Facts about axitinib
Axitinib is a type of targeted therapy called a tyrosine kinase inhibitor. This means it works by targeting receptors present on the cancer cells. Axitinib targets several different receptors, which in turn blocks tumor growth and angiogenesis (the development of a blood supply to the tumor).
How to take axitinib
Axitinib comes in a tablet form (1mg or 5mg tablets) and is taken twice a day, 12 hours apart. The tablet should be swallowed whole with a glass of water, with or without food. If you vomit after taking the dose, do not take another dose. Take your next dose at the usual time.
The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include: grapefruit, grapefruit juice, dexamethasone, ketoconazole, rifampin, phenytoin, St. John’s wort, and modafanil. Be sure to tell your healthcare provider about all medications and supplements you take.
Side effects of axitinib
Below are some of the possible side effects and suggestions for dealing with them. Be sure to tell your oncology team if you are experiencing any of these problems.
High Blood Pressure
High blood pressure (hypertension) was seen in clinical trials and typically occurred within the first few months of therapy. Patients should have their blood pressure checked regularly during therapy. Any hypertension should be treated appropriately. If hypertension cannot be controlled, the axitinib dose may be reduced or stopped.
Your oncology team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods and absorbs fluid, which can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange sections, boiled potatoes, white rice and products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses on non-alcoholic, un-caffeinated fluid a day to prevent dehydration. Read Low Fiber Diet for Diarrhea for more tips.
Nausea and/or Vomiting
Take anti-nausea medications if prescribed. If you continue to have nausea or vomiting, notify your doctor or nurse so they can help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea & Vomiting Tip Sheet for more suggestions.
Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.
While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team and see OncoLink’s section on fatigue for helpful tips on dealing with this side effect.
Decrease in Appetite
Hand and Foot Syndrome (HFS)
HFS is a skin reaction that appears on the palms of the hands and/or the soles of the feet as a result of certain chemotherapy agents. It can start as a feeling of tingling or numbness in the palms and/or soles and progress to swelling, redness, peeling skin, and tenderness or pain. Notify your healthcare team right away if you notice any of these signs of HFS so they can make recommendations or dose changes to prevent it from getting worse. Learn more about HFS on OncoLink.
In studies, hypothyroidism (under active thyroid) and hyperthyroidism (over active thyroid) were seen in patients taking this medication. Your doctor will perform blood tests to check the function of your thyroid and treat this side effect if it develops. Symptoms of thyroid problems include: tiredness, feeling hot or cold, change in your voice, weight gain or loss, hair loss and muscle cramps.
Low White Blood Cell Count (Leukopenia or Neutropenia)
White blood cells (WBC) are important for fighting infection. While receiving treatment, your WBC count can drop, putting you at a higher risk of getting an infection. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4°), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
Tips to preventing infection:
For more suggestions, read the Neutropenia Tip Sheet.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment, even if your menstrual cycle stops or you believe your sperm is affected.
Other Side Effects
Axitinib can cause liver toxicity, which your doctor may monitor for using blood tests called liver function tests. Some patients experienced changes in their voice, including hoarseness.
Studies did not evaluate wound healing with axitinib, but other medications in the same category do affect wound healing. Therefore, the manufacturer recommends stopping the drug at least 24 hours before any surgical procedure and consider not restarting until there is adequate wound healing.
In clinical trials, some patients developed proteinuria, which is the presence of protein in the urine and can be a sign of kidney damage. Your oncology team will periodically check your urine for protein.
A neurologic complication, called reversible posterior leukoencephalopathy syndrome, has been reported. If you experience headache, seizure, confusion, blindness or other visual changes, inform your healthcare provider right away.
Emergent Side Effects
In studies, patients experienced blood clots, stroke and heart attack. If you experience symptoms of these problems, you should contact your healthcare provider immediately or go to an emergency room. Symptoms can include: swelling, redness or pain in an extremity, chest pain or pressure, pain in your arm, back, neck or jaw, shortness of breath, numbness or weakness on one side of the body, trouble talking, confusion or mental status changes.
Some patients experienced bleeding or a tear in the intestinal wall. Signs of these problems include: unexpected bleeding, blood in the stool or black stools, cough up or vomit blood or vomit that looks like coffee grounds, severe pain in the abdomen. If you experience any of these, contact your healthcare provider immediately or go to the emergency room.