Sorafenib (Generic Name)

Other Names: Nexavar

About this drug

This drug is used to treat cancer. It is given by mouth (orally).

Possible side effects

  • Increased risk for bleeding
  • Bone marrow depression; This is a decrease in the number of white blood cells, red blood cells, and platelets. It may increase your risk for infection, fatigue, and bleeding.
  • Poor wound healing
  • Rash; It may be red, itchy, and look like pimples.
  • Hand-and-foot syndrome; The palms of your hands or soles of your feet may tingle or become numb, painful, swollen, or red. Rarely, blistering and severe skin reactions occur.
  • Increased blood pressure; Your blood pressure will be monitored as needed.
  • Hair thinning or patchy hair loss
  • Nausea and vomiting
  • Decrease in your appetite
  • Changes in bowel movements; Some patients experience diarrhea, while other patients experience constipation.
  • Soreness of the mouth and throat; You may have red areas, white patches, or sores that are painful.
  • Fatigue
  • Weakness
  • Changes in digestive enzymes and electrolytes; Your doctor will monitor your blood tests as needed.
  • Muscle and joint pain
  • Heart attack (rare)
  • Effects on an unborn child; This drug may have harmful effects on an unborn child. For this reason, men and women should use effective methods of birth control during cancer treatment and for 2 weeks after stopping this drug. If you are exposed to this drug while pregnant, ask to speak to a genetic counselor. A genetic counselor can review the potential risks of problems with the fetus and with future pregnancies.
  • Breastfeeding; Women are advised not to breastfeed during treatment because this drug could enter the breast milk and seriously harm a breastfeeding infant.

Treating side effects

  • Due to an increased risk of bleeding and wound healing problems, your cancer doctor may recommend that you stop taking sorafenib before you have a surgical procedure. If you must have emergency surgery, or you have an accident that results in bleeding or a wound, tell your treating doctor that you are on sorafenib. Call your cancer doctor as soon as possible for further instructions.
  • Ask your doctor or nurse about medication that is available to help prevent or lessen nausea, vomiting, pain, and diarrhea.
  • If you are constipated, ask your doctor or nurse for medications and diet suggestions that may help you move your bowels regularly. Do not use enemas, laxatives, or suppositories without checking with your doctor or nurse.
  • Do not put anything on your rash, reddened skin, or sores on your skin unless your doctor or nurse says you may. Keep the area clean and dry.
  • It is not known how much scalp hair loss you may have while on the drug. If you are concerned about losing your hair, speak with your nurse about obtaining a wig before you lose your hair. Also, call the American Cancer Society at 1-800-ACS- 2345 for information about the “Look Good, Feel Better” program close to where you live. It is a free program where women undergoing chemotherapy learn about wigs, turbans, and scarves as well as makeup techniques and skin and nail care.
  • Mouth care is very important. Your mouth care should consist of gently brushing with a very soft tooth brush and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. Do this at least after every meal and at bed time. Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Discuss effective methods of birth control with your doctor.

Food and drug interactions

  • There are no known interactions of sorafenib with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. St. John’s Wort may interact with sorafenib. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s advice.
  • Swallow the tablet whole with water, at least 1 hour before or 2 hours after eating.
  • Do not break, chew, or crush the tablet.

When to call the doctor

Notify your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38.0 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Trouble breathing
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than 3 times in 1 day
  • Black or tarry stools
  • Chest pain. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. The discomfort may go away and come back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. Sometimes discomfort is felt in one or both arms, the back, neck, jaw, or stomach. If these symptoms last more than 3 to 5 minutes, call 9-1-1 immediately.
  • Diarrhea of 5 or 6 stools in 1 day, or diarrhea with weakness

Notify your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Palms or soles of feet tingle; become numb, painful, swollen; or develop blisters
  • Sores, rash, reddened areas, or itchiness that is unrelieved by prescribed medication
  • Nausea, vomiting, pain, or diarrhea that is unrelieved by prescribed medications
  • No bowel movement for 3 days, or if you feel uncomfortable
  • Painful mouth or throat, or if you are unable to eat or drink
  • Persistent loss of appetite or fast weight loss (such as 5 pounds in 1 week)
  • Extreme fatigue or weakness that interferes with daily activities

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