Sorafenib (By mouth)

Introduction:

Sorafenib (soe-RAF-e-nib)

Treats late-stage kidney cancer and liver cancer that cannot be treated with surgery.

Brand Name(s):

Nexavar

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• You may also receive medicines to help prevent nausea and vomiting.
• Take this medicine on an empty stomach (at least 1 hour before or 2 hours after a meal).
• Swallow the tablet whole with water. Do not crush, break, or chew it.
• Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.

If a dose is missed:

• This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor for instructions.
• If you vomit after taking your medicine, call your doctor or pharmacist for instructions.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using a blood thinner (such as warfarin, Coumadin®), or medicine for seizures (such as carbamazepine, phenobarbital, phenytoin, Dilantin®, Tegretol®). Tell your doctor if you use dexamethasone (Decadron®), rifabutin (Mycobutin®), rifampin (Rifadin®), or St. John's wort, or if you have ever been treated with cancer drugs (such as docetaxel, doxorubicin, fluorouracil, irinotecan, Adriamycin®, Adrucil®, Camptosar®, Rubex®, Taxotere®).

Warnings While Using This Medicine:

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. In addition, use effective birth control for at least 2 weeks after stopping treatment.
• Make sure your doctor knows if you are also breastfeeding, or if you have kidney problems, liver problems, high blood pressure, bleeding problems, or heart problems.
• This medicine may increase your chance of bleeding. To help with this problem, 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.
• Tell your doctor right away if you start having severe stomach burning, cramps or pains, bloody or black tarry stools, trouble breathing, heartburn, indigestion, nausea, or vomiting of material that looks like coffee grounds. These could be symptoms of a serious bowel problem.
• Cancer medicines can cause nausea and/or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
• Your blood pressure should be checked weekly, especially during the first six weeks of starting this medicine. Your doctor may need to treat you if you develop high blood pressure while you are using this medicine.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blurred vision.
• Chest pain or discomfort.
• Dark-colored urine or pale stools.
• Dizziness, lightheadedness, or fainting.
• Fever, chills, cough, or sore throat.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach that may be sudden and severe.
• Numbness, tingling, or pain in your hands or feet.
• Red or black stools.
• Redness, pain, swelling, or blisters on the palms of your hands or soles of your feet.
• Shortness of breath.
• Slow, fast, or irregular heartbeat.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Hair thinning or patchy hair loss.
• Headache.
• Mild nausea, vomiting, diarrhea, constipation, or stomach pain.
• Muscle pain or joint pain.
• Skin rash, redness, or itching.
• Sores or white patches on your lips, mouth, or throat.
• Weight loss.

If you notice other side effects that you think are caused by this medicine, tell your doctor: