Lenvima is a brand-name prescription medication that’s used to treat certain types of cancer in adults. It’s FDA-approved for:

  • Differentiated thyroid cancer (DTC). DTC is the most common type of thyroid cancer. It’s usually treated with radioactive iodine. Lenvima is used to treat DTC that has come back or spread after being treated. It’s used when the cancer is getting worse, and radioactive iodine isn’t working anymore.
  • Advanced renal cell carcinoma (RCC). RCC is a type of kidney cancer. Lenvima is used after you’ve had one course of treatment with a similar cancer drug. For this purpose, Lenvima is used with everolimus (Afinitor, Zortress).
  • Hepatocellular carcinoma (HCC). HCC is the most common type of liver cancer. Lenvima is used as a first treatment for HCC that can’t be treated with surgery.
  • Advanced endometrial cancer*. Advanced endometrial cancer affects the lining of your uterus. Lenvima is used for endometrial cancer that got worse after past treatment and can’t be treated with surgery or radiation therapy. For this purpose, Lenvima is used with pembrolizumab (Keytruda).

* For this use, Lenvima received accelerated approval from the FDA. Accelerated approval is based on information from early clinical trials. The FDA’s decision for full approval will be made after additional clinical trials are completed.

Details

Lenvima is a type of drug called a kinase inhibitor. It’s a targeted therapy for cancer. Targeted cancer therapies interfere with certain proteins that help the cancer grow and spread.

Lenvima comes as a capsule that you take by mouth. It’s available in two strengths: 4 mg and 10 mg.

Effectiveness

Lenvima has been found to be effective in treating each of the cancer types listed above. To learn more, see the “Lenvima uses” section below.

Lenvima is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Lenvima contains the active drug lenvatinib.

Lenvima can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Lenvima. These lists do not include all possible side effects.

For more information on the possible side effects of Lenvima, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they’ve approved. If you would like to report to the FDA a side effect you’ve had with Lenvima, you can do so through MedWatch.

Mild side effects

Mild side effects of Lenvima can include*:

  • decreased appetite
  • weight loss
  • headache
  • hand-foot syndrome (a condition that causes redness, itching, or peeling on the skin on your hands and feet)
  • hoarse voice
  • cough
  • rash
  • swelling of your hands or feet

Mild side effects can also include the following side effects, which are explained in the “Side effect details” section:

  • pain in your joints or muscles
  • digestive problems such as constipation, nausea and vomiting, or pain in your abdomen (belly)
  • fatigue (lack of energy)
  • stomatitis (sores or swelling in your mouth)

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* These are partial lists of mild side effects from Lenvima. To learn about other mild side effects, talk with your doctor or pharmacist or view Lenvima’s medication guide.

Serious side effects

Serious side effects from Lenvima aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Heart problems, including heart failure. Symptoms can include:
    • shortness of breath
    • swollen ankles and feet
  • Blood clots in your arteries, which could cause a heart attack or stroke. Symptoms may vary depending on the location of the blood clot and can include:
    • chest pain
    • pain in your arms, back, neck, or jaw
    • trouble breathing
    • trouble speaking
    • weakness or numbness in one side of your body
    • sudden, severe headache
    • sudden changes in your vision, such as blurred vision
  • Prolonged QT interval (a type of abnormal heart rhythm). Symptoms can include:
    • fainting
    • feeling like your heart is fluttering
  • Liver problems, such as hepatitis (swelling of the liver) and liver failure. Symptoms can include:
    • jaundice (yellowing of your skin and the whites of your eyes)
    • unusually dark urine or pale stools
    • severe upper abdominal (belly) pain
  • Kidney problems, such as kidney failure. Symptoms can include:
    • urinating less than usual
    • swollen ankles and feet
    • muscle cramps
    • nausea
    • shortness of breath
  • Gastrointestinal perforation (a tear in the wall of your stomach or intestine). Symptoms can include:
    • severe abdominal pain
    • nausea and vomiting
  • Fistula (an abnormal opening between two parts of your body). Symptoms can include:
    • severe abdominal pain
  • Reversible posterior leukoencephalopathy syndrome (swelling in your brain). Symptoms can include:
    • severe headache
    • weakness
    • confusion
    • changes in your vision, including loss of vision
  • Underactive thyroid gland (reduced production of thyroid hormones by your thyroid gland). Symptoms can include:
    • fatigue
    • feeling cold
    • constipation
    • weight gain
    • dry skin
  • Serious bleeding problems. Symptoms can include:
    • severe nosebleeds that won’t stop
    • coughing up blood
    • blood in your urine
    • passing red, black, or tarry stools
    • heavy or unusual vaginal bleeding in women
  • Protein in your urine. Symptoms can include:
    • swelling of the arms, feet, hands, or legs
    • urinating more often than usual
  • Slow healing of wounds.
  • Low level of calcium in your blood.

Other serious side effects are explained in “Side effect details” below. These include:

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on some of the side effects this drug may cause.

High blood pressure

High blood pressureis one of the most common side effects of Lenvima. In clinical studies, 42% to 73% of people who took Lenvima had high blood pressure. Rates varied depending on the condition treated, dosage used, and if Lenvima was taken with other drugs.

In comparison, high blood pressure occurred in:

  • 16% of people taking a placebo (a treatment with no active drug)
  • 10% of people taking everolimus (Afinitor, Zortress) alone
  • 31% of people taking sorafenib (Nexavar) alone

High blood pressure can be serious. If it’s not managed, it can raise your risk for heart attack, stroke, and kidney damage.

Your doctor will check your blood pressure often while you’re taking Lenvima. If your blood pressure gets too high, your doctor may prescribe medication to lower it. They may also lower your dose of Lenvima or have you stop taking it for a while.

