Web Online-Cancer-Information.blogspot.com

Cancer growth inhibitors

In order to grow and divide cancer cells 'communicate' with each other using chemical signals. Cancer growth inhibitors interfere with this process and so affect the cancer’s ability to develop.

Find below the specific information about bortezomib, erlotinib, gefitinib, imatinib and sorafenib.

Cancer growth inhibitors listed by brand name

On the Cancerbackup website, drugs are referred to by their generic names. Sometimes, however, they are more commonly called by a brand name. This is an alphabetical list of brand names for cancer growth inhibitors with links to the relevant information.

  • Glivec®
  • Iressa®
  • Nexavar®
  • Tarceva®
  • Velcade®

Bortezomib (Velcade®)

This information is about bortezomib (pronounced bore-tez-oh-mib), which is commonly known as Velcade®. It is currently used to treat people with multiple myeloma. Velcade may also be used to treat other types of cancer as part of a research trial.

  • Velcade
  • How Velcade works
  • How it is given
  • Possible side effects

Velcade

Velcade is a new type of anti-cancer drug called a proteosome inhibitor. In the UK it is currently used to treat multiple myeloma. It is given to people who have already been treated with at least one other type of chemotherapy and who have already had or are unsuitable for a bone marrow transplant, but whose myeloma has continued to develop.

How Velcade works

Proteosomes are a group of enzymes found in all cells in the body. They have an important role in controlling cell function and growth. By interfering with the function of proteosomes, Velcade may cause cancer cells to die and may stop the cancer from growing. Cancer cells are more sensitive to the effects of Velcade than normal cells are.

How it is given

Velcade is given by injection into a vein (intravenously) through a fine tube (cannula). It may be given through a central line, which is inserted under the skin into a vein near the collarbone, or through a PICC line, which is inserted into a vein in the bend of the arm.

Velcade is usually given as four doses over a three-week period. The doses are given on the first and fourth day of the first two weeks, followed by a ten-day rest period. This completes one cycle of treatment. You can have up to eight cycles of treatment over six months.

Possible side effects

Each person’s reaction to any drug is different. Some people have very few side effects while others may experience more. The side effects described in this information will not affect everyone having Velcade. We have outlined the most common side effects. We have not included those that are rare, however, and which are therefore unlikely to affect you. If you notice any effects which you think may be due to the drugs, but are not listed below, please let your nurse or doctor know.

Nausea (feeling sick) and vomiting Your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled, or if it continues, tell your doctor, who can prescribe other anti-sickness drugs which may be more effective.

Fatigue (tiredness and a feeling of weakness) You may feel very tired. It is important to allow yourself plenty of time to rest.

Diarrhoea This can usually be controlled with anti-diarrhoea medicines, but let your doctor know if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea.

Dehydration It is important that you drink plenty of fluids (2–3 litres per day).

Constipation This can usually be relieved by drinking plenty of fluids, eating a high-fibre diet and taking gentle exercise.

Symptoms of a fever These may include a high temperature and chills. These symptoms can be controlled or reduced with drugs, which your doctor can prescribe for you.

Loss of appetite A dietitian or specialist nurse at your hospital can give advice on how to maintain your weight.

Headaches Let your doctor know if you have headaches while being treated with Velcade.

Dizziness on standing You may feel dizzy for a few moments if you stand too quickly. This is caused by a temporary fall in blood pressure and is more likely if you have a history of fainting or take blood pressure medication. Move slowly from lying to sitting and then sitting to standing.

Lowered resistance to infection Velcade can reduce the production of white blood cells by the bone marrow, making you more prone to infection. Contact your doctor or the hospital straightaway if your temperature goes above 38°C (100.5°F) or if you suddenly feel unwell (even with a normal temperature).

Low platelet count Platelets help to clot the blood and prevent bleeding. The number of platelets in your blood will be checked regularly. If the number is low, you may bruise very easily or develop blood spots or rashes on the skin. You may suffer from nosebleeds or bleed more heavily than usual from minor cuts or grazes.

