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Indications

High Alert

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypertension, DEEP VEIN THROMBOSIS, HF, MI, peripheral edema, QT interval prolongation, TORSADES DE POINTES.

Derm: alopecia, ERYTHEMA MULTIFORME, hair color change, hand-foot syndrome, impaired wound healing, NECROTIZING FASCIITIS, rash, skin discoloration, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.

EENT: epistaxis.

Endo: hypoglycemia, hypothyroidism, adrenal insufficiency, hyperthyroidism.

F and E: dehydration, hypophosphatemia.

GI: diarrhea, dyspepsia, hepatotoxicity, nausea, stomatitis, vomiting, lipase/amylase, liver enzymes, anorexia, cholecystitis, constipation, esophagitis, GI PERFORATION, oral pain.

GU: hemolytic uremic syndrome, fertility, nephrotic syndrome, proteinuria, renal failure.

Hemat: anemia, hemorrhage, lymphopenia, neutropenia, thrombocytopenia, thrombotic thrombocytopenic purpura.

Metab: hyperuricemia.

MS: arthralgia, back pain, limb pain, myalgia, osteonecrosis (primarily ONJ).

Neuro: fatigue, dizziness, dysgeusia, headache, POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES).

Resp: PULMONARY EMBOLISM.
Misc: fever, TUMOR LYSIS SYNDROME.

Interactions

Drug-Drug:

Drug-Natural Products:

Drug-Food:

Availability

(Generic available)

Route/Dosage

Gastrointestinal Stromal Tumor and Renal Cell Carcinoma

Renal Impairment

Adjuvant Treatment of Renal Cell Carcinoma

Renal Impairment

Pancreatic Neuroendocrine Tumor

Renal Impairment

US Brand Names

Sutent

Action

Therapeutic Effects:

Classifications

Therapeutic Classification: antineoplastics

Pharmacologic Classification: kinase inhibitors

Pharmacokinetics

Absorption: Well absorbed following oral administration.

Distribution: Extensively distributed to tissues.

Protein Binding: Sunitinib: 95%; primary active metabolite: 90%.

Metabolism/Excretion: Metabolized by the liver via the CYP3A4 isoenzyme to its primary active metabolite. This metabolite is further metabolized by CYP3A4. Excretion is primarily fecal.

Half-life: Sunitinib: 40–60 hr; primary active metabolite: 80–110 hr.

Time/Action Profile

(plasma concentrations)

ROUTEONSETPEAKDURATION
POunknown6–12 hr24 hr

Patient/Family Teaching

Pronunciation

su-NI-ti-nib