If your blood pressure can’t be managed, you’ll need to stop taking Lenvima.

Digestive problems

Some people may have digestive problems while taking Lenvima. These problems can include diarrhea, nausea, vomiting, constipation, or abdominal (belly) pain. These are all common side effects of this drug.

Diarrhea

Diarrhea is a possible side effect of Lenvima. In clinical studies, diarrhea occurred in 39% to 81% of people who took Lenvima. Rates varied depending on the condition treated, dosage used, and if Lenvima was taken with other drugs.

In comparison, diarrhea occurred in:

  • 17% of people taking a placebo
  • 34% of people taking everolimus alone
  • 46% of people taking sorafenib alone

Talk with your doctor right away if you get diarrhea while taking Lenvima, because diarrhea can quickly become serious. Your doctor will likely recommend a medication to treat the diarrhea. They may also lower your dose of Lenvima or ask you to stop taking it for a while.

If you get diarrhea, it’s also important to drink plenty of liquids. This helps to avoid dehydration (low fluid level). If your diarrhea isn’t relieved with medication, talk with your doctor or go to the emergency room.

Nausea and vomiting

Nausea and vomiting can occur with Lenvima use.

In clinical studies, 20% to 47% of people who took Lenvima had nausea. Rates varied depending on the condition treated, dosage used, and if Lenvima was taken with other drugs.

In comparison, nausea occurred in:

  • 25% of people taking a placebo
  • 16% of people taking everolimus alone
  • 14% of people taking sorafenib alone

Vomiting occurred in 16% to 48% of people who took Lenvima. Rates varied depending on the condition treated, dosage used, and if Lenvima was taken with other drugs.

In comparison, vomiting occurred in:

  • 15% of people taking a placebo
  • 12% of people taking everolimus alone
  • 8% of people taking sorafenib alone

If you experience nausea or vomiting while taking Lenvima, talk with your doctor about how to manage this. For example, nausea can be relieved by eating little and often, rather than having large main meals.

If you’re vomiting, it’s important to drink plenty of fluids to avoid dehydration. If you can’t keep fluids down, talk with your doctor right away or go to the emergency room. Also, if you vomit blood or what looks like coffee grounds, go to the emergency room right away.

Abdominal pain

Taking Lenvima may cause abdominal (belly) pain. In clinical studies, abdominal pain occurred in 30% to 37% of people who took Lenvima. Rates varied depending on the condition treated, dosage used, and if Lenvima was taken with other drugs.

In comparison, abdominal pain occurred in:

  • 11% of people taking a placebo
  • 8% of people taking everolimus alone
  • 28% of people taking sorafenib alone

Severe abdominal pain can sometimes be a symptom of one of the more serious side effects of Lenvima. These include gastrointestinal perforation (a tear in the wall of your stomach or intestine) or liver problems such as hepatitis (swelling of the liver).

See your doctor right away if you get severe pain while taking Lenvima.

Constipation

Constipation is a possible side effect of Lenvima. In clinical studies, constipation occurred in 16% to 32% of people who took Lenvima. Rates varied depending on the condition treated, dosage used, and if Lenvima was taken with other drugs.

In comparison, constipation occurred in:

  • 15% of people taking a placebo
  • 18% of people taking everolimus alone
  • 11% of people taking sorafenib alone

Constipation is also a side effect of various strong pain relievers (such as morphine and fentanyl) that are often prescribed to manage pain from cancer. If you get constipation while taking Lenvima, talk with your doctor about the best ways to manage it.

Muscle and joint pain

Some people may get pain in their muscles or joints while taking Lenvima. This is a common side effect of the drug.

In clinical studies, 31% to 62% of people who took Lenvima had muscle or joint pain. Rates varied depending on the condition treated, dosage used, and if Lenvima was taken with other drugs.

In comparison, muscle and joint pain occurred in:

  • 28% of people taking a placebo
  • 32% of people taking everolimus alone
  • 20% of people taking sorafenib alone

If you get bothersome muscle or joint pain, ask your doctor or pharmacist to recommend a pain reliever. You can also talk with your doctor about other ways to manage your pain.

Fatigue

Most people having treatment for cancer will experience fatigue (lack of energy) at some point. Fatigue is a common side effect of Lenvima.

In clinical studies, 44% to 73% of people who took Lenvima had fatigue. Rates varied depending on the condition treated dosage used, and if Lenvima was taken with other drugs.

In comparison, fatigue occurred in:

  • 35% of people taking a placebo
  • 40% of people taking everolimus alone
  • 36% of people taking sorafenib alone

If you have fatigue, it’s important to take time to rest. However, trying to stay active can also help improve your energy levels. Talk with your doctor about how much activity is right for you and about the best ways to manage fatigue.

Mouth sores

Stomatitis (mouth sores) are painful areas inside the mouth, such as ulcers or small cuts. Mouth sores are common side effects of many cancer treatments, including Lenvima

In clinical studies, 11% to 44% of people who took Lenvima had mouth sores. Rates varied depending on the condition treated dosage used, and if Lenvima was taken with other drugs.

In comparison, mouth sores occurred in:

  • 8% of people taking a placebo
  • 50% of people taking everolimus alone
  • 14% of people taking sorafenib alone

You may get mouth sores that are red, swollen, or have white patches in the center. These sores can also develop in your throat. They can make it painful to eat and swallow.

If you get mouth sores, talk with your doctor about the best way to treat this problem.

The Food and Drug Administration (FDA) approves prescription drugs such as Lenvima to treat certain conditions.

Lenvima for hepatocellular carcinoma (HCC)

Lenvima is FDA-approved to treat hepatocellular carcinoma (HCC) in adults. HCC is the most common type of liver cancer. Lenvima is used as a first treatment for HCC that can’t be treated with surgery.