If you develop any unexplained bleeding or bruising you need to contact your doctor or the hospital straight away. You may need to be admitted to hospital for a platelet transfusion. A fluid containing platelets is given by drip into your blood. These platelets will start to work immediately to prevent bruising and bleeding.

Numbness or tingling in hands or feet This is due to the effect of Velcade on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty with tasks like doing up buttons. Tell your doctor if you notice any numbness or tingling in your hands or feet. This may improve if the dose of Velcade is reduced or if it is stopped.

Muscle cramps and painful limbs Let your doctor know if you experience muscle cramps or painful limbs, as they can prescribe medication to help.

Talk to your doctor or nurse if you have any questions about these or any other side effects. It is also important to let them know if you have any symptoms or side effects that may be related to the treatment you are having.

Patients wishing to enter trials should speak to their cancer specialist, who can advise them whether Velcade may be a suitable treatment in their case. Cancer specialists can also advise patients on other cancer treatments which are appropriate for their situation.


Erlotinib (Tarceva®)

This information is about erlotinib (pronounced err-lot-i-nib), which is a treatment for people with cancer. Erlotinib is sometimes called Tarceva® (tar-see-ver). It is used to treat people with non-small cell lung cancer (NSCLC). Erlotinib may also be used to treat other types of cancer as part of a research trial.

  • Erlotinib
  • Epidermal growth factor receptor inhibitors
  • What erlotinib looks like
  • How it is given
  • Possible side effects
  • Additional information
  • Things to remember about erlotinib tablets

Erlotinib

Erlotinib belongs to a group of cancer drugs known as epidermal growth factor receptor (EGFR) inhibitors. It is a type of drug called a tyrosine kinase inhibitor. It is used to treat people with non-small cell lung cancer (NSCLC), whose cancer has come back after, or not responded to, at least one course of chemotherapy.

Erlotinib is also being studied as a possible treatment for many other cancers, including pancreatic cancer, ovarian cancer and cancer of the head and neck. These studies are being carried out on cancers that have come back after initial treatment (recurrent), or have spread to other parts of the body (advanced or metastatic).

Trials are in progress to find out if erlotinib is best given alone or in combination with chemotherapy or radiotherapy.

Epidermal growth factor receptor inhibitors

Epidermal growth factor receptor inhibitors are used to try to destroy some types of cancer cells while causing little harm to normal cells.

Structures called epidermal growth factor receptors (EGFRs) sit on the surface of many types of cancer cells. Epidermal growth factor is a protein present in the body. The receptors allow epidermal growth factor to attach to them. When these growth factors (such as transforming growth factor alpha and epidermal growth factor) bind to the receptors, an enzyme called tyrosine kinase (TK) inside the cell triggers chemical signals to make the cell grow and divide.

Erlotinib attaches itself to the tyrosine kinase enzyme and prevents the receptor from being activated. This may stop the cell dividing. Erlotinib can therefore stop the cancer cells from growing. It works in a different way from both chemotherapy and hormonal therapy.

Tests may be done to check the level of EGFR. These will tell if you are likely to benefit from erlotinib. Testing can be done at the same time as diagnosis, or samples of cancer cells from previous biopsies or surgery may be used.

What erlotinib looks like

Erlotinib is a tablet.

How it is given

It is taken as a single dose each morning with a large glass of water, at least one hour before (or two hours after) a meal.

Possible side effects

Each person's reaction to an anti-cancer drug is different. Some people have very few side effects, while others may experience more. If you do notice any effects which you think may be due to the drug, but which are not listed here, please discuss them with your doctor.

The side effects of erlotinib are generally mild and some of these can be reduced with medicines. As it is still a new drug, it is too early to know all there is about the possible side effects.

A rash Many people develop a rash, particularly on their face, neck, chest, back and arms. This generally starts about 8–10 days after starting treatment but usually improves after a few weeks. In most people the rash is mild. However, it is important to let your doctor know if you develop a rash.

Diarrhoea This is also quite common but, again, it is usually mild and can be controlled easily with medicine. Tell your doctor if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea. Let your doctor know if you develop any black 'tarry' looking stools.

