Hepanib - Tablet Sorafenib - 200mg 28 Tablet(s) / Box Everest Pharmaceuticals Ltd. Introduction: Hepanib belongs to the class of medicines known as tyrosine kinase inhibitors used in the treatment of liver cancer, kidney cancer, and thyroid cancer. Hepanib should be taken on an empty stomach, but try to have it at the same time every day to get the most benefits. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too... Uses of Hepanib: Liver cancerKidney cancerThyroid cancer Side effects of Hepanib: FatigueNauseaLoss of appetiteDiarrheaAbdominal painHair lossWeight lossRashPainful blisters on hands and feet How to use Hepanib: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Hepanib is to be taken empty stomach. How Hepanib works: Hepanib is an anti-cancer medication. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps to stop or slow the spread of cancer cells. What if you forget to take Hepanib?: If you miss a dose of Hepanib, skip it and continue with your normal schedule. Do not double the dose. Indication: Renal cell carcinoma, Hepatocellular Carcinoma, Thyroid Cancer Administration: Should be taken on an empty stomach. Take on an empty stomach or w/ a low or moderate fat meal. If the patient intends to have a high fat meal, sorafenib should be taken on an empty stomach at least 1 hr before or 2 hr after meals. Swallow whole, do not chew/crush. Adult Dose: Oral Advanced renal cell carcinoma, Hepatocellular Carcinoma, Thyroid Cancer Adult: 400 mg bid. May continue until patient is no longer responding or unacceptable toxicity occurs. Hepatic Impairment Mild to moderate: Dose adjustment not necessary Severe hepatic impairment: Not studied Child Dose: Safety and efficacy not established Renal Dose: Renal Impairment Mild to moderate: Dose adjustment not necessary Severe renal impairment: Not studied Contraindication: Hypersensitivity Mode of Action: Sorafenib inhibits cell surface and intracellular kinases to reduce proliferation of tumour cells. Precaution: Interrupt teatment if patient develops cardiac infarction, ischaemia and/or bleeding fatalities. Regular monitoring of BP, CBC and platelet is recommended. Monitor INR in patients who are on treatment with warfarin. Adequate contraception should be used during and for at least 2 wk after stopping treatment. May need to discontinue treatment if severe or persistent hypertension occurs. Lactation: not known whether distributed in breast milk, discouraged Side Effect: >10% Thrombocytopenia (12-46%),Anemia (44%),Diarrhea (43%),Rash/desquamation (40%),Fatigue (37%),Abd pain (31%),Hand-foot skin reaction (30%),Weight loss (30%),Anorexia (29%),Alopecia (27%),Nausea (24%),Lymphopenia (23%),Neutropenia (18%),Hemorrhage (15-18%),Hypertension (9-17%),Vomiting (16%),Constipation (15%),Neuropathy (13%),Dry skin (11%) 1-10% Headache (10%),Joint pain (10%),Congestive heart failure, MI (1.9%),QT prolonation (rare) <1% Acute renal failure,Angioedema and arrhythmia may occur,Bone pain reported Frequency Not Defined Stevens-Johnson Syndrome,Hyperthyroidism,Interstitial lung disease Potentially Fatal: Bleeding fatalities. Hypertensive crisis. Interaction: Inducers of isoenzyme CYP3A4 e.g. carbamazepine, dexamethasone, phenobarbital, phenytoin, rifampicin may decrease sorafenib plasma concentration. Coadmin with sorafenib may increase the plasma concentration of doxorubicin and irinotecan.