Effectiveness for HCC

Lenvima has been found to be effective for treating HCC in people who couldn’t have surgery to treat their cancer.

In a clinical study, people with HCC who took Lenvima were 36% less likely to have their cancer progress (get worse) than people who took a drug called sorafenib (Nexavar). In this study:

  • for at least half of the people who took Lenvima, their cancer didn’t progress for at least 7.3 months
  • for at least half of the people who took sorafenib, their cancer didn’t progress for at least 3.6 months

The clinical study also looked at overall survival rates of people taking each drug. (The overall survival rate refers to the length of time people lived after joining the study.) Researchers found that the overall survival rates for people taking each drug weren’t significantly different.

In this study:

  • at least half of the people who took Lenvima lived for 13.6 months or longer after joining the study
  • at least half of the people who took sorafenib lived for 12.3 months or longer after joining the study

It’s important to note that everyone’s situation is unique, and your results from Lenvima may not match those seen in clinical trials. If you have questions about life expectancy while you’re taking Lenvima, talk with your doctor.

Lenvima for advanced endometrial cancer

Lenvima is FDA-approved to treat advanced endometrial cancer* in adults. Endometrial cancer affects the lining of your uterus. The cancer is considered advanced if it’s spread from the uterus to other parts of your body.

Lenvima is used for endometrial cancer that got worse after past treatment and can’t be treated with surgery or radiation therapy. For this purpose, Lenvima is taken with a drug called pembrolizumab (Keytruda).

Lenvima is not approved for endometrial cancer that’s caused by a genetic defect. These cancers are described as microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR). These are abnormalities in certain proteins and genes within the cancer cells.

* For this use, Lenvima received accelerated approval from the FDA. Accelerated approval is based on information from early clinical trials. The FDA’s decision for full approval will be made after additional clinical trials are completed.

Effectiveness for advanced endometrial cancer

In a clinical study, Lenvima used with Keytruda was found to be effective for treating advanced endometrial cancer that wasn’t MSI-H or dMMR.

In this study:

  • 10.6% of people who took Lenvima with Keytruda had a complete response (their cancer went away completely with treatment)
  • 27.7% of people who took Lenvima with Keytruda had a partial response (their tumor shrunk by at least 30%).

The responses lasted for at least 6 months for 69% of people. In this study, the researchers didn’t compare Lenvima plus Keytruda with any other treatments.

Lenvima for differentiated thyroid cancer (DTC)

Lenvima is FDA-approved to treat differentiated thyroid cancer (DTC) in adults.

DTC is the most common type of thyroid cancer. “Differentiated” means the cancer cells look very similar to normal thyroid cells when viewed under a microscope. Types of DTC include papillary cancer, follicular cancer, and Hürthle cell cancer.

DTC develops in the follicular cells in your thyroid gland. The follicular cells absorb iodine from your blood and use it to make thyroid hormones. These hormones help control your metabolism.

DTC is usually treated with radioactive iodine. The follicular cells absorb radioactive iodine in the same way as normal iodine, and the radiation kills the follicular cells.

Lenvima is used when radioactive iodine isn’t working for you anymore. It treats DTC that’s locally recurrent (has come back in your thyroid gland) or metastatic (has spread to other parts of your body). It’s used when the cancer is progressing (getting worse).

Effectiveness for DTC

Lenvima has been found to be effective in treating locally recurrent or metastatic DTC that’s progressing and can no longer be treated with radioactive iodine.

In a clinical study people with this condition who took Lenvima were 79% less likely to have their cancer progress (get worse) than people who took placebo. (A placebo is a treatment containing no active drug.)

In this study:

  • for at least half of the people who took Lenvima, their cancer didn’t progress for at least 18.3 months
  • for at least half of the people who took a placebo, their cancer didn’t progress for at least 3.6 months

Lenvima for advanced kidney cancer

Lenvima is FDA-approved to treat advanced renal cell carcinoma (RCC), a type of kidney cancer. Advanced means that the cancer has spread from the kidney to other parts of the body.

Lenvima is used for advanced RCC after you’ve had one course of treatment with a similar type of anti-cancer drug. For this purpose, Lenvima is taken with a drug called everolimus (Afinitor, Zortress).

Effectiveness for advanced RCC

Lenvima used with everolimus has been found to be more effective for treating advanced renal cell carcinoma (RCC) than everolimus on its own.

In a clinical study of people with advanced RCC, people who took Lenvima with everolimus were 63% less likely to have their cancer progress (get worse) than people who only took everolimus.

In this study:

  • for at least half of the people who took Lenvima with everolimus, their cancer didn’t progress for at least 14.6 months
  • for at least half of the people who took everolimus only, their cancer didn’t progress for at least 5.5 months

Lenvima and children

Lenvima is not FDA-approved to treat cancer in children. It’s not known if this drug is safe or effective for children to use.

Here are answers to some frequently asked questions about Lenvima.

What’s the life expectancy when you take Lenvima?

Life expectancy with Lenvima can depend on many factors. These include the type and stage of cancer you have, if you get certain side effects, other treatments you may have, and your overall health.

In clinical studies, the overall survival rates (the length of time people lived after joining the study) for those taking Lenvima were as follows.

  • At least half of the people who took Lenvima for hepatocellular carcinoma (HCC) lived for 13.6 months or longer.
  • At least half of the people who took Lenvima with everolimus (Afinitor, Zortress) for advanced renal cell carcinoma (RCC) lived for 25.5 months or longer.

Overall survival rates for people with endometrial cancer and differentiated thyroid cancer (DTC) were not reported in clinical studies of Lenvima.

