Lenvatinib 4mg Capsules | Apple Pharmaceuticals

1. LENVATINIB 4MG Lenvatinib 4mg is also known as tyrosine kinase inhibitor. Lenvatinib 4mg targets something to the cancer cells. Lenvatinib 4mg is well absorbed. In which Food does not affect the range of absorption but lower the rate. Lenvatinib 4mg which is a prescription drug used under proper guidance of medical oncologist. INDICATION • Indicated For the treatment of thyroid cancer which cannot be treated with radioactiveiodine. • Indicated By combined with everolimus to treat the advanced renal carcinoma in which other drugs failed to be effective. • Indicated For the treatment of hepatocellular primary liver cancer DOSAGE The recommended dose of differentiated thyroid cancer is Lenvatinib 24 mg, it administers by two 10mg and one 4 mg capsules taken orally, once in a day along with or without food. The recommended dose of renal cell carcinomas is Lenvatinib 18 mg, given as one 10mg capsule and two 4 mg capsules administrated in combination with 5mg

2. everolimus orally taken once in a day with or without food. The recommended dose of first-line treatment of unresectable hepatocellular carcinoma is based on actual body weight If < 60 kg then 8mg PO qDay If ≥ 60 kg then 12mg PO qDay Administration: • Lenvatinib capsule must take at same time each day • Follow the drug till disease progression. • Lenvatinib capsules must swallowed whole. • In a small glass of liquid dissolved the capsules • In 1 tablespoon apple juice or water and embed the capsules into the liquid without breaking or crushing them. • Dip the capsules in the liquid for at least 10 minutes. • The liquid is agitated for at least 3 minutes. Drink the mixture. • Add 1 tablespoon of water or apple juice to the glass after drinking the mixture • Mix up the contents a few times and swallow the additional liquid. OVERDOSAGE: Lenvatinib has no individual antitoxin for overdose. Since high plasma protein binding. Lenvatinib is not expected to be dialyzable. Take the patients to emergency medical department or call poison control helpline.

3. MECHANISM Lenvatinib called as targeted therapy. In which it aims something particular to the cancer cells, hence reduces side effects caused by repairing to the healthy cells. Lenvatinib mechanism by inhibiting two processes which allow cancer cells to develop • Prevention of a protein that promotes cell division • Stopping the VEGF receptor, which is necessary for angiogenesis, or the growth of a blood supply to the tumor. This discards the tumor's source of nutrients. ADME Maximum plasma concentration is 1 to 4 hours post dose. Effect with food is low to the extent of absorption. Human plasma proteins bounding about 98% to 99%. Metabolized in CYP3A and aldehyde oxidase. Lenvatinib metabolic pathway is identified as enzymatic and non-enzymatic processes. The drug excreted via 64% feces and 25% urine, The terminal half-life of Lenvatinib is 28 hours.

4. PREGNANCY Pregnancy category: D when given to pregnant women, Lenvatinib 4mg drugs can cause harm to the fetal. There are no specific data available on human related to drug associated risk. Advice pregnant women specific risk to fetus. PRECAUTION • When using Lenvatinib 4mg Hypertension reslted in 73% of Lenvatinib-treated patients in clinical trials (grade 3 hypertension was 44%); regulate blood pressure before to treatment; check blood pressure after 1 week, then q2weeks for the first 2

5. months. • Lenvatinib 4mg causes Arterial thromboembolic events occurred in 5% of treated patients; stop drug following a thromboembolic event; forever stop treatment following an arterial thrombotic event. • When using ofLenvatinib 4mg capsules will occurs Gastrointestinal perforation or fistula (2%); stop if patient experience a GI perforation or life-threatening fistula; permanently stop therapy in patients who have gastrointestinal perforation of any serious or Grade 3 or 4 fistula.