Metastatic medullary thyroid cancer (MTC)
- 140 mg PO qday on empty stomach. Patients should not to eat for at least 2 hours before and at least 1 hour after administration.
- Avoid coadministration of strong CYP3A4 inducers
- Do not ingest foods (e.g., grapefruit, grapefruit juice) or nutritional supplements that are known to inhibit cytochrome P450
- Withhold dose for Grade 4 hematologic adverse reactions, =>Grade 3 nonhematologic adverse reactions, or intolerable Grade 2 adverse reactions
- Upon resolution, reduce dose as follows:
- if previous daily dose 140 mg, resume at 100 mg/day
- if previous daily dose 100 mg, resume at 60 mg/day
- if previous daily dose 60 mg, resume at 60 mg if tolerated, otherwise, discontinue
- Safety and effectiveness in pediatric patients have not been studied
Grade 3) in 13% of patients