Tiredness (fatigue) and a general feeling of weakness Fatigue is a less common side effect but is not often severe. It is important to allow yourself plenty of time to rest.

Nausea (feeling sick) and vomiting Mild nausea is quite common but it is usually very easy to control. Vomiting can occasionally occur. Your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled, or if it continues, tell your doctor. They can prescribe other anti-sickness drugs which may be more effective.

Eye problems Erlotinib can occasionally affect the cornea of the eye (the clear part at the front of the eye) but this is rarely severe. It is recommended that people taking this drug have an assessment of the cornea before and during treatment to detect any early signs of corneal problems.

Sore mouth In a minority of people erlotinib can cause a sore mouth. Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly can help. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.

Additional information

Some other medicines can be harmful to take when you are having erlotinib. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.

Contraception It is not advisable to become pregnant or father a child while taking erlotinib, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. It is important to discuss this with your doctor.

Smoking may make erlotinib work less effectively.

Things to remember about erlotinib tablets

  • Keep the tablets in a safe place where children cannot reach them, as erlotinib could harm them.
  • Store them in their original container.
  • If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.
  • If you are sick just after taking the tablets let your doctor know, as you may need to take another dose. Do not take another tablet without first telling your doctor.
  • If you forget to take a tablet, do not take a double dose. Tell your doctor and keep to your regular dose schedule.

Gefitinib (Iressa®)

This information is about a drug called gefitinib (pronounced gef-it-i-nib), which is commonly known as Iressa®. It is a man-made chemical that has been used in research trials to treat some types of cancer. Iressa has been withdrawn as a treatment on the basis of the results of these trials. It is now only given to a few patients in the UK.

  • Developing a new drug
  • Iressa
  • How it works
  • How it is given
  • Possible side effects
  • Additional information

Developing a new drug

When a drug is being developed it has to go through various stages of research, called clinical trials or studies. These are intended to establish a safe dosage and find out what side effects the drug may cause. Trials can also show how effective a drug is, and whether it is better than the existing treatments, or has extra benefit when given alongside existing treatment.

Many drugs that are thought to be promising may be found not to be as good as existing treatments, or to have side effects that outweigh any benefits. For this reason, doctors and other medical staff carry out frequent and careful checks on the progress of each patient taking one of these developmental drugs.

If you are having a developmental drug, your doctor will explain all about the drug, the procedures being used, and how you will be looked after while you are taking it. If at any time you have concerns, you should ask your doctor or nurse for information and advice.

Iressa

A number of different trials have used Iressa. Some of the early trials showed that it can shrink cancer tumours a little in some patients with advanced cancer (cancer which has already spread), who have had standard treatments for their particular type of cancer. Iressa also helped to improve symptoms for some people. However, the drug had no effect on some people in these trials.

Further trials were carried out to determine exactly how effective Iressa was and whether it helped to improve survival when compared to a placebo (an inactive drug). Unfortunately, the results of a large trial of nearly 1700 people with advanced lung cancer showed that Iressa did not help people to live any longer.

In light of these results Iressa has been withdrawn from use in the UK. The company that makes Iressa is continuing to provide the drug for people who are currently taking it and who, following discussion with their specialists, wish to remain on it.

How it works

Iressa works by blocking (inhibiting) signals within the cancer cells, which prevents a series of chemical reactions that cause the cell to grow and divide. It is known as a signal transduction inhibitor. This process is described in detail below.

On the surface of many types of cancer cell are structures known as epidermal growth factor receptors (EGFRs). The receptors allow epidermal growth factor (a protein present in the body) to attach to them. When the epidermal growth factor (EGF) attaches to the receptor, it causes an enzyme called tyrosine kinase (TK) to trigger chemical processes inside the cell to make it grow and divide.

Iressa attaches itself to the EGF receptor on the cell and prevents the receptor from being activated. This stops the cells from dividing. Iressa therefore has the potential to stop the cancer cells from growing. It works in a different way from both chemotherapy and hormonal therapy.

How it is given

Iressa is taken as a tablet once a day. The tablet should be taken at roughly the same time each day.

