Nexavar is a brand-name prescription medication that’s used to treat certain types of liver, kidney, and thyroid cancer in adults. Nexavar is FDA-approved to treat:

  • Hepatocellular carcinoma (HCC). HCC is the most common type of liver cancer. Nexavar is used in people with HCC whose tumor can’t be surgically removed.
  • Advanced renal cell carcinoma (RCC). RCC is the most common type of kidney cancer.
  • Differentiated thyroid carcinoma (DTC). DTC is the most common type of thyroid cancer. It’s usually treated with radioactive iodine. Nexavar is used to treat DTC that’s come back or spread after being treated. It’s used when the cancer is getting worse, and radioactive iodine isn’t working anymore.

Nexavar comes as a tablet that’s taken by mouth.

Nexavar is a targeted therapy that belongs to a class of medications called kinase inhibitors. Nexavar works by slowing the growth of cancer cells and killing certain cells in your body that help cancer grow and spread.

Effectiveness

For more information on Nexavar’s effectiveness, see the “Nexavar uses” section below.

Nexavar 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.

Nexavar contains the active drug sorafenib.

Nexavar can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Nexavar. These lists don’t include all possible side effects.

For more information on the possible side effects of Nexavar, 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 it has approved. If you would like to report to the FDA a side effect you’ve had with Nexavar, you can do so through MedWatch.

Mild side effects

Mild side effects of Nexavar can include:*

  • infections, such as respiratory infections
  • hair loss
  • weight loss
  • nausea and vomiting
  • abdominal (belly) pain
  • high blood pressure
  • bleeding

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

  • fatigue (lack of energy)
  • hand-foot skin reaction (a condition that causes redness, itching, or peeling of the skin on your hands and feet)
  • skin rash
  • decreased appetite
  • diarrhea

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 Nexavar. To learn about other mild side effects, talk with your doctor or pharmacist, or view Nexavar’s medication guide.

Serious side effects

Serious side effects from Nexavar 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 attack and heart failure. Symptoms will vary depending on the condition you have, but they may include:
    • chest pain
    • trouble breathing
    • fast heartbeat
    • dizziness
    • swelling in your lower legs
  • Severe skin reactions, such as Stevens-Johnson syndrome. Symptoms can include:
    • redness
    • pain
    • swelling
    • blistering of your skin
    • peeling of your skin
  • Gastrointestinal perforation (a tear in the wall of your stomach or intestine). Symptoms can include:
    • fever
    • nausea and vomiting
    • serious abdominal pain
  • Liver problems. Symptoms can include:
    • jaundice (yellowing of your skin or the whites of your eyes)
    • abdominal pain
    • decreased appetite
  • QT prolongation (a type of abnormal heart rhythm). Symptoms can include:
    • dizziness
    • irregular heartbeat
    • fast heartbeat
  • Underactive thyroid gland (reduced production of thyroid hormones by your thyroid gland) in people with thyroid cancer. Symptoms can include:
    • feeling tired
    • feeling cold
    • constipation
    • muscle weakness

Other serious side effects, explained in more detail below in “Side effect details,” 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.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Nexavar. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

In clinical trials, allergic reactions weren’t common. However, between 0.1 % and less than 1% of people taking Nexavar did experience an allergic reaction.

Call your doctor right away if you have a severe allergic reaction to Nexavar. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Rash

Some people may get a rash while taking Nexavar. In clinical trials, most rashes occurred within the first 6 weeks of taking the medication.

Although most of the rashes weren’t severe, some people developed serious rashes such as Stevens-Johnson Syndrome (SJS) or toxic epidermal necrolysis (TEN). These are very serious rashes that can cause severe blistering of the skin and can even be fatal.

In clinical studies:

  • 19% to 40% of people taking Nexavar for any of the approved uses developed a rash. Up to 5% of people taking Nexavar developed a rash that was considered serious.
  • 7% to 16% of people taking a placebo (a treatment with no active drug) had a rash. Less than 1% of those taking a placebo had a serious rash.

Talk with your doctor if you develop a rash after taking Nexavar. Although most rashes aren’t serious, some can be very severe and may even lead to death. It’s important that your doctor looks at the rash and determines the best way to treat it before it becomes a serious problem.

