Formulation and Specifications: Capsules: 4mg, 10mg
Indications: Patients with progressive, locally advanced or metastatic radioiodine-refractory differentiated thyroid cancer.
Key points for rational dosing:
1. The recommended daily dose is 24 mg once daily and should be continued until disease progression or intolerable toxic effects.
2. CYP3A4 substrates known to have a narrow therapeutic index (e.g., astemizole, terfenadine, cisapride, pimozide, quinidine, bepridil) or ergot alkaloids (ergotamine, dihydroergotamine) should be used with caution in patients receiving lenvatinib.
3. The occurrence of adverse reactions needs to be closely monitored during drug administration. The most common adverse reactions (>30%) in thyroid cancer treatment are hypertension, fatigue, diarrhea, arthralgia/myalgia, loss of appetite, weight loss, nausea, oral mucositis, headache, vomiting, proteinuria, etc. Reduce the dose, suspend the medication or stop it permanently if necessary.
4. Once persistent or intolerable grade 2 to 3 adverse reactions occur, dosing should be suspended until remission to grade 0 to 1 or baseline levels, and the daily dose should be reduced according to the adjusted dose reduction recommendation: 20mg → 14mg → 10mg.
5. In patients with severe renal impairment and hepatic impairment, the dose of lenvatinib should be changed to 10 mg.
6. Lenvatinib should be taken at regular times of the day, either on an empty stomach or with food. If a patient misses a dose and is unable to take it within 12 hours, there is no need to make up the dose and the next dose should be taken at the regular dosing time.