Sorafenib
Sorafenib is an oral kinase inhibitor used to treat advanced liver, kidney and thyroid cancers; Nexavar tablets in 200mg are the strength sold here.
What sorafenib treats
Sorafenib is an oral cancer medicine. It is used for hepatocellular carcinoma (the commonest form of liver cancer), for advanced renal cell carcinoma (kidney cancer that has spread beyond the kidney) and for differentiated thyroid cancer that no longer responds to radioactive iodine. In each case it is used once the disease is advanced, with the aim of slowing it and holding it steady.
Two targets in one tablet
A growing tumour needs two things: a steady order to divide, and a blood supply to feed it. Sorafenib cuts into both, which is why it is called a multikinase inhibitor. Within the cancer cell it disables RAF kinases, the enzymes passing on the divide order. On the cell surface it occupies the VEGF and PDGF receptors, so the signals that summon new vessels go unanswered and the tumour is left short of oxygen and nutrients.
Breakfast comes second
A 7 a.m. tablet means breakfast waits until 8, and an evening tablet goes in either an hour before dinner or a couple of hours after it. The Nexavar sold here is a 200mg film-coated tablet, one in the morning and one at night, swallowed whole with water. Food in the stomach lowers how much sorafenib is absorbed, so the gap around meals is part of the treatment rather than a detail.
Side effects
Hand-foot skin reaction is the one to expect: palms and soles turn red, dry, tender or blistered, often within the first few weeks. Diarrhoea, tiredness, a rash, thinning hair, a sore mouth, appetite loss and weight loss are also common, and blood pressure tends to creep up. Rarer but serious are bleeding, chest pain or a heart attack, a hole forming in the wall of the bowel, and severe blistering skin reactions. Sorafenib is not taken during pregnancy because it can harm a developing baby.
Other medicines and supplements
The liver breaks sorafenib down with the enzyme CYP3A4. Rifampicin, carbamazepine, phenytoin and St John's wort speed that enzyme up and leave less sorafenib in the body; ketoconazole and similar antifungals slow it down and leave more. Taken with warfarin, sorafenib makes bruising and bleeding more likely because it adds to the blood-thinning effect.
Sources
- Sorafenib: MedlinePlus Drug Information — MedlinePlus / U.S. National Library of Medicine
- Sorafenib 200mg film-coated tablets - Summary of Product ... - medicines — Electronic medicines compendium (EMC)
Is Sorafenib available to order in Hong Kong?
Sorafenib can be ordered online with delivery to Hong Kong. The page lists generic Nexavar tablets in 200mg. Tracked courier delivery to Hong Kong takes 5 to 9 business days and includes online tracking.
How are Sorafenib prices shown?
The price depends on the strength and pack size you choose. The Nexavar page shows current prices in HKD or the currency you select.
Is there a generic Nexavar?
Yes, generic Nexavar is listed as 200mg tablets and contains sorafenib. No plain sorafenib tablets or other named versions appear on this page. That is the only product shown for this ingredient here.
What brand names does sorafenib have?
Nexavar is a brand name of sorafenib. Here, sorafenib can be bought online as generic Nexavar. These are generics, not the original brand.
Can sorafenib be taken with food?
It is taken on an empty stomach: at least an hour before eating or two hours after. A fatty meal slows absorption and lowers the amount that reaches the blood, so the two daily doses are usually timed around breakfast and the evening meal rather than with them.
How long does sorafenib take to work?
There is no effect you can feel within hours. Sorafenib is taken every day without a break, and whether it is helping is judged from scans taken every few weeks or months. Side effects, when they come, usually show up in the first weeks rather than later.
What is hand-foot skin reaction?
It is redness, dryness, tenderness or blistering on the palms and soles, and it affects a large share of people taking sorafenib, usually within the first weeks. Soft shoes, gloves for heavy tasks, lukewarm rather than hot water and a regular moisturiser make it easier to live with.
What if I miss a dose of sorafenib?
Take the missed tablet when you remember, as long as the next meal is still at least an hour away. If the next dose is nearly due, leave the missed one out and carry on with the usual schedule. Two doses are never taken together to catch up.
Does sorafenib raise blood pressure?
A rise in blood pressure is common on sorafenib and often appears within the first weeks. It can climb a long way, so readings are taken before treatment starts and at intervals while it continues.