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Nexavar® (sorafenib) for kidney cancer

Nexavar is a medication used to treat advanced kidney cancer in adults

Dosage:  400mg twice a day 
How supplied:  200mg tablets
Storage:   Room temperature between 68°F to 77°F (20°C to 25°C).
Route of Administration:  Nexavar is a tablet(s) taken by mouth 1 hour before or 2 hours after a meal
Schedule:  2 tablets (400mg) every 12 hours

Do Not take Nexavar if you:

  • Are allergic to sorafenib, or any of the ingredients in Nexavar
  • Have squamous cell lung cancer and receive Carboplatin and Paclitaxel

How should I take Nexavar?

  • Take it exactly the way your healthcare provider tells you
  • Must be taken on an empty stomach, at least 1 hour before or 2 hours after a meal.
  • Do not take a tablet that has been crushed or broken
  • If you miss a dose, skip the dose and take your next dose at your regular time
  • If you vomit after taking a dose, do not take an additional dose
  • If you think you have taken an extra dose of this medication, call your healthcare provider right away

Dietary restrictions 

  • Do not eat grapefruit or drink grapefruit juice at the same time as tablets of Nexavar. They may change the amount of Nexavar in your body.

What is the most important information I should know about Nexavar?

  • Nexavar may cause birth defects or death of an unborn baby
  • Women should not get pregnant during treatment with Nexavar and for at least 6 months after stopping treatment. Women should use effective birth control during treatment with Nexavar and for at least 6 months after stopping treatment. Talk with your doctor about effective birth control methods
  • Men should use effective birth control during treatment with Nexavar and for at least 3 months after stopping treatment. Talk with your doctor about effective birth control methods
  • Call your doctor right away if you become pregnant during treatment with Nexavar.
  • Nexavar may cause fertility problems in males.  Talk to your healthcare provider about this.

I should tell my healthcare provider if I: 

  • have any allergies
  • have heart problems or chest pain
  • have abnormal magnesium, potassium, or calcium blood levels
  • have bleeding problems
  • have high blood pressure
  • have kidney problems in addition to kidney cancer
  • have liver problems in addition to liver cancer
  • need to have surgery or have had recent surgery
  • need to have major dental work ( tooth pulled )
  • am pregnant or planning to become pregnant
  • am breastfeeding or planning to breast-feed. It is not known if Nexavar passes into your breast milk. Do not breastfeed during treatment with Nexavar and for 2 weeks after receiving the last dose of Nexavar.

Tell your healthcare provider at each visit about all the medications you take including prescription and non-prescription medicine, vitamins, and herbal supplements. Nexavar may affect the way other medicines work and other medicines may affect how Nexavar works. For example:

  • some drugs used to treat high blood pressure
  • some antibiotics (used to treat infections)
  • some drugs used to treat HIV
  • some drugs used to treat depression
  • drugs used to treat irregular heart beats
  • herbal supplements like St. John’s Wort

Especially, tell your doctor if you take warfarin (Coumadin®)

What are possible side effects of Nexavar?

Common Side effects with Nexavar may include:

  • diarrhea (frequent or loose bowel movements)
  • fatigue/weakness
  • abdominal pain
  • weight loss
  • nausea or vomiting 
  • hand foot skin reaction
  • rash, redness, itching or peeling of your skin
  • hair thinning or patchy hair loss
  • mouth sores
  • loss of appetite

Nexavar may cause serious side effects, including:

  • Decreased blood flow to the heart, heart attack and heart failure.  Get emergency help right away and call your doctor if you develop symptoms such as chest pain, shortness of breath, racing heartbeat, swelling in lower legs, feet and abdomen, feel lightheaded or faint, tiredness, nausea, vomiting, sweating a lot. 
  • Bleeding problems: vomiting blood, or vomit that looks like coffee grounds, coughing blood, red or black stools, bruising, wounds that do not heal, unusual bleeding.   Tell your doctor if you have any bleeding while taking Nexavar 
  • High blood pressure. Your blood pressure should be checked every week during the first 6 weeks of starting Nexavar.  Your blood pressure should be checked regularly and any high blood pressure should be treated while you are receiving Nexavar.
  • Skin problems such as hand-foot skin reaction, or rash. Hand-foot syndrome may cause redness, pain, swelling, or blisters on the palms of your hands or soles of your feet.  If you get this side effect, your doctor may change your dose or stop treatment for some time.
  • Serious skin and mouth reactions. Tell your doctor right away if you develop a skin rash, blistering and peeling of the skin or sores inside of your mouth.
  • Perforation of the bowel (an opening in the wall of your stomach or intestines): Tell your doctor right away if you get high fever, nausea, vomiting, or severe abdominal pain.
  • Changes in your heartbeat which could be life threatening. Tell your doctor immediately if you faint, lightheaded, dizzy, or feel your heart beating irregularly or fast.
  • Liver problems that may lead to liver failure or death. Tell your doctor if you notice dark urine, your skin or the white part of your eyes turn yellow, light colored bowel movements, or worsening nausea, vomiting, or  abdominal pain.
  • Wound healing problems. If you need to have a surgical or dental procedure, tell your doctor that you are taking Nexavar. Nexavar should be stopped at least 10 days prior to elective surgery and at least 2 weeks until your wound heals after some types of surgery.
  • Change in thyroid hormone level.  Your healthcare provider may need to change your thyroid medicine during treatment, based on your thyroid levels.
  • Birth defects or death of an unborn baby. See “What is the most important information I should know about Nexavar?”

These are not all of the possible side effects of Nexavar. Tell your healthcare provider if you have any side effects that bother you or that do not go away.   

Call your doctor for medical advice about side effects. For more information, ask your healthcare provider or pharmacist.  

Patient Assistance Program: Reach (Resources for Expert Assistance and Care Helpline). To enroll speak to your healthcare provider or call 1-866-639-2827

Patient Support Program:  Call 1866 Nexavar ( 1-866-639-2827 ) or  www:REACHPatientSupport.com  

Resources:  Bayer Healthcare 1-866-639-2827

www.nexavar.com

Adapted from the NEXAVAR (sorafenib) package insert. Bayer HealthCare Pharmaceuticals Inc.   July 2020

KCA disclaimer statement: you should rely primarily upon your doctor for medical information.

www.kidneycancer.org