Lenvatinib Side Effects

Medically reviewed by Drugs.com. Last updated on Feb 13, 2025.

Applies to lenvatinib: capsule oral, oral capsule.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. If you are a woman who can bear children, your doctor may give you a pregnancy test before starting treatment to make sure you are not pregnant. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine and for at least 30 days after your last dose. If you think you have become pregnant while using the medicine, tell your doctor right away.

Your doctor will check your blood pressure on a regular basis while you are taking this medicine. You might need to monitor your blood pressure at home. Tell your doctor right away if you have a severe headache, lightheadedness, or changes in your vision.

This medicine may increase your risk of having blood clots, heart attack, or stroke. Check with your doctor right away if you have chest pain or discomfort, nausea, numbness or weakness in your arm or leg, or on one side of your body, pain or discomfort in your arms, jaw, back, or neck, trouble breathing, sweating, or vomiting.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Check with your doctor right away if you have decreased frequency or amount of urine, bloody urine, increased thirst, swelling of the face, fingers, or lower legs, trouble breathing, or weight gain. These could be symptoms of a serious kidney problem.

Check with your doctor right away if you have severe stomach pain, or gagging, coughing or choking when you eat or drink. These could be symptoms of a perforation (tear) or fistula (hole) in the bowel.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem, including QT prolongation.

This medicine may cause hypocalcemia (low calcium levels in the blood). Check with your doctor right away if you have stomach cramps, confusion, seizures, difficulty in breathing, irregular heartbeat, mood or mental changes, muscle cramps, numbness and tingling around the mouth, fingertips, or feet, or tremors.

Check with your doctor right away if you have a headache, seizures, confusion, blurred vision or other visual problems. These may be symptoms of a rare and serious brain condition called reversible posterior leukoencephalopathy syndrome (RPLS).

This medicine may increase your risk of bleeding. Tell your doctor right away if you cough up blood or have bleeding gums, difficulty with breathing or swallowing, dizziness, increased menstrual flow or vaginal bleeding, nosebleeds, prolonged bleeding from cuts, red or dark brown urine, or red or black, tarry stools. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.

Make sure any doctor or dentist who treats you knows that you are using this medicine. Lenvatinib may cause slow wound healing and a serious jaw bone problem (osteonecrosis), especially if you have a dental problem, if you are taking a medicine to treat bone problems (eg, bisphosphonates, denosumab), or if you are having an invasive dental procedure. You may need to stop using this medicine for at least 1 week before surgery (including dental work) or at least 2 weeks after major surgery.

Check with your doctor right away if you have a heavy jaw feeling, loosening of a tooth, or pain, swelling, or numbness in the mouth or jaw.

Talk with your doctor before using this medicine if you plan to have children. Some men and women who use this medicine have become infertile (unable to have children).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of lenvatinib

Along with its needed effects, lenvatinib may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking lenvatinib:

Other side effects of lenvatinib

Some side effects of lenvatinib may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to lenvatinib: oral capsule.

Cardiovascular adverse events

• Very common (10% or more): Hypertension (73%)
• Common (1% to 10%): Hypotension, QT prolongation, arterial thromboembolic event, cardiac dysfunction (cardiac failure, decreased ventricular function, pulmonary edema), myocardial infarction, cerebrovascular accident^[Ref]

Renal

• Very common (10% or more): Proteinuria (34%), renal impairment (14%)
• Common (1% to 10%): Increased creatinine, renal failure
• Postmarketing reports: Nephrotic syndrome^[Ref]

Hematologic

• Very common (10% or more): Hemorrhagic events (35%)
• Common (1% to 10%): Decreased platelet count
• Postmarketing reports: Arterial (including aortic) aneurysms, dissections, and rupture, impaired wound healing^[Ref]

Hepatic

• Common (1% to 10%): Hyperbilirubinemia, increased alkaline phosphatase, increased ALT, increased AST
• Very rare (less than 0.01%): Hepatic failure, acute hepatitis
• Postmarketing reports: Cholecystitis^[Ref]

Gastrointestinal

• Very common (10% or more): Diarrhea (67%), nausea (47%), stomatitis (41%), vomiting (36%), abdominal pain (31%), constipation (29%), oral pain (25%), dry mouth (17%), dyspepsia (13%)
• Common (1% to 10%): GI perforation/fistula, increased serum amylase, increased lipase
• Postmarketing reports: Pancreatitis, increased amylase^[Ref]

Nervous system

• Very common (10% or more): Headache (38%), dysgeusia (18%), dizziness (15%)
• Common (1% to 10%): Reversible posterior leukoencephalopathy syndrome^[Ref]

Endocrine

• Very common (10% or more): TSH suppression impairment (up to 88%)^[Ref]

Metabolic

• Very common (10% or more): Decreased appetite (54%), weight decreased (51%)
• Common (1% to 10%): Dehydration, hypoalbuminemia, hypomagnesemia, hypoglycemia, hypocalcemia, hypercalcemia, hyperkalemia, hypercholesterolemia^[Ref]

Dermatologic

• Very common (10% or more): Palmar-plantar erythrodysesthesia (32%), rash (21%), alopecia (12%)
• Common (1% to 10%): Hyperkeratosis^[Ref]

Genitourinary

• Very common (10% or more): Urinary tract infections (11%)^[Ref]

Immunologic

• Very common (10% or more): Dental and oral infections (10%)^[Ref]

Musculoskeletal

• Very common (10% or more): Arthralgia/myalgia (62%)
• Uncommon (0.1% to 1%): Osteonecrosis of the jaw^[Ref]

Other

• Very common (10% or more): Fatigue (67%), peripheral edema (21%)^[Ref]

Psychiatric

• Very common (10% or more): Insomnia (12%)^[Ref]

Respiratory

• Very common (10% or more): Dysphonia (31%), cough (24%), epistaxis (12%)
• Common (1% to 10%): Pulmonary embolism^[Ref]

See also:

Frequently asked questions

• Is lenvatinib an immunotherapy or chemotherapy drug?
• How long does it take for Lenvima to work?
• How long does it take for lenvatinib to work?
• What type of drug is Lenvima? Is it a chemo drug?
• Lenvatinib vs sorafenib: for first line treatment in HCC?
• Is lenvatinib / pembrolizumab used in endometrial cancer?
• How does lenvatinib work?
• How is lenvatinib taken / administered?

Further information

Lenvatinib side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer