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Lenvatinib

Generic Name: lenvatinib (len VA ti nib)
Brand Name: Lenvima
Dosage Forms: oral capsule (10 mg; 12 mg daily-dose; 14 mg daily-dose; 18 mg daily-dose; 20 mg daily-dose; 24 mg daily-dose; 4 mg; 8 mg daily-dose)

Medically reviewed by Philip Thornton, DipPharm. Last updated on March 29, 2021.

What is lenvatinib?

Lenvatinib is a kinase inhibitor used to treat certain types of cancer. Kinase inhibitors are enzyme inhibitors that blocks the action of one or more protein kinases.

Lenvatinib is used to treat thyroid cancer. It is usually given after radioactive iodine has been tried without success.

Lenvatinib is used together with everolimus (Afinitor) to treat advanced kidney cancer when other medicines have not been effective.

Lenvatinib is used together with pembrolizumab (Keytruda) to treat a certain type of endometrial cancer (a type of uterine cancer) that has progressed and cannot be removed with surgery or radiation.

Lenvatinib is also used to treat liver cancer that cannot be removed with surgery.

Warnings

Some people taking lenvatinib have developed a perforation (a hole or tear) or a fistula (an abnormal passageway) within the stomach or intestines. Get emergency medical help if you have severe stomach pain, or if you feel like you are choking and gagging when you eat or drink.

Call your doctor at once if you have signs of serious side effects, including: severe chest pain, shortness of breath, swelling in your ankles, numbness or weakness, confusion, severe headache, problems with speech or vision, seizure (convulsions), unusual bleeding, coughing up blood, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Before taking this medicine

You should not use lenvatinib if you are allergic to it.

To make sure lenvatinib is safe for you, tell your doctor if you have:

You may need to have a negative pregnancy test before starting this treatment. Do not use lenvatinib if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy while you are using lenvatinib and for at least 30 days after your last dose.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because lenvatinib can harm an unborn baby.

It is not safe to breast-feed a baby while you are using this medicine. Also do not breast-feed for at least 1 week after your last dose.

How should I take lenvatinib?

Lenvatinib is usually taken once per day. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Take lenvatinib at the same time each day, with or without food.

To get a full dose, you may need to take a combination of lenvatinib capsules with different amounts (strengths) of medicine in them. Follow your doctor's dosing instructions very carefully.

Swallow the capsule whole and do not crush, chew, break, or open it.

If you cannot swallow a capsule whole, dissolve the capsules in water as follows:

  • Measure 1 tablespoon of water or apple juice and pour the liquid into a small glass.

  • Place the capsules (whole, not crushed or broken) into the liquid. Use only enough capsules for one dose.

  • Allow the capsules to dissolve in the liquid for at least 10 minutes. Then, stir the mixture for at least 3 more minutes.

  • Drink this mixture right away. Add a little more water or juice to the glass, swirl gently and drink right away.

Lenvatinib is usually given until your body no longer responds to the medication.

Call your doctor if you are sick with vomiting or severe diarrhea. Prolonged illness can lead to dehydration and kidney failure while you are taking lenvatinib.

You may need to take medicine to prevent diarrhea while you are using lenvatinib. Carefully follow your doctor's instructions about when to start taking the anti-diarrhea medicine.

You will need frequent blood and urine tests, and your blood pressure will need to be checked often.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose of Lenvatinib for Thyroid Cancer:

24 mg orally once a day

Comment:
-Treatment should be continued until disease progression or unacceptable toxicity.

Use: For the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC)

Usual Adult Dose of Lenvatinib for Renal Cell Carcinoma:

18 mg orally once a day

Comments:
-This drug is given in combination with 5 mg everolimus.
-Refer to everolimus prescribing information for recommended dosing information.
-Treatment should be continued until disease progression or unacceptable toxicity.

Use: In combination with everolimus for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior anti-angiogenic therapy

Usual Adult Dose of Lenvatinib for Hepatocellular Carcinoma:

-Weight less than 60 kg: 8 mg orally once a day
-Weight 60 kg or greater: 12 mg orally once a day

Comment:
-Treatment should be continued until disease progression or unacceptable toxicity.

Use: For the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC)

Usual Adult Dose of Lenvatinib for Endometrial Carcinoma:

20 mg orally once daily

Comments:
-This drug is given in combination with pembrolizumab 200 mg IV over 30 minutes every 3 weeks.
-Refer to the pembrolizumab prescribing information for other dosing information.
-Treatment should be continued until disease progression or unacceptable toxicity.

Use: In combination with pembrolizumab for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy and are not candidates for curative surgery or radiation

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if you are more than 12 hours late for the dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking lenvatinib?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Lenvatinib side effects

Get emergency medical help if you have signs of an allergic reaction to lenvatinib: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some people taking lenvatinib have developed a perforation (a hole or tear) or a fistula (an abnormal passageway) within the stomach or intestines. Call your doctor if you have severe stomach pain, or if you feel like you are choking and gagging when you eat or drink.

Also call your doctor at once if you have:

  • severe diarrhea;

  • headache, confusion, change in mental status, vision loss, seizure (convulsions);

  • little or no urination;

  • unusual bleeding (nosebleeds, heavy menstrual bleeding), or any other bleeding that will not stop;

  • signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • heart problems - chest pain, pain in your jaw or shoulder, swelling, rapid weight gain, feeling short of breath;

  • signs of a blood clot - sudden numbness or weakness, problems with vision or speech;

  • liver problems - dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • low calcium level - muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes); or

  • increased blood pressure - severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common lenvatinib side effects may include:

  • bleeding;

  • stomach pain, nausea, vomiting, diarrhea;

  • loss of appetite, weight loss;

  • abnormal thyroid function tests;

  • muscle or joint pain;

  • swelling in your arms and legs;

  • mouth sores;

  • rash;

  • redness, itching, or peeling skin on your hands or feet;

  • headache, tiredness; or

  • cough, trouble breathing, hoarse voice.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect lenvatinib?

Lenvatinib can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Other drugs interact with lenvatinib, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Popular FAQ

How quickly lenvatinib will work for you depends upon many factors, such as your type of cancer and progression, other treatments you have received, and your overall health. Lenvatinib is usually given until your body no longer responds to the medication or the side effects become too severe to tolerate. Continue reading

Lenvatinib is considered a targeted treatment, not a chemotherapy drug. Lenvatinib (brand name: Lenvima) is considered a targeted treatment, not a chemotherapy drug. Lenvatinib blocks cell proteins and signals directed at blood vessels that help the cancer to survive. These types of drugs are often referred to as “precision medicine”. Continue reading

Pembrolizumab (Keytruda) is approved by the FDA to be used in combination with lenvatinib (Lenvima) for the treatment of certain patients with advanced endometrial cancer that is not MMR deficient (dMMR) or MSI high (MSI-H) after at least one other drug treatment has been tried. Continue reading

In studies that compared lenvatinib with sorafenib as first-line treatment in patients with inoperable liver cancer, the primary endpoint, overall survival (OS), was found to be non-inferior (13.6 months with lenvatinib vs 12.3 months with sorafenib). Lenvatinib did not show an improvement in overall survival (how long patients lived) when statistically compared to sorafenib. Continue reading

Lenvatinib (Lenvima) is a targeted treatment for cancer, not a chemotherapy drug. Lenvatinib blocks proteins that encourage cancer cell growth. It inhibits signals to help slow growth of new blood vessels from existing blood vessels (known as angiogenesis) that support the tumor's growth. Continue reading

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use lenvatinib only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.