It’s important to note that everyone’s situation is unique, and your results from Lenvima may not match those seen in clinical trials. If you have questions about life expectancy while you’re taking Lenvima, talk with your doctor.

Is Lenvima a type of chemotherapy?

No, Lenvima is not a type of chemotherapy. It’s a targeted therapy for cancer. Targeted therapies act more precisely on cancer cells than chemotherapy does.

Chemotherapy involves using drugs that kill cancer cells. However, the drugs can also kill healthy cells, especially those that multiply quickly (such as blood cells). This is why chemotherapy often causes side effects. However, targeted therapies can also have significant side effects.

Targeted therapies like Lenvima block specific proteins that are more active in cancer cells than in healthy cells. These proteins are associated with the growth and spread of the cancer. Blocking their action can prevent the cancer cells from growing and multiplying.

Can I take Lenvima if I have high blood pressure?

If you have high blood pressure, it needs to be managed with medication before you can start taking Lenvima. This is because Lenvima can make high blood pressure worse.

In most cases, you can take Lenvima if your blood pressure can be managed. Your doctor will check your blood pressure often while you take Lenvima.

If your blood pressure gets too high, it will need to be treated. Your doctor may increase the dose of your blood pressure medication or prescribe an extra medication. They may also lower your dose of Lenvima or have you stop taking it for a while.

If your blood pressure can’t be managed, you’ll need to stop taking Lenvima.

Which tests will I need to receive during Lenvima treatment?

While you take Lenvima, you’ll have frequent tests to check how the drug is working for you. You’ll also have tests to monitor you for possible side effects. The types of tests you’ll have include:

  • blood pressure checks (Lenvima can cause high blood pressure.)
  • electrocardiogram (EKG) tests to check your heartbeat (Lenvima can sometimes cause an abnormal heart rhythm.)
  • urine tests to check for protein in your urine (Lenvima can sometimes cause protein in your urine.)
  • blood tests to check your:
    • liver function, also called liver function tests (Lenvima can sometimes cause liver and kidney problems.)
    • kidney function (Lenvima can sometimes cause kidney problems.)
    • calcium level (Lenvima can sometimes lower your calcium level, and if this happens, you may need to take a calcium supplement.)
    • thyroid hormones, also called thyroid function tests (Lenvima can sometimes make your thyroid gland underactive.)

Talk with your doctor if you have questions about the tests you’ll need during treatment.

Will Lenvima cure my condition?

There’s currently no cure for cancer. However, Lenvima can help extend the length of time you live without your cancer getting worse.

How well Lenvima works for you may depend on several factors. These include the type of cancer you have, the stage of your cancer when it was first diagnosed, how far the cancer has spread, and your overall health.

In clinical studies, a small number of people had a complete response to Lenvima treatment. (A complete response means that their cancer went away completely.)

It’s important to note that a complete response doesn’t necessarily mean the cancer is cured. It’s still possible for cancer to come back after a complete response.

Of the people with endometrial cancer who had a complete response in the studies, 69% lived with no signs of cancer for at least 6 months. It’s not known how long the complete responses lasted in people with other types of cancer.

The Lenvima dosage your doctor prescribes will depend on several factors. These include:

  • the type of cancer you’re using Lenvima to treat
  • how well your liver and kidneys are working
  • other medical conditions you may have
  • if you get certain side effects

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Lenvima comes as a capsule that you take by mouth. It’s available in two strengths: 4 mg and 10 mg.

Dosage for hepatocellular carcinoma (HCC)

The usual dosage of Lenvima for treating HCC (a type of liver cancer) is based on your body weight.

  • For adults who weigh 132 pounds (60 kg) or more, the recommended dosage is 12 mg once a day.
  • For adults who weigh less than 132 pounds (60 kg), the recommended dosage is 8 mg once a day.

Dosage for advanced endometrial cancer

The usual dosage of Lenvima to treat endometrial cancer in adults is 20 mg once a day. (Endometrial cancer affects the lining of your uterus.)

Lenvima is used with a medication called pembrolizumab (Keytruda) to treat endometrial cancer. Pembrolizumab is given as an intravenous (IV) infusion by your doctor every 3 weeks. (With an IV infusion, the drug is injected into your vein over a period of time.)

Dosage for differentiated thyroid cancer (DTC)

The usual dosage of Lenvima to treat differentiated thyroid cancer in adults is 24 mg once a day.

Dosage for advanced kidney cancer

The usual dosage of Lenvima to treat advanced renal cell carcinoma (RCC) in adults is 18 mg once a day. (RCC is a type of kidney cancer.)

Lenvima is used with a medication called everolimus (Afinitor, Zortress) to treat advanced RCC. You’ll take 5 mg of everolimus by mouth once a day.

What if I miss a dose?

Take your dose of Lenvima at the same time each day. If you forget to take a dose at your usual time, here’s what to do:

  • If you’re less than 12 hours late for your dose, take the missed dose. Then take your next dose at its usual time.
  • If you’re more than 12 hours late for your dose, skip the missed dose. Then take your next dose at its usual time.

Never take two doses together to make up for a missed dose. This can raise your risk for side effects.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Lenvima is meant to be used as a long-term treatment. If you and your doctor determine that Lenvima is safe and effective for you, you’ll likely take it long term.

Lenvima is FDA-approved to treat the following types of cancer:

What Lenvima does

Lenvima is a targeted therapy. This means it works by interfering with specific proteins that help the cancer cells grow and spread.

Lenvima is a type of drug called a multi-kinase inhibitor. It blocks the action of several different enzymes called kinases. (Enzymes are proteins that help particular chemical reactions happen inside cells.)

Lenvima blocks the action of certain kinases that either help the cancer cells grow and multiply or that help tumors form new blood vessels.