Possible side effects

Each person's reaction to any drug is different. Some people have very few side effects, while others may experience more. We have outlined the most common side effects. These will not affect everyone taking Iressa. We have not included those side effects that are rare, and which are therefore unlikely to affect you. If you notice any effects that you think may be due to the drugs, but which are not listed below, please let your nurse or doctor know.

Diarrhoea This can usually be easily controlled with medicine, but tell your doctor if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea.

Acne-like rash Your skin may become dry, sore and itchy. Let your doctor know if you develop this side effect as they can prescribe medicines to help.

Loss of appetite If you don't feel like eating it may be helpful to speak to a dietitian at the hospital.

Nausea (feeling sick) and vomiting Let your doctor know if nausea and vomiting is a problem as very effective anti-sickness medication can be prescribed.

Tiredness Some people get very tired while taking Iressa.

Eye problems If you notice any change to your vision, or pain or redness of your eyes, let your doctor know.

Change in blood pressure Iressa may make your blood pressure rise, especially if you already have high blood pressure. Tell your doctor if you get any headaches, dizziness or blurred vision.

Breathing problems A rare side effect of gefitinib is inflammation of the lungs. If you become breathless or your breathing worsens, tell your doctor straight away. Although this is a rare side effect it is potentially very serious, and a small number of people have died because of the lung problems they have developed while taking Iressa. If you are worried about this potential side effect talk to your doctor or nurse.

Additional information

  • Keep the tablets in a safe place where children cannot reach them, as Iressa could harm them.
  • Iressa may interact with grapefruit juice. It is advisable not to drink it while you are having Iressa treatment.
  • If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.
  • If you are sick just after taking the tablet, tell your doctor, as you may need to take another one.
  • If you forget to take a tablet, you can take it as soon as you remember, as long as it is more than 12 hours before your next scheduled dose. If it is less than 12 hours, do not take the missed dose.
  • Iressa may interact with other medicines. Let your doctor know about any medications you are taking, including any non-prescribed drugs such as complementary herbal therapies.
  • It is not advisable to become pregnant or father a child while having this treatment, as the developing foetus may be harmed. It is important to use effective contraception.

Imatinib (Glivec®)

This information is about a drug called imatinib (pronounced i-mat-i-nib), which is also known as Glivec® (gli-vec). Imatinib is a man-made drug currently used for the treatment of patients with chronic myeloid leukaemia (CML), and a rare type of cancer known as gastro-intestinal stromal tumour (GIST). It may also be used to treat other types of cancers as part of a research trial.


  • How imatinib works
  • How it is given
  • Possible side effects
  • Additional information
  • Things to remember about imatinib tablets

How imatinib works

Imatinib works by blocking (inhibiting) signals within cancer cells and preventing a series of chemical reactions that cause the cell to grow and divide.

The growth of cells in our bodies is controlled by a group of chemicals called growth factors. These chemicals can attach themselves to special proteins on the surface of particular cells. This starts a series of chemical reactions within the cell which trigger it to grow and multiply. In people with chronic myeloid leukaemia or GIST, cells are produced which have a damaged receptor protein. This receptor sends out the grow-and-divide signal to the cells even when there is no growth factor present.

Imatinib identifies the faulty receptor and sticks to it, which prevents it from stimulating the cells to grow. Imatinib is known as a signal transductase inhibitor, because it blocks the 'grow' signal. The chemical it blocks is called tyrosine kinase, so imatinib is also known as a tyrosine kinase inhibitor.

How it is given

Imatinib is normally given once daily. It is available as 100mg and 400mg tablets or capsules. The tablets should be taken with a meal and a large glass of water. Imatinib is usually taken for as long as patients are benefiting from it.

Possible side effects

Each person’s reaction to a cancer drug is different. Some people may have very few side effects, while others may experience more. We have outlined the most common side effects. We have not included those that are very rare, and which are therefore extremely unlikely to affect you. If you notice any effects that you think may be due to the drug but are not listed here, please discuss them with your doctor or nurse.

The side effects of imatinib are generally mild or moderate. They often occur during the first month of treatment and may get better after this initial period. The most common side effects are listed below.

