Levat 10 - Capsule Lenvatinib - 10mg 30 Capsule(s) / Box Jenphar Bangladesh Ltd. Introduction: Levat 10 is an oral receptor tyrosine kinase inhibitor used in the treatment of thyroid cancer. Levat 10 can be taken with or without food, 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 much can cause very serious side effects.... Uses of Levat 10: Thyroid cancer Side effects of Levat 10: BleedingCoughDecreased appetiteErythema (skin redness)Hoarseness of voiceItchingJoint painMouth soreMuscle painNauseaPeripheral edemaRashSkin peelingStomach painTirednessVomitingWeight loss How to use Levat 10: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Levat 10 may be taken with or without food, but it is better to take it at a fixed time. How Levat 10 works: Levat 10 is a tyrosine kinase inhibitor. It works by blocking the oxygen and nutrient supply to cancer cells due to which they stop growing. Indication: Patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated, thyroid cancer. In combination with everolimus for the treatment of patients with, advanced renal cell carcinoma, following 1 prior vascular endothelial growth factor-targeted therapy. Administration: Swallow capsule whole May take with or without food Take at the same time each day Adult Dose: Adult Differentiated thyroid cancer (DTC) 24 mg once daily. Renal cell carcinoma (RCC) 18 mg in combination w/ everolimus 5 mg once daily. Patient w/ severe hepatic impairment Initially 14 mg once daily for DTC. 10 mg once daily for RCC. Renal Dose: Patient w/ severe renal impairment Initially 14 mg once daily for DTC. 10 mg once daily for RCC. Contraindication: Hypersensitivity. Lactation. Mode of Action: Receptor tyrosine kinase (RTK) inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4) Also inhibits other RTKs that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1, 2, 3, and 4; the platelet-derived growth factor receptor alpha (PDGFR-alpha), KIT, and RET Precaution: Monitor BP after 1 wk of treatment then every 2 wk for the 1st 2 month & monthly thereafter. Monitor urine protein regularly. Actively managed GI toxicity to reduce the risk of development of renal impairment/renal failure. Monitor for clinical symptoms or signs of cardiac decompensation. Posterior reversible encephalopathy syndrome/reversible posterior leucoencephalopathy syndrome. Monitor liver function tests before initiation of treatment, then every 2 wk for the 1st 2 month & monthly thereafter during treatment. Adjust initial dose in patients w/ severe renal or hepatic impairment. Serious tumour-related bleeds including fatal haemorrhagic events, GI perforation & fistula formation may occur.... Side Effect: >10% Percentages are for all grades of adverse effects unless otherwise noted Hypertension (73%),Diarrhea (67%),Fatigue (67%),Arthralgia/myalgia (62%),Decreased appetite (54%),Weight decreased (51%),Nausea (47%),Hypertension, grades 3-4 (44%),Stomatitis (41%),Headache (38%),Vomiting (36%),Proteinuria (34%),Palmar-plantar erythrodysesthesia (32%),Abdominal pain (31%),Dysphonia (31%),Constipation (29%),Oral pain (25%),Cough (24%),Peripheral edema (21%),Rash (21%),Dysgeusia (18%),Dry mouth (17%),Dizziness (15%),Dyspepsia (13%),Alopecia (12%),Epistaxis (12%),Insomnia (12%),Urinary tract infection (11%) 1-10% Percentages are for all grades of adverse effects unless otherwise noted Dental infections (10%) Hypotension (9%) Diarrhea, grades 3-4 (9%) Dehydration (9%) Prolonged QT interval (9%) Hypocalcemia (9%) Decreased appetite, grades 3-4 (7%) Hyperkeratosis (7%) Hypokalemia (6%) AST increased (5%) ALT increased (4%) Lipase increased (4%) Creatinine... Interaction: Decreased exposure w/ oral CYP3A4/Pgp substrates [eg, astemizole, terfenadine, cisapride, pimozide, quinidine, bepridil or ergot alkaloids (ergotamine, dihydroergotamine)]. May reduce effectiveness of oral hormonal contraceptives.