Sunitinib blocks the action of the abnormal protein called receptor tyrosine kinases that signals the multiplication of cancer cells. It slows down the activity of these proteins to decrease the growth and spread of cancer. Sunitinib also slows the development of new blood vessels within tumors.
Sutent is a prescription medicine available in oral dosage form (capsules).
What Is Sutent Used For?
Sunitinib is indicated to treat different types of cancers, such as:
Brand Name(s): Sutent
Drug Availability: Prescription
Therapeutic Classification: Anticancer
Available Generically: Yes
Controlled Substance: N/A
Administration Route: Oral
Active Ingredient: Sunitinib
Dosage Form(s): Capsules
Gastrointestinal stromal tumors (GIST), which develops in the stomach, intestines, and esophagus: Prescribed when not treated successfully with Gleevec (imatinib) or for people who cannot take imatinib Advanced renal cell carcinoma (RCC): A late-stage cancer that begins in the cells of the kidneys Recurrent RCC: As an additional treatment in patients at high risk for kidney cancer after nephrectomy (surgical removal of the kidney) Pancreatic neuroendocrine tumors (pNET): Tumors that are locally advanced or metastatic and cannot be treated with surgery in adult patients
Sunitinib is also being studied in the treatment of other kinds of cancers.
How to Take Sutent
Follow the directions on the prescription label carefully. Ask your healthcare provider or pharmacist about any part you do not understand.
Sutent comes as an oral capsule to take by mouth. Take the capsule with or without food. The dosing schedule and the dosing strength may vary when treating different cancers.
If taking Sutent for GIST and RCC, take it once a day for four weeks, followed by a two-week break. Begin the next dosing cycle and repeat the process every six weeks for as long as your healthcare provider has prescribed.
For RCC treatment, Sutent usually is prescribed once a day for four weeks, followed by a two-week break. Begin the next dosing cycle and repeat every six weeks for nine cycles.
When treating pNET, Sutent is usually taken once a day.
Take your medicine around the same time every day to avoid missing the dose. Take Sutent precisely as prescribed. Do not take more, less, or more often than indicated by your healthcare provider.
Swallow the capsules whole. Do not split, chew, or break them open.
Depending on your dose of Sutent, you may have to take more than one capsule at a time.
Your healthcare provider may alter your dose of Sutent during your treatment, considering how well it works and affects you. Continue to take Sutent even if you feel well. Do not stop taking Sutent without consulting your healthcare provider.
Do not eat grapefruit or drink grapefruit juice while taking Sutent. Grapefruit can increase the amount of certain drugs in the bloodstream.
Storage
Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.
Avoid pouring unused and expired drugs down the drain or in the toilet. Visit the FDA’s website to know where and how to discard of unused and expired drugs. You may also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.
If you travel with Sutent, become familiar with your final destination’s regulations. In general, be sure to make a copy of your Sutent prescription. Keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.
Off-Label Uses
One study has shown that sunitinib may treat advanced thyroid cancers and soft tissue sarcoma (non-GIST).
What Are the Side Effects of Sutent?
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
Some common side effects of Sutent are:
Fatigue or weakness Bruising or bleeding Indigestion Diarrhea Nausea or vomiting Stomach pain Acid reflux Decreased appetite Mild mouth irritation/sores Change in taste Swelling in the mouth High blood pressure Hand-foot syndrome (redness, swelling, blisters, or rash on your hands or feet Changes in skin or hair color Mild rash
The side effects usually go away within a few days. Talk with your healthcare provider if symptoms become severe or don’t go away.
Severe Side Effects
Some side effects can be severe. If you experience any of these symptoms, call your healthcare provider or 911 immediately:
Allergic reaction causing hives, rash, swelling of the eyes, face, lips, tongue, or throat Blistering or peeling of skin inside the mouth Bloody or black and tarry stools Blood in the urine, cloudy urine, or decreased urination Confusion Chest pain or pressure Decreased alertness or concentration Depression Dizziness or fainting Difficulty swallowing or breathing Fever Headache Hoarseness Nervousness Pain with deep breathing Rapid, irregular, or pounding heartbeat Seizures Shortness of breath Stomach pain, swelling, or tenderness Swelling of the feet or ankles or swelling, tenderness, warmth, or redness of a leg Unexplained weight gain Unusual bruising or bleeding Vision changes Vomit that looks like coffee grounds
Dosage: How Much Sutent Should I Take?
Modifications
The following modifications (changes) should be kept in mind when using Sutent:
If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (capsules): For the treatment of advanced pancreatic cancer or pancreatic neuroendocrine tumor (pNET): Adults—37. 5 milligrams (mg) once a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 50 mg per day. Children—Use and dose must be determined by your doctor. For the treatment of GIST and kidney cancer: Adults—50 milligrams (mg) once a day for 4 weeks. This is followed by 2 weeks without medicine. Your doctor may tell you to repeat this cycle. Children—Use and dose must be determined by your doctor. For treatment of kidney cancer after surgical removal of kidney: Adults—50 milligrams (mg) once a day for 4 weeks. This is followed by 2 weeks without medicine for nine 6-week cycles. Your doctor may adjust your dose as needed and tolerated. Children—Use and dose must be determined by your doctor.