When tumors form new blood vessels, it allows the cancer cells to get oxygen and nutrients. This helps the tumor to grow rapidly. It also helps the cancer cells spread into other parts of your body.

By blocking these different kinases, Lenvima helps shrink the tumor and can stop the cancer from getting worse in your body.

How long will Lenvima work?

How long Lenvima will work for you depends on various factors, including the type and stage of your cancer. You’ll have various tests throughout your treatment to check that the drug is working for you.

Lenvima starts to work as soon as you start taking it, although you probably won’t notice any changes. The drug works over time to shrink tumors and slow the growth of the cancer in your body.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Lenvima, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for hepatocellular carcinoma (HCC)

Examples of other drugs that may be used to treat this type of liver cancer include:

  • other targeted therapy drugs, such as
    • sorafenib (Nexavar)
    • regorafenib (Stivarga)
    • ramucirumab (Cyramza)
  • immunotherapy drugs, such as:
  • chemotherapy

Alternatives for advanced endometrial cancer

Examples of other drugs that may be used to treat advanced endometrial cancer include:

  • other targeted therapy drugs, such as:
  • hormone therapy, such as:
    • medroxyprogesterone acetate (Provera)
    • megestrol acetate (Megace)
    • tamoxifen
  • immunotherapy drugs, such as:
    • pembrolizumab (Keytruda)
  • chemotherapy

Alternatives for differentiated thyroid cancer (DTC)

Examples of other drugs that may be used to treat DTC include:

  • radioactive iodine
  • other targeted therapy drugs, such as:
    • sorafenib (Nexavar)
  • chemotherapy

Alternatives for advanced kidney cancer

Other drugs may be used to treat advanced renal cell carcinoma (RCC), a type of kidney cancer. Examples of these drugs include:

  • other targeted therapy drugs, such as:
    • everolimus (Afinitor, Zortress)
    • temsirolimus (Torisel)
    • bevacizumab (Avastin, Mvasi)
    • sunitinib (Sutent)
    • pazopanib (Votrient)
    • cabozantinib (Cabometyx)
    • axitinib (Inlyta)
    • sorafenib (Nexavar)
  • immunotherapy drugs, such as:
    • ipilimumab (Yervoy)
    • nivolumab (Opdivo)
    • pembrolizumab (Keytruda)
    • avelumab (Bavencio)
    • interferon
    • interleukin-2 (Aldesleukin, Proleukin)
  • chemotherapy

You may wonder how Lenvima compares with other medications that are prescribed for similar uses. Here we look at how Lenvima and Opdivo are alike and different.

Ingredients

Lenvima contains the active drug lenvatinib. Opdivo contains the active drug nivolumab.

Uses

Lenvima is a targeted therapy for cancer. Targeted therapies work by interfering with specific proteins that help the cancer cells grow and spread.

Opdivo is an immunotherapy drug for cancer. Immunotherapies work by helping your immune system attack the cancer cells.

Lenvima and Opdivo are both FDA-approved to treat:

  • Hepatocellular carcinoma (HCC). HCC is the most common type of liver cancer. Lenvima is used as a first treatment for HCC that can’t be treated with surgery. Opdivo is used for HCC that’s previously been treated with sorafenib (Nexavar).
  • Advanced renal cell carcinoma (RCC). RCC is a type of kidney cancer. Lenvima is used after you’ve had one course of treatment with a similar cancer drug. For this purpose, Lenvima is used with everolimus (Afinitor, Zortress). Opdivo is used on its own for people who’ve taken an anti-angiogenesis drug for their cancer in the past. It’s used with ipilimuab (Yervoy) for people with intermediate or poor risk cancer, who’ve not yet had treatment for their cancer.

Lenvima is also FDA-approved to treat certain types of the following cancers in adults:

Opdivo is also FDA-approved to treat certain types of the following cancers in adults:

* For this use, Lenvima received accelerated approval from the FDA. Accelerated approval is based on information from early clinical trials. The FDA’s decision for full approval will be made after additional clinical trials are completed.

Opdivo is also approved for use in children ages 12 years and older with certain types of colorectal cancer.

Drug forms and administration

Lenvima comes as a capsule that you take by mouth once a day.

Opdivo comes as a liquid solution that’s given as an intravenous (IV) infusion by your doctor. (With an IV infusion, the drug is injected into your vein over a period of time.) The Opdivo IV infusions each last about 30 minutes. You’ll get Opdivo every 2, 3, or 4 weeks.

Side effects and risks

Lenvima and Opdivo have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug or with both Lenvima and Opdivo (when taken individually).

  • Can occur with Lenvima:
    • weight loss
    • hand-foot syndrome (a condition that causes redness, itching, or peeling of the skin on your hands and feet)
    • hoarse voice
  • Can occur with Opdivo:
    • itching
    • diarrhea
  • Can occur with both Lenvima and Opdivo:
    • pain in your joints or muscles
    • nausea and vomiting
    • headache
    • abdominal (belly) pain
    • decreased appetite
    • rash
    • cough

Serious side effects

These lists contain examples of serious side effects that can occur with Lenvima, or with Opdivo.

  • Can occur with Lenvima:
    • diarrhea
    • high blood pressure
    • prolonged QT interval (a type of abnormal heart rhythm)
    • liver problems, such as hepatitis (swelling of the liver) and liver failure
    • fistula (an abnormal opening between two parts of your body)
    • reversible posterior leukoencephalopathy syndrome (swelling in your brain)
    • serious bleeding problems
    • slow healing of wounds
    • protein in your urine
  • Can occur with Opdivo:
    • colitis (swelling in your large intestine)
    • hepatitis
    • hormonal problems, including changes in your thyroid hormone and cortisol levels
    • type 1 diabetes
    • severe skin reactions, including Stevens-Johnson syndrome
    • encephalitis (swelling in your brain)
    • immune system reaction (when your immune system attacks your organs), which can cause inflammation (swelling) in other parts of your body, including your muscles, heart, nerves, stomach, and eyes
    • infusion reactions (reaction that occurs during or shortly after you receive a drug infusion)
  • Can occur with both Lenvima and Opdivo:

Effectiveness

Lenvima and Opdivo have different FDA-approved uses, but they’re both used to treat the following conditions in adults:

  • hepatocellular carcinoma (HCC)
  • advanced renal cell carcinoma (RCC)

These drugs haven’t been directly compared in clinical studies. However, studies have found both Lenvima and Opdivo to be effective for treating these conditions.

In one recent review of studies, researchers compared the effectiveness of these drugs for treating RCC.

They found that Lenvima used with everolimus (Afinitor, Zortress) may be more effective than Opdivo for people who’ve previously taken an anti-angiogenesis drug for their cancer.

However, they also found that serious side effects may be more common with Lenvima used with everolimus compared with Opdivo.

If you’re interested in taking one of these drugs to treat your cancer, talk with your doctor about which one would be a better fit for you.

Costs

Lenvima and Opdivo are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Lenvima is significantly more expensive than Opdivo. The actual price you’ll pay for either drug will depend on your insurance plan, your location, and if applicable, the pharmacy you use.

Like Opdivo (above), the drug Nexavar has uses similar to those of Lenvima. Here’s a comparison of how Lenvima and Nexavar are alike and different.

Ingredients

Lenvima contains the active drug lenvatinib. Nexavar contains the active drug sorafenib.

Uses

Lenvima and Nexavar are both targeted therapies for cancer. Targeted therapies work by interfering with specific proteins that help the cancer cells grow and spread.

Lenvima and Nexavar are both FDA-approved to treat:

  • Hepatocellular carcinoma (HCC). HCC is the most common type of liver cancer. Both Lenvima and Nexavar are used for HCC that can’t be treated with surgery.
  • Advanced renal cell carcinoma (RCC). RCC is a type of kidney cancer. Nexavar is approved for all people with RCC, while Lenvima is only approved for people who’ve taken an anti-angiogenesis drug for their cancer in the past. Lenvima is used with a drug called everolimus (Afinitor, Zortress).
  • Differentiated thyroid cancer (DTC). DTC is the most common type of thyroid cancer. It’s usually treated with radioactive iodine. Lenvima and Nexavar are both used to treat DTC that has come back or spread after past treatment. They’re used when the cancer is getting worse and treatment with radioactive iodine isn’t working anymore.

Lenvima is also FDA-approved to treat certain types of endometrial cancer* in adults.

* For this use, Lenvima received accelerated approval from the FDA. Accelerated approval is based on information from early clinical trials. The FDA’s decision for full approval will be made after additional clinical trials are completed.

Drug forms and administration

Lenvima comes as a capsule that you take by mouth once a day. Nexavar comes as a tablet that you take by mouth twice a day.

Side effects and risks

Lenvima and Nexavar have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug or with both Lenvima and Nexavar (when taken individually).

  • Can occur with Lenvima:
    • pain in your joints or muscles
    • headache
    • hoarse voice
  • Can occur with Nexavar:
    • diarrhea
    • infections
    • hair loss
    • rash
  • Can occur with both Lenvima and Nexavar:
    • hand-foot syndrome (a condition that causes redness, itching, or peeling of the skin on your hands and feet)
    • decreased appetite
    • weight loss
    • nausea and vomiting
    • abdominal (belly) pain

Serious side effects

These lists contain examples of serious side effects that can occur with Lenvima, with Nexavar, or with both drugs (when taken individually).

Effectiveness

Lenvima and Nexavar have different FDA-approved uses, but they’re both used to treat the following conditions in adults:

  • hepatocellular carcinoma (HCC), a liver cancer
  • advanced renal cell carcinoma (RCC), a kidney cancer
  • differentiated thyroid cancer

The use of Lenvima and Nexavar in treating HCC has been directly compared in a clinical study. The study looked at overall survival rates of people taking each drug. (The overall survival rate refers to the length of time people lived after joining the study.)

  • Of the people who took Lenvima, at least half of them lived for 13.6 months or longer after joining the study.
  • Of those taking Nexavar, at least half lived for 12.3 months or longer after joining the study.

It’s important to note that everyone’s situation is unique, and your results from Lenvima may not match those seen in clinical trials. If you have questions about life expectancy while you’re taking Lenvima, talk with your doctor.

The clinical study also looked at how long each drug kept people’s cancer from progressing (getting worse).

  • For at least half of the people who took Lenvima, their cancer didn’t progress for at least 7.3 months.
  • For at least half of the people who took sorafenib, their cancer didn’t progress for at least 3.6 months.

These drugs haven’t been directly compared in clinical studies for treating kidney or thyroid cancer. However, studies have found both Lenvima and Nexavar to be effective for treating these conditions.

Costs

Lenvima and Nexavar are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Lenvima and Nexavar generally cost about the same. The actual price you’ll pay for either drug will depend on your insurance plan, your location, and the pharmacy you use.

Lenvima is approved by the Food and Drug Administration (FDA) to be used with everolimus (Afinitor, Zortress) for advanced renal cell carcinoma (a type of kidney cancer). It’s also approved to be used with pembrolizumab (Keytruda) for endometrial cancer.

There are no known interactions between Lenvima and alcohol.

However, drinking alcohol could make certain side effects of Lenvima worse. These include nausea, diarrhea, and fatigue (lack of energy). Also, drinking heavily can cause dehydration (low fluid level), which raises your risk for kidney side effects with Lenvima.