Most rashes only require some cream or ointment to clear up. However, for a bad rash, your doctor may have you stop taking Nexavar and switch to a different medication.

Hemorrhage

There is a risk of hemorrhage (severe bleeding) with Nexavar use. In clinical trials, hemorrhage occurred in:

  • 15% to 18% of people taking Nexavar
  • 8% to 20% of people taking a placebo

In rare cases, a hemorrhage can even lead to death. However, it’s important to note that in clinical trials for Nexavar, people taking a placebo (treatment with no active drug) had a higher rate of death from hemorrhage than did people taking Nexavar. In those trials:

  • up to 2.4% of people taking Nexavar died from a hemorrhage
  • up to 4% in those taking a placebo died from a hemorrhage

Symptoms of a hemorrhage can include:

  • vomiting or coughing up blood
  • pink or brown urine
  • red or black, or tarry stools
  • heavy or unusual vaginal bleeding in women
  • bruising easily
  • nosebleeds

Talk with your doctor about your risk for severe bleeding while taking Nexavar. If you have symptoms of a hemorrhage, call your doctor right away.

Diarrhea

Diarrhea is a common side effect of Nexavar. In clinical trials:

  • 43% to 68% of people taking Nexavar had diarrhea. Of the people who took Nexavar, 2% to nearly 11% had diarrhea that was considered severe.
  • 13% to 25% of people taking a placebo had diarrhea. Of those who took a placebo, up to 2% had severe diarrhea.

If you develop diarrhea while taking Nexavar, talk with your doctor. They can recommend ways to help relieve this side effect and keep your body hydrated.

Hand-foot skin reaction

Hand-foot skin reaction is a possible side effect of Nexavar. This reaction usually occurs in the palms of your hands and the bottoms of your feet. It can cause swelling, redness, and pain. Sometimes hand-foot skin reaction causes blistering, which can become very painful.

Hand-foot skin reactions usually happen within the first 6 weeks of treatment.

In clinical trials:

  • 21% to 69% of people taking Nexavar developed hand-foot skin reactions. This reaction was much more common in people taking Nexavar for differentiated thyroid cancer (DTC) than for other conditions. Of the people taking Nexavar, 6% to 19% had serious reactions.
  • 3% to 8% of people taking a placebo developed a hand-foot skin reaction. Of those taking a placebo, less than 1% developed a reaction that was considered serious.

Some people developed serious reactions and had to stop taking Nexavar. See your doctor if you notice any swelling, blistering, or pain on your hands or feet. They can determine how severe it is and the best way to treat the reaction before it gets worse.

Decreased appetite

Some people may notice a decreased appetite while taking Nexavar. You may not be as hungry as usual, or you may not have a desire to eat.

In clinical studies:

  • 16% to 30% of people taking Nexavar had a decreased appetite. Up to 3% of people taking Nexavar had a severe loss of appetite.
  • 5% to 18% of people taking a placebo had a decreased appetite. Less than 4% of people taking a placebo had a severe loss of appetite.

Talk with your doctor if you have a decreased appetite or are losing weight. They can recommend ways to increase your appetite.

Fatigue

Nexavar may cause fatigue (lack of energy). In clinical studies:

  • 37% to 46% of people taking Nexavar had fatigue. Of the people who took Nexavar, 5% to 10% had fatigue that was considered serious.
  • 20% to 45% of people taking a placebo had fatigue. Of those who took a placebo, 1% to 14% had serious fatigue.

Talk with your doctor if you begin to feel more tired than usual or don’t have the energy to complete your everyday tasks. They may be able to recommend ways to relieve this side effect.

The Food and Drug Administration (FDA) approves prescription drugs such as Nexavar to treat certain conditions. Nexavar may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Nexavar for liver cancer

Nexavar is FDA-approved to treat hepatocellular carcinoma (HCC), the most common type of liver cancer. Nexavar is used in adults with HCC whose tumor can’t be surgically removed.

HCC occurs when the cells in your liver grow abnormally and too quickly. HCC can be caused by liver damage that’s happened over time. This damage may be due to alcohol use or a hepatitis infection.

