: 10 mg orally once daily
2.9 Preparation and Administration
LENVIMA capsules can be swallowed whole or dissolved in a small glass of liquid. To dissolve in liquid, put capsules into 1 tablespoon of water or apple juice without breaking or crushing the capsules. Leave the capsules in the water or apple juice for at least 10 minutes. Stir for at least 3 minutes. After drinking the mixture, add 1 tablespoon of water or apple juice to the glass, swirl the contents a few times and swallow the water or apple juice.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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