In addition, both alcohol and Lenvima can affect your liver. If you drink alcohol, talk with your doctor about how much is safe to drink during your Lenvima treatment.

Lenvima can interact with several other medications. Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Lenvima and other medications

Below is a list of medications that can interact with Lenvima. This list does not contain all drugs that may interact with Lenvima.

Before taking Lenvima, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Lenvima and drugs that can cause an abnormal heart rhythm

Lenvima can sometimes cause prolonged QT interval (a type of abnormal heart rhythm). This can lead to a life threatening abnormal heartbeat called ventricular fibrillation.

Certain other drugs can also cause this side effect. If you take Lenvima with one of these other drugs, this can raise your risk for prolonged QT interval.

Examples of drugs that can raise your risk for QT prolongation with Lenvima include:

  • certain drugs to treat irregular heartbeats, such as:
    • amiodarone (Pacerone)
    • quinidine
    • procainamide
    • sotalol (Sotylize, Betapace, Betapace AF, Sorine)
    • disopyramide (Norpace)
  • certain antipsychotic drugs, such as:
    • pimozide (Orap)
    • haloperidol
    • quetiapine (Seroquel, Seroquel XR)
    • ziprasidone (Geodon)
  • certain antimicrobials, such as:
    • clarithromycin
    • moxifloxacin (Avelox)
  • methadone (Methadose, Dolophine)
  • ondansetron (Zuplenz, Zofran ODT)
  • tamoxifen

While taking Lenvima, you should avoid taking these drugs if possible. If you need to take one of these drugs during your Lenvima treatment, your doctor will monitor your heart with electrocardiogram (EKG) tests.

If you get prolonged QT interval (a type of abnormal heart rhythm), your doctor may lower your dose of Lenvima or have you stop taking it until your heart rhythm recovers.

Lenvima and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Lenvima. However, you should still check with your doctor or pharmacist before using any of these products while taking Lenvima.

Lenvima and foods

There aren’t any foods that have been specifically reported to interact with Lenvima. If you have any questions about eating certain foods with Lenvima, talk with your doctor.

As with all medications, the cost of Lenvima can vary. To find current prices for Lenvima in your area, check out WellRx.com. The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay will depend on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you may have to get Lenvima at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before they approve coverage for Lenvima. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Lenvima.

If you’re not sure if you’ll need to get prior authorization for Lenvima, contact your insurance plan.

Financial and insurance assistance

If you need financial support to pay for Lenvima, or if you need help understanding your insurance coverage, help is available.

Eisai Inc. offers financial support in the form of the Lenvima $0 Co-pay Program and an Eisai Assistance Program. For more information and to find out if you’re eligible for support, call 866-61-EISAI (866-613-4724) or visit the company website.

Eisai Inc. also offers guidance in learning about your insurance coverage. To see if you’re eligible for support, call 866-61-EISAI (866-613-4724) or visit the program website.

Generic version

Lenvima is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

You should take Lenvima according to your doctor or healthcare provider’s instructions.

When to take

Lenvima is taken once a day. It doesn’t matter what time of day you choose, but you should take it at the same time each day.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Lenvima with food

You can take Lenvima either with or without food.

Can Lenvima be crushed, split, or chewed?

No, you shouldn’t crush, split, or chew Lenvima capsules. If you have trouble swallowing the capsules whole, you can dissolve them in a small amount of liquid.

To do this, put the capsules you need for your dose into a glass. Put them in whole, without opening or crushing the capsules. Add one tablespoon of water or apple juice to the glass and leave the capsules to dissolve for at least 10 minutes. Then, stir the mixture for at least 3 minutes before drinking it.

After you drink the mixture, add another tablespoon of water or apple juice to the glass. Swirl this around the glass a few times to mix with any remaining medication, then drink this as well.

It’s not known if Lenvima is safe to take during pregnancy because it hasn’t been studied in pregnant women. However, animal studies, along with what’s known about how the drug works, suggest that Lenvima could harm a developing fetus.

If you’re pregnant or planning a pregnancy, talk with your doctor about the risks and benefits of taking Lenvima.

It’s not known if Lenvima is safe to take during pregnancy. Women who could become pregnant should use birth control while taking Lenvima and for at least 30 days after stopping treatment.

Talk with your doctor if you have questions about your birth control options .

You shouldn’t breastfeed while taking Lenvima or for at least 1 week after stopping treatment. It’s not known if Lenvima passes into breast milk. However, if it does, Lenvima could cause serious side effects in a breastfed child.

If you’re breastfeeding, talk with your doctor about the best way to feed your child while taking Lenvima.