HCC starts in the liver. This is different from cancer that starts elsewhere in the body and spreads to the liver. People with HCC may experience abdominal (belly) pain, jaundice (yellowing of the skin and whites of the eyes), or bleeding easier than usual.

Effectiveness for liver cancer

In a clinical study, Nexavar was found to be effective in treating HCC. 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 starting treatment.)

In the study:

  • at least half of the people taking Nexavar lived for 10.7 months or longer after starting treatment
  • at least half of the people taking a placebo (a treatment with no active drug) lived for 7.9 months or longer after starting treatment

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

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

  • for at least half of the people taking Nexavar, their cancer didn’t progress for at least 5.5 months
  • for at least half of the people taking a placebo, their cancer didn’t progress for at least 2.8 months

Nexavar for thyroid cancer

Nexavar is FDA-approved for use in adults with differentiated thyroid cancer (DTC). This is the most common type of thyroid cancer.

DTC occurs in the thyroid gland, which is located in your neck. The thyroid gland is responsible for making hormones in your body that control your metabolism and heart rate.

If the cells in your thyroid gland begin to grow abnormally, you may develop DTC. People with DTC may experience trouble swallowing, swelling or a lump in the neck, or a cough that won’t go away.

DTC is usually treated with radioactive iodine. Nexavar is used to treat DTC that’s come back or spread after being treated. It’s used when the cancer is getting worse, and radioactive iodine isn’t working anymore.

Effectiveness for thyroid cancer

A clinical study has shown Nexavar to be an effective treatment for people with DTC. The study looked at overall survival rates of people taking either Nexavar or a placebo. (The overall survival rate refers to the length of time people lived after starting treatment.)

  • Of the people who took Nexavar, at least half of them lived for 42.8 months or longer after starting treatment.
  • Of those who took a placebo, at least half of them lived for 39.4 months or longer after starting treatment.

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

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

In the study:

  • for at least half of the people taking Nexavar, their cancer didn’t progress for at least 10.8 months after starting treatment
  • for at least half of the people taking a placebo, their cancer didn’t progress for at least 5.8 months after starting treatment

Nexavar for kidney cancer

Nexavar is FDA-approved for use in adults with advanced renal cell carcinoma (RCC), which is the most common type of kidney cancer.

RCC occurs when the cells in the tubes of your kidneys grow abnormally or out of control. RCC is considered advanced when the cancer has spread to other areas of the body, such as the lymph nodes around the kidney.

People with RCC may experience symptoms such as back pain, weight loss, and blood in their urine.

Effectiveness for kidney cancer

In clinical studies, Nexavar was found to be effective at treating RCC. One study measured how long each treatment kept people’s cancer from progressing (getting worse). In the study:

  • for at least half of the people taking Nexavar, their cancer didn’t progress for at least 167 days after starting treatment
  • for at least half of the people taking a placebo, their cancer didn’t progress for at least 84 days after starting treatment

Another clinical study involved 65 people with RCC that had spread to other areas of their body. After 24 weeks of treatment:

  • 50% of people taking Nexavar didn’t have their cancer progress (get worse)
  • 18% of people taking a placebo didn’t have their cancer progress

In this study:

  • at least half of the people taking Nexavar didn’t have their cancer progress for at least 163 days after starting treatment
  • at least half of the people taking a placebo didn’t have their cancer progress until at least 41 days after starting treatment

Off-label use for Nexavar

In addition to the uses listed above, Nexavar may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. Below is an example of off-label use for Nexavar.

Nexavar for AML

Nexavar is being studied for use in people with acute myeloid leukemia (AML). However, it’s not currently approved for this use.

AML is a type of cancer that occurs in your white blood cells. A clinical trial is testing the use of Nexavar to treat certain types of AML in adults.

A study was also done to see if adding Nexavar to current chemotherapy treatments would help people live longer. In the study, people taking both Nexavar and chemotherapy lived longer than those taking chemotherapy only.

Talk with your doctor if you’re interested in taking Nexavar off-label to treat AML.

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

  • side effects that you experience while taking Nexavar
  • other medical conditions you may have

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

Nexavar comes as a tablet that’s taken by mouth. It’s available in one strength: 200 mg.