Nausea This is usually mild. The nausea can be relieved with anti-sickness (anti-emetic) drugs, which your doctor can prescribe. It can also be reduced by taking the tablet after food.

Diarrhoea This can usually be controlled easily with anti-diarrhoea medication, but let your doctor know if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea.

Headaches Some people have headaches when taking imatinib. Let your doctor know if you get any headaches as pain killers can be given to help.

Leg aches/cramps These can often be eased by taking mild painkillers, which your doctor can prescribe.

Fluid retention This is fairly common and is not harmful, although it can be upsetting. Many people gain weight, or notice swelling around the eyes and ankles due to the retention of fluid. Diuretics (drugs which make you pass more urine) can help to get rid of some of the fluid, but often it settles of its own accord. Let your doctor know if you put on a lot of weight very quickly.

Visual disturbances Imatinib can cause pain in the eyes and deterioration of vision. It may also cause more tears to be produced, which can lead to watery eyes.

Itchy rash If your skin becomes dry, this may be relieved with antihistamine tablets and skin lotion.

Lowered resistance to infection Imatinib can reduce the production of white blood cells by the bone marrow, making you more prone to infection. Your blood cells will be monitored while you are taking imatinib.

Contact your doctor or the hospital straightaway if:

  • Your temperature goes above 38ºC (100.5ºF)
  • You suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.

Bruising or bleeding Imatinib can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.

Anaemia (low number of red blood cells) While having treatment with imatinib you may become anaemic. This may make you feel tired and breathless. You may need to have a transfusion of blood if the number of red blood cells becomes too low.

Loss of appetite A dietitian or specialist nurse at your hospital can give advice and tips on boosting appetite, coping with eating difficulties and maintaining weight.

Additional information

Some medicines can be harmful to take when you are having imatinib. Always tell your doctor about any other medicine you are taking, including those bought over the counter and herbal medicines.

Contraception Little is known about the effects of imatinib on a developing foetus. Therefore, it is not advisable to become pregnant or father a child while taking this drug.

Things to remember about imatinib tablets

  • It is important to take your tablets at the right times. You must take them as directed by your doctor.
  • Keep the tablets in a safe place where children cannot reach them, as imatinib could harm them.
  • If your doctor decides to stop the treatment, return any tablets you have to the pharmacist. Do not flush them down the toilet or throw them away.
  • If you forget to take a tablet do not take a double dose. Tell your doctor and keep to your regular dose schedule.

If you have any questions about these or any other side effects talk to your doctor or nurse. It is important to let them know if you are having any symptoms or side effects that may be related to any treatment you are having.


Sorafenib (Nexavar®)

This information is about sorafenib (pronounced so-ra-fe-nib), also called Nexavar® (necs-a-var), which is used to treat people with a type of kidney cancer called renal cell carcinoma (RCC). Sorafenib may be used to treat other types of cancer as part of a research trial.


  • Sorafenib
  • Multi-targeted kinase inhibitors
  • What sorafenib looks like
  • How it is given
  • Possible side effects
  • Less common side effects
  • Additional Information
  • Things to remember about sorafenib tablets

Sorafenib

Sorafenib is a type of drug called a multi-targeted kinase inhibitor. It interferes with the growth of kidney cancer cells. It also works by slowing the growth of new blood vessels within the tumour. It is used to treat people with kidney cancer that has spread outside the kidney and who are no longer being helped by treatment with interferon-alpha (IFN) or interleukin-2 (IL-2), or for whom these drugs are not suitable.

Sorafenib is also being studied as a possible treatment for many other cancers, including melanoma, non small-cell lung cancer and mesothelioma.

Multi-targeted kinase inhibitors

Multi-targeted kinase inhibitors work by interfering with proteins called kinases. Kinases are important in regulating how cells work and grow. They send signals within the cell that tell it to divide and make new cells. Kinase inhibitors block these signals and so affect the cancer’s ability to grow.

Some types of kinases stimulate cells to make new blood vessels. Making blood vessels is called angiogenesis. Cancer cells need to make new blood vessels so that they can grow and spread. In kidney cancer, higher-than-normal amounts of a type of protein called vascular endothelial growth factor (VEGF) are made. Stimulation of VEGF increases the production of blood vessels, thus helping the cancer to grow. Sorafenib blocks the activity of VEGF.

