Indications: Lenvatinib (Lenvima) is a kinase inhibitor indicated for the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer.

Dosing: The recommended dose is 24 mg orally, once daily. Patients with severe renal or hepatic impairment should be given a reduced dose of 14 mg once daily.

Pharmacokinetics: Following oral administration of lenvatinib, peak plasma concentration occurred in 1 to 4 hours, and the terminal elimination half-life is 28 hours. The primary route of metabolism is enzymatic. It is excreted through feces and urine.

Side Effects/Risks: The most common adverse reactions include hypertension, fatigue, diarrhea, arthraligia/myalgia, proteinuria, palmar-plantar erythrodysesthesia syndrome, abdominal pain, and dysphonia.

More Information: Control blood pressure prior to starting treatment with lenvatinib. Monitor for cardiac decompensation, liver function, proteinuria, QT interval prolongation, hypocalcemia, and TSH levels. Discontinue for life-threatening hypertension, arterial thromboembolic events, hepatic failure, nephrotic syndrome, gastrointestinal perforation, or life-threatening fistula.

Source: Highlights of prescribing information: Lenvima (lenvatinib). U.S. Food & Drug Administration website. http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/206947s000lbl.pdf. Revised February 2015. Accessed March 3, 2015.