Dosage for liver cancer

To treat hepatocellular carcinoma (HCC), a type of liver cancer, the Nexavar dosage is usually 400 mg twice a day. You’ll take two tablets that are 200 mg each.

You shouldn’t take Nexavar with food. Take your dose at least 1 hour before or 2 hours after eating.

If you develop side effects while taking Nexavar, your doctor may decrease your dose or have you stop taking the drug.

Dosage for thyroid cancer

To treat differentiated thyroid carcinoma (DTC), a type of thyroid cancer, the usual Nexavar dosage is 400 mg twice a day. You’ll take two tablets that are 200 mg each.

You shouldn’t take Nexavar with food. Take your dose at least 1 hour before or 2 hours after eating.

If you develop side effects while taking Nexavar, your doctor may decrease your dose or have you stop taking the drug.

Dosage for kidney cancer

For advanced renal cell carcinoma (RCC), a type of kidney cancer, the typical Nexavar dosage is 400 mg twice a day. You should take two tablets that are 200 mg each, twice per day.

You shouldn’t take Nexavar with food. Take your medication at least 1 hour before or 2 hours after eating.

If you develop side effects during treatment, your doctor may decrease your dose or have you stop taking Nexavar.

What if I miss a dose?

If you forget to take a dose, just skip the dose you missed. Then take your next dose at the regular time. Never take two doses of Nexavar 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?

Nexavar is meant to be used as a long-term treatment. Usually, you’ll take Nexavar until your cancer gets worse or until you have bad side effects from the medication. If you and your doctor determine that Nexavar is safe and effective for you, you’ll likely take it long term.

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 Nexavar, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below 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 liver cancer

Examples of other drugs that may be used to treat hepatocellular carcinoma (HCC) include:

Alternatives for thyroid cancer

Examples of other drugs that may be used to treat differentiated thyroid carcinoma (DTC) include:

  • lenvatinib (Lenvima)
  • vincristine
  • carboplatin
  • docetaxel (Taxotere)
  • radioactive iodine
  • doxorubicin
  • nivolumab (Opdivo)

Alternatives for kidney cancer

Examples of other drugs that may be used to treat advanced renal cell carcinoma (RCC) include:

  • sunitinib (Sutent)
  • pazopanib (Votrient)
  • cabozantinib (Cabometyx)
  • lenvatinib (Lenvima)
  • bevacizumab (Avastin)
  • pembrolizumab (Keytruda)
  • avelumab (Bavencio)
  • ipilimumab (Yervoy)
  • cisplatin

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

Ingredients

The active drug ingredient in Nexavar is sorafenib. The active drug in Lenvima is lenvatinib. Both sorafenib and lenvatinib are targeted therapies that belong to a class of medications known as kinase inhibitors. Targeted therapies work by interfering with certain proteins that help cancer cells to grow and spread.

Uses

Both Nexavar and Lenvima are FDA-approved to treat:

  • Hepatocellular carcinoma (HCC). HCC is the most common type of liver cancer. Both drugs are used in people with HCC whose tumor can’t be surgically removed. For this purpose, Lenvima is approved for use as the first treatment you receive for this condition. However, Nexavar can be used even if you have tried other treatments for your HCC.
  • Advanced renal cell carcinoma (RCC). RCC is the most common type of kidney cancer. For this condition, Lenvima is only approved for people who’ve already tried a certain type of medication called an anti-angiogenesis drug, such as Nexavar, for their cancer. It’s used with a drug called everolimus (Afinitor). On the other hand, Nexavar doesn’t need to be used with another medication. With Nexavar, it doesn’t matter which treatments you may have received for RCC in the past.
  • Differentiated thyroid carcinoma (DTC). DTC is the most common type of thyroid cancer. It’s usually treated with radioactive iodine. Both Nexavar and Lenvima are used to treat DTC that’s come back or spread after being treated, and when radioactive iodine isn’t working anymore.

Lenvima is also FDA-approved to treat certain types of endometrial cancer* in adults. For this purpose, it’s 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.

Drug forms and administration

Nexavar is a tablet that’s taken twice a day by mouth. Lenvima is a capsule that’s taken by mouth once a day.