What sorafenib looks like

Sorafenib is a red, round tablet.

How it is given

Sorafenib should be taken on an empty stomach with a glass of water, at least one hour before or two hours after a meal. The usual dose is two 200mg tablets twice daily. Your doctor may adjust the dose.

Possible side effects

Each person's reaction to an anti-cancer drug is different. Some people have very few side effects, while others may experience more. If you notice any effects which you think may be due to the drug, but which aren’t mentioned here, please discuss them with your doctor.

The side effects of sorafenib are generally mild and may go away during treatment as your body adjusts to the medicine. As it is still a new drug it is too early to know everything about the possible side effects. Check with your doctor if any side effects continue or are troublesome.

Hand/foot skin reaction This is common. You may notice redness of the palms of your hands and soles of your feet. Sometimes the hands and feet become sore or swollen. There may also be changes of sensation such as numbness or tingling. If you notice this, let your specialist know. Occasionally, if soreness doesn't settle or if blistering develops, your doctors may need to reduce the dose of sorafenib or interrupt the treatment. Very occasionally treatment may need to be discontinued.

Effects on the skin Changes in the skin such as a rash, redness, dryness or itching are quite common. These side effects are usually mild. Speak to your doctor or nurse if you have any of these symptoms. They can advise you about creams or lotions to use, or prescribe medicines to relieve itching.

High blood pressure Sorafenib can cause high blood pressure in some people. If this develops, it is most likely to happen within the first few weeks of taking the drug. Your blood pressure will be checked every week for the first six weeks of treatment. If you develop high blood pressure you may be prescribed medicines to control this.

Tiredness and feeling weak This is common but fatigue is usually mild. It's important to allow yourself plenty of time to rest.

Diarrhoea You may have frequent or loose bowel movements. Tell your doctor if this is severe or if it continues. It's important to drink plenty of fluids if you have diarrhoea.

Sore mouth and ulcers Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly can help. Tell your nurse or doctor if you have mouth problems. They may prescribe mouthwashes and medicines to prevent or clear any mouth infection.

Feeling sick (nausea) Mild nausea is quite common but is usually easy to control. Your doctor can prescribe effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce this.

Constipation It usually helps to drink plenty of fluids, eat a high fibre diet and take gentle exercise. Sometimes you may need to take medicines to stimulate your bowel. Your doctor can prescribe these.

Thinning hair You may notice your hair becomes thinner. It is very unlikely you will lose all of your hair. Hair loss is temporary and the hair re-grows once treatment has finished.

Hoarseness You may develop hoarseness or a husky voice.

Muscle pains (arthralgia) Some people have muscle, joint or bone pain while on treatment. Your doctor can prescribe painkillers if you are affected.

Less common side effects

Bleeding problems Sorafenib may increase your chance of bleeding. This is a less common side effect and can affect people in different ways. For example, your gums may bleed, or you may bruise more easily or notice blood in your urine or stools. If you notice any unusual bleeding contact your doctor immediately.

Heart problems This drug may occasionally cause problems with the blood supply to the heart. If you have chest pain, breathlessness or other symptoms that may mean your heart is affected, contact your doctor immediately.

Additional Information

Other medicines Some medicines can interact with sorafenib and may make it less effective. Let your doctor know about any medicines you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.

Contraception It is not advisable to become pregnant or father a child while taking sorafenib, as the drug may harm a developing foetus. It is important to use effective contraception while taking this drug, and for at least a few months afterwards.

Fertility It is not yet known how sorafenib may affect fertility.

Things to remember about sorafenib tablets

  • Sorafenib could be harmful to children. Keep the tablets in a safe place where children cannot reach them.
  • If your doctor advises you to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.
  • If you are sick just after taking the tablets let your doctor know, as you may need to take another dose. Do not take another tablet without first telling your doctor.
  • If you forget to take a tablet do not take a double dose. Tell your doctor and keep to your regular dose schedule.