This drug comes with several precautions. Before taking Lenvima, talk with your doctor about your health history. Lenvima may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • High blood pressure. Lenvima can cause and worsen high blood pressure. If your blood pressure is high, it’ll need to be managed with medication before you start Lenvima. Your doctor will check your blood pressure regularly while you take Lenvima. If your blood pressure gets too high, your doctor may prescribe medication to lower it. They may also lower your dose of Lenvima or have you stop taking it for a while. If your blood pressure can’t be managed, you’ll need to stop taking Lenvima.
  • Heart problems. Lenvima can cause problems with how well your heart works. These problems include heart failure and prolonged QT interval (a type of abnormal heart rhythm). If you already have heart problems, talk with your doctor about whether Lenvima is right for you. This is especially important if you have a weak or slow heartbeat, heart failure, or an abnormal heart rhythm such as long QT syndrome. Your doctor may want to monitor your heartbeat with an electrocardiogram (EKG) while you take Lenvima. If you get heart problems, your doctor may lower your Lenvima dose or have you stop taking it for a while. If your heart problem continues, you’ll need to stop taking Lenvima.
  • Low levels of calcium,potassium, or magnesium in your blood. If you have low levels of calcium, potassium, or magnesium in your blood, it raises your risk for getting heart problems with Lenvima. In addition, taking Lenvima can lower your calcium levels. You’ll have blood tests to check your electrolytes before you start taking Lenvima. If your electrolyte levels are low, you’ll need treatment to correct this before you can take Lenvima. During treatment, your electrolytes will be checked regularly. If needed, you’ll be prescribed medication to correct any imbalances.
  • A history of blood clots in your arteries. Lenvima may cause blood clots that result in a heart attack, stroke, or vision problems. If you’ve had one of these problems in the past, talk with your doctor about whether Lenvima is right for you. If you get a blood clot in an artery, you’ll need to stop taking Lenvima.
  • Liver problems. Lenvima can cause serious liver problems, such as hepatitis (swelling of the liver) and liver failure. If you already have a liver problem, talk with your doctor about whether Lenvima is right for you. If you take Lenvima, you may be prescribed a lower than usual dose. During treatment, you’ll have frequent blood tests to check your liver function. If you get new or worsening liver problems, your doctor may lower your Lenvima dose or have you stop taking it for a while. If your liver problem continues, you’ll need to stop taking Lenvima.
  • Kidney problems. Lenvima can cause serious kidney problems, including kidney failure. If you already have kidney problems, talk with your doctor about whether Lenvima is right for you. If you take Lenvima, you may be prescribed a lower than usual dose. During treatment, you’ll have frequent blood and urine tests to check your kidneys. If you get new or worsening kidney problems, your doctor may lower your Lenvima dose or have you stop taking it for a while. If your kidney problem continues, you’ll need to stop taking Lenvima.
  • Underactive thyroid gland. Lenvima can lower your thyroid hormone levels. If you have an underactive thyroid gland, talk with your doctor about whether Lenvima is right for you. You’ll have blood tests to check your thyroid hormone levels while you take Lenvima. If needed, your doctor may adjust your dose of thyroid medication.
  • Recent or planned surgery. Lenvima can cause problems with wound healing, and it can raise your risk for serious bleeding. If you’ve recently had surgery, talk with your doctor about whether Lenvima is right for you. In most cases, Lenvima shouldn’t be started until at least 2 weeks after major surgery and until all wounds have healed. Typically, you should stop taking Lenvima 1 week before a planned surgery. Your doctor will tell you when to start taking Lenvima again after you’ve had surgery.
  • Pregnancy. It’s not known if Lenvima is safe to take during pregnancy. This drug may harm a developing fetus. For more information, see the “Lenvima and pregnancy” section above.
  • Breastfeeding. You should not breastfeed while taking Lenvima or for at least 1 week after your last dose. For more information, see the “Lenvima and breastfeeding” section above.

Note: For more information about the potential negative effects of Lenvima, see the “Lenvima side effects” section above.

Using more than the recommended dosage of Lenvima can lead to serious side effects.

Do not use more Lenvima than your doctor recommends.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Lenvima from the pharmacy, the pharmacist will add an expiration date to the label on the pack. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time.

The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Lenvima capsules should be stored at room temperature (77°F or 25°C) in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Lenvima and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Lenvima is FDA-approved to treat the following cancers in adults:

  • Differentiated thyroid cancer (DTC). Lenvima is approved for DTC, a form of thyroid cancer, that is locally recurrent or metastatic. It’s approved for progressive cancers that are refractory to treatment with radioactive iodine.
  • Advanced renal cell carcinoma (RCC). Lenvima is approved for use in people who’ve previously had treatment with one anti-angiogenic drug. Lenvima is approved for use with everolimus (Afinitor, Zortress) for RCC.
  • Hepatocellular carcinoma (HCC). Lenvima is approved as a first-line treatment for HCC that can’t be treated with surgery.
  • Advanced endometrial cancer. Lenvima is approved for endometrial cancer that has progressed after previous treatment and can’t be treated with surgery or radiation therapy. It’s not approved for endometrial cancer that’s microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR). Lenvima is approved for use with pembrolizumab (Keytruda) for endometrial cancer.

Mechanism of action

Lenvima contains lenvatinib, a multi-kinase inhibitor. It blocks the kinase actions of several cell-surface receptors, including:

  • vascular endothelial growth factor receptors (VEGFR 1, 2, and 3)
  • fibroblast growth factor receptors (FGFR1, 2, 3 and 4)
  • platelet derived growth factor receptor alpha (PDGFRα)
  • tyrosine-kinase receptor (KIT)
  • rearranged during transfection receptor (RET)

By blocking the action of VEGFR kinases, Lenvima reduces tumor angiogenesis, thereby restricting the ability of the tumor to grow and spread.

The other receptor kinases listed are involved in various other processes that promote growth and multiplication of cancer cells. By blocking their action, Lenvima stops the growth and spread of cancer cells.

Lenvima helps shrink the tumor and helps stop the cancer from progressing.

Pharmacokinetics and metabolism

Lenvima reaches peak plasma concentration 1 to 4 hours after oral administration. Food doesn’t affect the extent of Lenvima absorption, but it may slow the rate.

Lenvima is 98% to 99% bound to plasma proteins. Lenvima metabolism occurs via CYP3A, aldehyde oxidase, and non-enzymatic processes.

Lenvima has a terminal half-life of approximately 28 hours. The drug is mainly eliminated in the feces (64%), with some in the urine (25%).

Contraindications

There are no contraindications to Lenvima use. However, certain treatment-related toxicities may require Lenvima to be discontinued permanently.

Storage

Lenvima should be kept at room temperature (77°F or 25°C). However, the drug is stable at temperatures of 59°F to 86°F (15°C to 30°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.