Nexavar tablets need to be taken without food, at least 1 hour before or 2 hours after meals. Lenvima capsules can be taken with or without food.

Side effects and risks

Nexavar and Lenvima both contain medications to treat thyroid, kidney, and liver cancer. Therefore, these medications can cause very similar side effects. 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 Nexavar, with Lenvima, or with both Nexavar and Lenvima (when taken individually).

  • Can occur with Nexavar:
    • infections, such as respiratory infections
  • Can occur with Lenvima:
    • joint and muscle pain
  • Can occur with both Nexavar and Lenvima:
    • diarrhea
    • hand-foot skin reaction, a condition that causes redness, itching, or peeling of the skin on your hands and feet (for Lenvima, may occur when taking it to treat liver or thyroid cancer)

Serious side effects

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

Effectiveness

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

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

The use of Nexavar and Lenvima in treating HCC is being directly compared in a clinical study that ends in July 2020.

The study is looking at overall survival rates of people taking each drug. (The overall survival rate refers to the length of time people lived after starting treatment.)

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

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

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

Costs

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

To find current prices for Nexavar and Lenvima, check out WellRx.com. Your cost for either drug may depend on the condition you’re using it to treat and your dosage. Your cost may also depend on your insurance plan, your location, and the pharmacy you use.

Nexavar and Opdivo are prescribed for similar uses. Here’s a look at how these drugs are alike and different.

Ingredients

The active drug ingredient in Nexavar is sorafenib. The active drug in Opdivo is nivolumab.

Uses

Nexavar and Opdivo are both approved to treat:

  • Hepatocellular carcinoma (HCC). HCC is the most common type of liver cancer. Nexavar is used in people with HCC whose tumor can’t be surgically removed. Opdivo is used for HCC that’s previously been treated with Nexavar. For this purpose, Opdivo can be used alone or with ipilimumab (Yervoy).
  • Advanced renal cell carcinoma (RCC). RCC is the most common type of kidney cancer. Opdivo is used alone in people who’ve already tried a certain type of medication called an anti-angiogenesis drug, such as Nexavar. Opdivo can also be used along with ipilimumab in people with kidney cancer that has spread and that hasn’t been treated before. On the other hand, Nexavar doesn’t need to be used with other medications.

In addition, Nexavar is approved to treat:

  • Differentiated thyroid carcinoma (DTC) that’s come back or spread after being treated. It’s used when the cancer is getting worse, and radioactive iodine isn’t working anymore.

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

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

Drug forms and administration

Nexavar comes as a tablet that’s taken by mouth twice 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.) Each IV infusion takes about 30 minutes and is given at your doctor’s office or the hospital every 2 to 4 weeks.

Side effects and risks

Nexavar 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 Nexavar, with Opdivo, or with both Nexavar and Opdivo (when taken individually).

  • Can occur with Nexavar:
    • weight loss
    • bleeding
    • hand-foot skin reaction (a condition that causes redness, itching, or peeling of the skin on your hands and feet)
  • Can occur with Opdivo:
    • muscle, joint, or back pain
    • cough
    • trouble breathing
    • fever
  • Can occur with both Nexavar and Opdivo:
    • fatigue (lack of energy)
    • skin rash
    • diarrhea
    • nausea and vomiting
    • decreased appetite
    • infections, such as respiratory infections
    • abdominal (belly) pain

Serious side effects

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

  • Can occur with Nexavar:
    • thyroid problems in people with thyroid cancer
    • QT prolongation (a type of abnormal heart rhythm)
  • Can occur with Opdivo:
    • lung problems, including pneumonitis (inflammation in your lungs)
    • colitis (swelling in your large intestine)
    • changes in your hormones in your blood, such as your thyroid hormone or cortisol
    • kidney problems
    • immune-mediated encephalitis (swelling of the brain caused by your immune system)
    • infusion reaction, such as swelling or redness
    • type 1 diabetes
  • Can occur with both Nexavar and Opdivo:
    • liver problems, including hepatitis (inflammation of your liver)
    • severe rash or skin reactions, such as Stevens-Johnson Syndrome (SJS)

Effectiveness

Nexavar and Opdivo have different FDA-approved uses, but they’re both used to treat:

  • hepatocellular carcinoma (HCC), a type of liver cancer
  • advanced renal cell carcinoma (RCC), a type of kidney cancer

The use of Nexavar and Opdivo in treating HCC is currently being directly compared in a clinical study. This study is ongoing and doesn’t yet have results. However, other studies have found both Nexavar and Opdivo to be effective for treating HCC.

