Sunitinib is taken once daily. You may be asked to take it every day, or to take it for four weeks followed by two treatment-free weeks.
It may colour your urine - this is harmless.
Good dental hygiene is particularly important with this treatment - brush your teeth regularly, and have routine dental check-ups.
|Type of medicine||An anti-cancer medicine (a protein kinase inhibitor)|
Sunitinib is a medicine which is given to treat certain cancers. It is usually prescribed after other treatments have been tried first, or if other treatments are not suitable. The type of cancers that it is taken for are kidney cancer that has progressed or spread into other areas of the body; a stomach and bowel cancer called gastrointestinal stromal tumour (GIST); and cancers which have spread from the pancreas.
In cancer, certain cells in the body grow and multiply in a way that is 'out of control'. Medicines like sunitinib slow down the way cancer cells grow and spread. Sunitinib belongs to a group of anti-cancer medicines known as protein kinase inhibitors. These work by blocking chemical messengers (called kinases) which send signals to cells to grow.
Before taking sunitinib
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking sunitinib it is important that your doctor knows:
- If you have an infection or feel particularly unwell.
- If you have a heart condition or an unusual heart rhythm.
- If you have high blood sugar levels (diabetes mellitus) or have ever had very low blood sugar levels (hypoglycaemia).
- If you have high blood pressure or blood vessel disease.
- If you are pregnant or breast-feeding.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take sunitinib
- Before you start the treatment, read any printed information you have been given by your doctor and the printed manufacturer's leaflet from inside the pack of capsules. These will give you more information about sunitinib and will provide a full list of the side-effects which you may experience from taking it.
- Sunitinib will be prescribed for you by a specialist doctor who is experienced in treating your condition. Your dose will depend upon the type of cancer you have. It is important that you take the capsules exactly as you are told to. There are a number of different strengths of capsule and your dose may be made up of more than one strength. Sunitinib is taken once each day - try to take your doses at the same time of day each day. You may be told to take the capsules every day, or for treatment cycles of four weeks followed by two treatment-free weeks. The directions for taking the capsules will be printed on the label of the pack to remind you what your doctor has told you to do, but if you have any concerns or questions, you should contact your doctor or hospital clinic for further advice.
- Swallow the capsules with a drink of water. You can take sunitinib capsules before or after meals.
- Do not drink grapefruit juice while you are on sunitinib. This is because a chemical in grapefruit juice can interfere with the amount of sunitinib in your bloodstream.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, take the dose that is due but leave out the forgotten dose. Do not take two doses on the same day to make up for a missed dose.
Getting the most from your treatment
- You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular blood tests and check-ups during treatment.
- Sunitinib can cause your urine to look a different colour - this is harmless and nothing to be concerned about.
- Sunitinib could cause your blood sugar level to go too low (hypoglycaemia). Signs this could be happening include weakness, trembling, a racing pulse, sweating and cold, clammy skin. Drinking or eating something sugary will help raise your blood sugar level, but also contact your doctor or pharmacist for advice. If you have diabetes your doctor may need to adjust your treatment and you may need to test your blood sugar levels more regularly.
- If you buy or take any other medicines, check with a pharmacist that they are suitable to take alongside sunitinib.
- Good dental hygiene is particularly important while you are taking these capsules - brush your teeth regularly and remember to have routine dental check-ups. Tell your dentist that you are taking sunitinib, as some dental treatments may not be recommended for you.
- It is important that you do not get pregnant while you are taking sunitinib. If this could be a possibility for you, make sure you discuss with your doctor which types of contraception are suitable for you and your partner.
Can sunitinib cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with sunitinib. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common sunitinib side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting), indigestion, abdominal discomfort||Stick to simple foods - avoid rich or spicy foods. Let your doctor know if this continues|
|Diarrhoea or constipation||Drink plenty of water|
|Headache, aches and pains||Ask your doctor or pharmacist to recommend a suitable painkiller|
|Increased number of infections, bleeding problems such as nosebleeds||Speak with your doctor for advice|
|Skin colour changes, dry or cracked skin, rash or soreness particularly on the hands or feet, sore mouth, changes in the way things taste, feeling short of breath, cough||If troublesome, speak with your doctor|
|A loose tooth, jaw pain with swelling or numbness||Speak with your doctor as soon as possible - these may be signs of a problem called osteonecrosis of the jaw|
|Heart problems (let your doctor know straightaway if you get chest pain), high bloood pressure, changes to some blood tests||Your doctor will regularly check for these|
If you experience other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist for further advice.
How to store sunitinib
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Please return any unused or unwanted capsules to your clinic or pharmacy to destroy.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you are due to have an operation or any other medical treatment, tell the person carrying out the treatment which medicines you are taking.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Sutent® 12.5 mg, 25 mg, 37.5 mg and 50 mg Hard Capsules; Pfizer Limited, The electronic Medicines Compendium. Dated April 2017.
British National Formulary 73rd Edition (Mar 2017); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.