Drug reference

Sorafenib

Tyrosine Kinase Inhibitor · Antineoplastic

Tyrosine Kinase InhibitorAntineoplastic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

and reproductive function in

FDA category + note

Top interactionssee all 12 →

AmiodaroneSevereDatabaseDDInter
AmisulprideSevereDatabaseDDInter
AnagrelideSevereDatabaseDDInter
Arsenic TrioxideSevereDatabaseDDInter

Mechanism

Sorafenib is an oral multikinase inhibitor that targets multiple receptor tyrosine kinases involved in tumor angiogenesis and proliferation: VEGFR-1, -2, and -3; PDGFR-β; c-KIT; FLT-3; and the serine/threonine kinase RAF (including b-RAF and c-RAF). By simultaneously blocking angiogenic signaling and the RAF-MEK-ERK proliferative cascade, it provides both anti-angiogenic and direct anti-tumor effects. It is approved for hepatocellular carcinoma, renal cell carcinoma, and differentiated thyroid cancer.

Indications

Advanced and/or metastatic renal cell carcinomaProgressive, locally advanced or metastatic differentiated thyroid cancer (papillary, follicular or Hürthle cell) in adults whose disease does not respond to radioactive iodineAdvanced unresectable hepatocellular carcinomasystemic therapy of follicular cell-derived thyroid cancers without regard to driver mutation statussystemic therapy for radioiodine-refractory, progressive thyroid cancersthyroid cancerhepatocellular carcinomametastatic renal cell cancer (sunitinib and pazopanib are generally preferred first-line therapies)

Dosing

Adult: with paclitaxel for the treatment of adult patients with platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who received no more than two prior chemotherapy regimens and who have not received prior therapy with bevacizumab or other vascular endothelial growth factor (VEGF) inhibitors or VEGF receptor-targeted agents.…

Pharmacokinetics

Peak effect

within 1 week (steady-state concentrations)

Half-life

20 to 27 h (t1/2)

Bioavailability

—

Protein binding

99.5%

Metabolism

CYP3A4 (to inactive products)

Excretion

—

Side effects

Common

FatigueDizzinessnauseadiarrheaanorexiarashpalmar-plantar erythrodysesthesias

Serious

Cardiac decompensation
Electrolyte abnormalities
Thyroid dysfunction
Proteinuria
vascular toxicities (e.g., hypertension, proteinuria, bleeding, arterial thromboembolic events, intestinal perforation)
bone marrow suppression
GI perforation
cardiomyopathy