Severe allergic reaction: Avoid using Sutent if you have a known allergy to it or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you’re unsure.
Pregnancy: Sutent can harm a fetus. Avoid use during pregnancy.
Breastfeeding: Not enough is known about the safety of Sutent in human breast milk and nursing babies. Talk with your healthcare provider if you plan to breastfeed to weigh the benefits and risks of taking Sutent while nursing and the different ways to feed your baby.
Adults over 65: Clinical studies haven’t found differences in how people of this age respond differently to this medicine compared to younger adults. Older adults with several medical conditions or who are taking several medications should use caution with Sutent.
Children: The safety and efficacy of Sutent in children haven’t been established. Avoid use in this group.
Kidney toxicity: Renal (kidney) toxicity during treatment requires permanent discontinuation of Sutent.
Missed Dose
If you have missed a dose of Sutent, take it no later than 12 hours after. Skip the missed dose if you do not remember to take it within 12 hours. Take the following doses at the regular time. Do not take a double dose to make up for the missed one.
Try to find ways that work for you to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Sutent might be less effective at treating your condition.
Overdose: What Happens If I Take Too Much Sutent?
If you think you or someone else may have overdosed on Sutent, call a healthcare provider or the Poison Control Center (800-222-1222).
Precautions
What Are Reasons I Shouldn’t Take Sutent?
Avoid using it if you’re allergic to Sutent or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you’re unsure.
If someone collapses or isn’t breathing after taking Sutent, call 911 immediately.
Using this medicine while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. If you are a woman who can get pregnant, your doctor may do tests to make sure you are not pregnant before starting sunitinib treatment. Female patients should use an effective form of birth control during treatment with this medicine and for 4 weeks after the last dose. Male patients who have female partners should use effective birth control during treatment with this medicine and for 7 weeks after the last dose. If you think you have become pregnant while using the medicine, tell your doctor right away.
If you plan to have children, talk with your doctor before using this medicine. Some men and women using this medicine have become infertile (unable to have children).
Cancer medicines can cause nausea or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these unwanted effects.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
This medicine may cause serious heart problems (eg, heart attack, heart failure, cardiomyopathy). Tell your doctor if you have chest pain, decreased urine output, dilated neck veins, dizziness, faintness, irregular breathing, irregular heartbeat, nausea, pain or discomfort in arms, jaw, back or neck, sweating, swelling of face, fingers, feet, or lower legs, tightness in the chest, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain.
Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.
Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.
This medicine may also increase your risk of bleeding and cause delay in wound healing. Check with your doctor right away if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
It is important that you check with your doctor before having any dental procedures or surgeries done, or are receiving bisphosphonates (eg, alendronate, ibandronate, risedronate, Actonel®, Boniva®, Fosamax®, Zometa®) while you are using sunitinib. Tell your doctor right away if you have jaw tightness, swelling, numbing, or pain or a loose tooth. This could be symptoms of a severe jaw problem.
This medicine may cause a serious type of reaction called tumor lysis syndrome. Your doctor may give you medicine to help prevent this. Call your doctor right away if you have a decrease or change in the amount of urine, joint pain, stiffness, or swelling, lower back, side, or stomach pain, a rapid weight gain, swelling of the feet or lower legs, or unusual tiredness or weakness.
Thrombotic microangiopathy (damage in the smallest blood vessels) may occur while you are using this medicine. Tell your doctor right away if you have a fever, tiredness, confusion, loss of vision, or seizures.
Serious skin reactions, including erythema multiforme (EM), Stevens-Johnson syndrome (SJS), necrotizing fasciitis, and toxic epidermal necrolysis (TEN) can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, red irritated eyes, unusual tiredness and weakness, or fever or chills while you are using this medicine.
Check with your doctor right away if you have back pain, blurred vision, confusion, dizziness, drowsiness, fever, headache, seizures, or unusual tiredness or weakness. These may be symptoms of a rare and serious brain condition called reversible posterior leukoencephalopathy syndrome (RPLS).
This medicine may cause thyroid problems (eg, hyperthyroidism or hypothyroidism). Tell your doctor if you have nervousness, sensitivity to heat, sweating, trouble sleeping, weight loss, constipation, depressed mood, dry skin and hair, feeling cold, hair loss, hoarseness or husky voice, muscle cramps and stiffness, slowed heartbeat, weight gain, unusual tiredness or weakness.
This medicine may cause hypoglycemia (low blood sugar). Tell your doctor right away if you notice changes in your blood sugar or you have shaking, trembling, sweating, fast or pounding heartbeat, faintness or lightheadedness, hunger, or confusion.
