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Sunitinib: Brands, Price & Uses in Bangladesh
FDA-Approved Indications Advanced Renal Cell Carcinoma (RCC): Sunitinib is indicated for the treatment of advanced renal cell carcinoma.
About Sunitinib
Indications of Sunitinib
FDA-Approved Indications
- Advanced Renal Cell Carcinoma (RCC): Sunitinib is indicated for the treatment of advanced renal cell carcinoma.
- Adjuvant Treatment of Renal Cell Carcinoma: Sunitinib is indicated for the adjuvant treatment of adult patients at high risk of recurrent RCC following nephrectomy.
- Gastrointestinal Stromal Tumor (GIST): Sunitinib is indicated for the treatment of GIST after disease progression on, or intolerance to, imatinib mesylate.
- Pancreatic Neuroendocrine Tumors (pNET): Sunitinib is indicated for the treatment of progressive, well-differentiated pancreatic neuroendocrine tumors in patients with unresectable locally advanced or metastatic disease.
Sunitinib is used as monotherapy in each of these settings. Use of Sunitinib outside these approved settings (off-label) should only occur under specialist oncology supervision.
Dosage & Administration of Sunitinib
Dosage by Indication
| Indication | Recommended Dose | Schedule |
|---|---|---|
| Renal cell carcinoma (advanced or adjuvant) | 50 mg Sunitinib orally once daily | 4 weeks on treatment followed by 2 weeks off (repeated cycles); adjuvant therapy is typically continued for approximately 9 cycles |
| Gastrointestinal stromal tumor (GIST) | 50 mg Sunitinib orally once daily | 4 weeks on treatment followed by 2 weeks off (Schedule 4/2) |
| Pancreatic neuroendocrine tumor (pNET) | 37.5 mg Sunitinib orally once daily | Continuous dosing, without a scheduled off-treatment period |
Dose Modification
Dose adjustments to Sunitinib are made in 12.5 mg increments or decrements based on individual safety and tolerability, generally within a range of 25 mg to 75 mg per day for RCC/GIST. Dose interruption and/or reduction is recommended for significant toxicity; see Precautions and Warnings.
Hepatic Impairment
No dose adjustment is required for Sunitinib in patients with mild to moderate hepatic impairment (Child-Pugh Class A or B). Sunitinib has not been studied in patients with severe (Child-Pugh Class C) hepatic impairment and is not recommended in this group.
Renal Impairment
No initial dose adjustment of Sunitinib is required for mild to moderate renal impairment. Patients with end-stage renal disease on hemodialysis may be started at the standard dose with close monitoring, as data are limited.
Administration
Sunitinib capsules should be swallowed whole, with or without food, at approximately the same time each day. If a dose is missed, it should not be doubled; the next dose should be taken at the usual scheduled time. Grapefruit and grapefruit juice should be avoided.
Side Effects of Sunitinib
Very Common / Common Side Effects
- Fatigue and asthenia
- Diarrhea, nausea, vomiting, and stomatitis/mucosal inflammation
- Decreased appetite and taste alteration
- Hand-foot syndrome (palmar-plantar erythrodysesthesia) and other skin rashes
- Yellow skin discoloration and hair depigmentation
- Hypertension
- Hypothyroidism
- Myelosuppression (neutropenia, thrombocytopenia, anemia)
- Bleeding events (e.g., epistaxis)
Serious Side Effects
See Precautions and Warnings for detailed discussion of hepatotoxicity, cardiotoxicity, QT prolongation, severe hypertension, hemorrhage, thrombotic microangiopathy, adrenal insufficiency, gastrointestinal perforation/fistula, osteonecrosis of the jaw, and impaired wound healing associated with Sunitinib.
Contraindications of Sunitinib
Sunitinib is contraindicated in patients with known hypersensitivity to Sunitinib or to any component of the formulation.
Frequently Asked Questions about Sunitinib
What is Sunitinib used for?
Sunitinib is used to treat certain advanced cancers, including advanced renal cell carcinoma (a type of kidney cancer), gastrointestinal stromal tumor (GIST) that has progressed on or is intolerant to imatinib, and progressive pancreatic neuroendocrine tumors. It is also used as adjuvant treatment after kidney cancer surgery in patients at high risk of recurrence.
How should I take Sunitinib?
Sunitinib capsules should be swallowed whole with water, with or without food, at the same time each day, exactly as prescribed by your oncologist. Do not stop or change your dose of Sunitinib without consulting your doctor, and avoid grapefruit or grapefruit juice while taking Sunitinib.
What are the most serious risks of Sunitinib?
Sunitinib carries a boxed warning for hepatotoxicity, which can be severe and, rarely, fatal, so liver function is monitored regularly. Other serious risks of Sunitinib include heart problems (decreased heart pumping function, heart failure), abnormal heart rhythm (QT prolongation), high blood pressure, serious bleeding, blood clotting disorders, adrenal gland problems, jaw bone problems (osteonecrosis), bowel perforation, and thyroid dysfunction. Because of these risks, Sunitinib must only be used under close specialist oncology supervision.
Can Sunitinib be used during pregnancy or breastfeeding?
Sunitinib can harm an unborn baby and is not recommended during pregnancy unless the potential benefit clearly outweighs the risk, as judged by your physician; effective contraception is advised during Sunitinib treatment. Breastfeeding is not recommended while taking Sunitinib, as it is not known whether it passes into breast milk. Always consult your physician about pregnancy or breastfeeding plans before starting Sunitinib.
What should I do if I miss a dose of Sunitinib?
If you miss a dose of Sunitinib, do not take a double dose to make up for it. Simply take your next dose at the regular scheduled time and contact your physician if you are unsure what to do.
What if I take too much Sunitinib?
If you or someone else has taken more Sunitinib than prescribed, seek immediate medical attention or contact emergency services or a poison control center right away, as overdose can worsen the known side effects of Sunitinib.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.