Gorafenib

Indications & Dose:

Treatment of metastatic colorectal cancer in patients who have previously been treated with, or who are unsuitable for standard treatment including fluoropyrimidine-based chemotherapy, a vascular endothelial growth factor inhibitor, and an epidermal growth factor receptor inhibitor Treatment of unresectable or metastatic gastrointestinal stromal tumours in patients who progressed on or are intolerant to previous treatment with imatinib and sunitinib.

BY MOUTH

Adult: 160 mg once daily for 21 consecutive days of repeated 28-day cycles, for dose adjustment due to side effects

Contraindications:

Side Effects:

Common or very common Abnormal international normalised ratio . biochemical disturbances . decreased

appetite , diarrhoea , dry mouth , dry skin , dysphonia , electrolyte disturbances , gastroenteritis ,gastrooesophageal reflux .haemorrhage (including fatal), hand foot skin reaction , headache , hypertension ,hypothyroidism , infection , malaise , mucosal inflammation , musculoskeletal stiffness , nail disorder, pain , pyrexia , rash , taste disorders , tremor, weight loss

Uncommon Gastro intestinal perforation (including fatal cases) and fistula discontinue treatment. hypertensive

crisis , myocardial infarction , myocardial ischaemia , severe (including fatal) liver injury

Rare Keratoacanthoma . posterior reversible encephalopathy syndrome , squamous cell carcinoma of

the skin , Stevens johnson syndrome , toxic epidermal

necrolysis

Frequency not known Alopecia . bone marrow suppression , hyperuricaemia , nausea , oral mucositis , thromboembolism ,tumour lysis syndrome , vomiting

PREGNANCY:  avoid

BREAST FEEDING :Avoid

HEPATIC IMPAIRMENT: advises caution

RENAL IMPAIRMENT: Caution 

Cautions:

Ensure measures to prevent hand foot skin reaction .Gilberts syndrome risk of hyperbilirubinaemia . history of ischaemic heart disease monitor for signs and symptoms of myocardial ischaemia and interrupt treatment if signs of ischaemia or infarction develop . hypertension control blood pressure before treatment

initiation and monitor as clinically indicated during treatment (review dose and consider treatment interruption if severe or persistent hypertension develops discontinue treatment if hypertensive crisis occurs). may impair wound healing withhold treatment for major surgical procedures . predisposition to bleeding.

Precautions:

Interaction:

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Lactations:

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Side Effects Or Adverse Reactions:

Patient And Carer Advice: