LENVANIX (LENVATINIB) 10MG Caps 30's

Lenvatinib is an oral multikinase inhibitor that selectively blocks VEGFR1–3, FGFR1–4, PDGFRα, KIT, and RET receptor tyrosine kinases — cutting off tumour angiogenesis (blood supply) and directly inhibiting tumour cell proliferation.

Lenvanix is used to treat adults with:

•       Differentiated thyroid cancer (DTC) — progressive, locally advanced or metastatic, radioactive iodine (RAI)-refractory disease. Dose: 24 mg once daily (two 10 mg + one 4 mg capsule).

•       Renal cell carcinoma (RCC) — in combination with everolimus (second line, after one prior anti-angiogenic therapy). Dose: 18 mg lenvatinib + 5 mg everolimus daily.

•       Hepatocellular carcinoma (HCC) — first-line, unresectable HCC (body weight ≥ 60 kg: 12 mg/day; < 60 kg: 8 mg/day).

•       Endometrial carcinoma — in combination with pembrolizumab, after prior systemic therapy, in patients who are not candidates for curative surgery or radiation. Dose: 20 mg/day.

Take once daily at the same time each day, with or without food. Swallow whole with water. The two capsule strengths (4 mg and 10 mg) are combined to achieve the prescribed total dose (e.g. 24 mg = two 10 mg + one 4 mg). Do not crush or chew.

Lenvatinib should not be used in: pregnancy (teratogenic — effective contraception required during treatment and for at least 1 month after); breastfeeding; known hypersensitivity.

Use with caution in: hypertension; cardiac disease; hepatic or renal impairment; risk factors for arterial thromboembolism; wound healing issues (hold for ≥ 6 days before major surgery, restart ≥ 2 weeks after).

•       Strong CYP3A4 inhibitors: minimal effect on lenvatinib (not primarily CYP3A4-metabolised); however, monitor for increased exposure.

•       QT-prolonging agents: lenvatinib itself can prolong QT — additive risk with other QT-prolonging drugs.

•       Warfarin / anticoagulants: bleeding risk — monitor INR.

Store below 25°C. Original packaging. Keep out of reach of children.

The two different capsule strengths (4 mg and 10 mg) are combined to reach your total daily dose. Make sure you understand exactly how many of each capsule to take daily before leaving the pharmacy — write it down. For example, for a 24 mg dose you would take two 10 mg capsules and one 4 mg capsule every day.

Blood pressure control is critical with lenvatinib — hypertension is very common and can be dangerous if untreated. Home blood pressure monitoring is strongly encouraged. Keep a log of readings and bring it to every appointment.

Women of childbearing potential must use highly effective contraception during treatment and for at least 1 month after the last dose. Male patients with female partners of childbearing potential should also use contraception.

Lenvatinib is available as 4 mg and 10 mg capsules — doses are constructed from combinations. Common total daily doses: 24 mg (DTC) = 2×10 + 1×4; 20 mg (EC) = 2×10; 18 mg (RCC) = 1×10 + 2×4; 12 mg (HCC ≥60 kg) = 1×10 + ½×4 — but capsules should not be broken; use 1×10 + 2×1 (not available) — confirm dose construction with oncologist.

In practice, dispensing is often 4 mg and 10 mg packs together. TSH monitoring is essential especially in DTC patients — RAI-refractory thyroid cancer patients may already be on levothyroxine suppression; lenvatinib worsens hypothyroidism. Dose hold/reduction schedule: 4-step reduction from 24 mg → 20 mg → 14 mg → 10 mg → discontinue.

Can lenvatinib affect my thyroid?

Yes, in all patients, and particularly in thyroid cancer patients. Lenvatinib commonly causes or worsens hypothyroidism. TSH will be monitored regularly, and thyroid hormone replacement will be prescribed if needed.

What is proteinuria and why does my doctor check my urine?

Proteinuria means protein leaking into the urine — a sign that the kidneys may be under stress from the medicine. A urine test before each treatment cycle detects any significant kidney involvement early. If protein levels are high, a dose pause may be needed.

Can I have surgery while taking lenvatinib?

Lenvatinib impairs wound healing. It should be stopped at least 6 days before any major surgery and only restarted after the wound is fully healed (at least 2 weeks post-surgery). Always inform your surgeon that you are on this medicine.

Will I lose my hair?

Alopecia occurs in some patients but is less common than with traditional chemotherapy. Thinning or changes in hair texture are more typical. Your oncology nurse can discuss scalp care and options.

What happens if I miss a dose?

If you remember on the same day, take it as soon as possible. If it is the next day, skip the missed dose and continue your regular schedule. Never take a double dose.