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.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Sunitinib is harmful to the fetus. Talk to your healthcare provider if you are pregnant or have a plan to become pregnant. If you can become pregnant, take a pregnancy test before starting treatment with Sutent. You must use an effective birth control method to prevent pregnancy during the treatment and four weeks after the last dose. If you become pregnant after taking Sutent, call your healthcare provider.
What Other Medications Interact With Sutent?
Use caution when taking Sutent with the following medications:
Antibiotics, such as Biaxin (clarithromycin), Rifadin (rifampin), or Mycobutin (rifabutin) Antifungals, such as Sporanox (itraconazole) or Nizoral (ketoconazole) Antivirals, such as Reyataz (atazanavir) or Norvir (ritonavir) Anticonvulsants, such as Trileptal (oxcarbazepine), Dilantin (phenytoin), Carbatrol (carbamazepine), or Tegretol (carbamazepine) Medications for human immunodeficiency virus (HIV), such as Evotaz (atazanavir and cobicistat), Crixivan (indinavir), or Viracept (nelfinavir) Corticosteroids, such as Decadron (dexamethasone) Binosto (alendronate) Boniva (ibandronate) Actonel (risedronate) Saint-John’s-wort
Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Sutent.
And be sure to talk with your healthcare provider about any other medicines you take or plan to take, including nonprescription products, vitamins, herbs, or plant-based medicines.
What Medications Are Similar?
Other drugs that are similar to Sutent in treating various cancers include:
Votrient (pazopanib)Avastin (bevacizumab)Inlyta (axitinib)Torisel (temsirolimus)Afinitor (everolimus)
Compared with Afinitor, Sutent improved progression-free survival in patients with metastatic non-clear cell renal cell carcinoma.
Votrient and Sutent have similar efficacy in treating metastatic renal cell cancer, but the safety and quality-of-life profiles are more favorable with Votrient.
Choosing a suitable drug is an essential factor in treating a specific condition. Your healthcare provider will choose the most appropriate drug for you, depending on your health condition.
How Can I Stay Healthy While Taking Sutent?
Cancer can be a challenging and sometimes life-threatening disease. But advanced medical research has made it possible to diagnose in time and find a suitable cancer treatment with high success rates. Many newer drugs like Sutent are available for the treatment and reduce the progression of cancer and making it possible to improve the quality and duration of life of the patients.
Sutent is a well-tolerated and effective drug for patients who do not find promising results from other medications. It comes with a boxed warning from the FDA regarding hepatotoxicity (kidney toxicity). It has no general contraindications, except for pregnancy. Your healthcare provider will prescribe the best suitable drug for your health condition with minimal side effects.
General tips to support your health include:
Be sure to tell your healthcare provider about all medicines, supplements, and herbal preparations that you may be taking during treatment. Take medications as recommended by your healthcare provider. Try your best to eat a healthy diet and stay hydrated during your treatment. Try to get enough rest and do exercises that make you happy. Spend quality time with the people and pets or in places you love. Consider support groups or working with a mental health provider to help you find coping strategies to change the way you think, feel, react, or respond to living with cancer.
There are several ways to support your body during cancer treatment. During your treatment, be sure to stay hydrated, especially if you experience vomiting or diarrhea as a treatment side effect. You can do this by drinking more water or even consuming broth.
Eat a balanced diet with enough protein to help your body stay strong. European Society for Clinical Nutrition and Metabolism (ESPEN) nutrition guidelines suggest that people undergoing cancer treatment need more protein (0.5 to 0.8 grams of protein per pound of body weight) compared to sedentary individuals. While some sources may encourage eating animal protein as the best way to increase your protein intake, there are many other ways to get enough protein, including a balanced vegetarian diet.
Seek out a registered dietitian nutritionists (RDs/RDNs) who specialize in nutrition during cancer treatment to help support you during this time. Talk with your healthcare provider about connecting with an RD/RDN as you map out your nutrition plan during treatment. This course may help you avoid malnutrition and can help support your body. Eating smaller meals more frequently throughout the day can help you manage any nausea.
Adding chemotherapy to your to-do list can make life even busier. Consider talking with your loved ones to help with certain tasks—like assisting you with the drive to the cancer center and other responsibilities. Websites—like CaringBridge or Lotsa Helping Hands—can also help update loved ones about your treatments and organize tasks.
For treatment-related nausea, consider doing the following in addition to taking anti-nausea medications:
After a meal, quietly rest and sit upright for at least one hour. Slowly sip liquids throughout the day and consider clear liquids—like apple juice, broth, ginger ale, or tea. Try Popsicles or hard candies. Don’t skip meals and snacks, which might worsen your nausea. Try to have a snack before your chemo treatment. Try to eat small amounts of food with high calories—like Greek yogurt—multiple times a day.
For vomiting, keep the following in mind:
If you’re lying down, immediately turn to your side when you vomit. This will prevent inhaling your vomit. After vomiting stops, sit upright and slowly drink small amounts of clear liquids. You can also try ice chips or frozen juice chips.
For additional tips, visit the American Cancer Society website. Also, talk with your healthcare provider or pharmacist.