These drugs haven’t been directly compared in clinical studies to treat advanced RCC. However, studies have found both Nexavar and Opdivo to be effective for treating RCC.

Costs

Nexavar 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, Nexavar costs significantly more than Opdivo. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

There are no known interactions between Nexavar and alcohol. However, if you’re taking Nexavar for liver cancer, drinking alcohol can make your cancer worse.

If you drink alcohol, talk with your doctor about how much is safe to drink during your Nexavar treatment.

Nexavar can interact with several other medications. It can also interact with certain supplements.

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.

Nexavar and other medications

Below is a list of medications that can interact with Nexavar. This list doesn’t contain all drugs that may interact with Nexavar.

Before taking Nexavar, 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.

Nexavar and certain seizure medications

Nexavar shouldn’t be taken with certain seizure medications. These drugs may decrease the amount of Nexavar in your body. This means Nexavar won’t work as well to treat your cancer.

Examples of seizure medications that may affect Nexavar include:

  • carbamazepine (Tegretol)
  • phenytoin (Dilantin)
  • phenobarbital

If you’re taking any seizure medications, talk with your doctor before starting Nexavar. They may have you take a different medication instead.

Nexavar and certain medications used to treat tuberculosis

You should avoid taking Nexavar with certain medications that treat or prevent tuberculosis (TB). Some of these medications may decrease the amount of Nexavar in your body. This could make Nexavar less effective.

Examples of TB medications to avoid taking along with Nexavar include:

  • rifampin (Rimactane, Rifadin)
  • rifabutin (Mycobutin)

Talk with your doctor about any TB drugs you’re taking before starting Nexavar.

Nexavar and dexamethasone

You should avoid taking Nexavar with dexamethasone (Hemady). Dexamethasone may decrease the amount of Nexavar in your body. This could make Nexavar less effective.

Dexamethasone is a steroid medication with many different uses, such as treating allergic reactions, skin rashes, and certain lung conditions.

If you’re taking dexamethasone, talk with your doctor before starting Nexavar.

Nexavar and neomycin

You shouldn’t take Nexavar with the antibiotic neomycin. This is because neomycin can decrease the amount of Nexavar in your body. This may make Nexavar less effective.

Talk with your doctor about other antibiotics you can take instead of neomycin during your Nexavar treatment.

Nexavar and herbs and supplements

You shouldn’t take Nexavar with the herbal supplement St. John’s wort. This is because St. John’s wort can decrease the amount of Nexavar in your body. This could make Nexavar less effective.

If you’re taking Saint John’s wort, talk with your doctor about other medications you can take instead during your Nexavar treatment.

Nexavar and foods

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

As with all medications, the cost of Nexavar can vary. To find current prices for Nexavar 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 depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Nexavar 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 approving coverage for Nexavar. 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 prior authorization request and decide if the drug will be covered.

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

Financial and insurance assistance

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

Bayer, the manufacturer of Nexavar, offers a program called REACH. This program gives access to financial counselors who can help you find cost savings options for Nexavar. These options include a copay card and an assistance program for people who can’t afford Nexavar.

For more information and to find out if you’re eligible for support, call 866-639-2827 or visit the program website.

Generic version

Nexavar isn’t 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 Nexavar according to your doctor’s or healthcare provider’s instructions.

When to take

Nexavar should be taken twice a day, usually once in the morning and once in the evening.

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 Nexavar with food

You shouldn’t take Nexavar with food. Take Nexavar at least 1 hour before or 2 hours after eating.

Can Nexavar be crushed, split, or chewed?

Bayer, the manufacturer of Nexavar, doesn’t recommend that you crush, split, or chew Nexavar tablets.

If you have trouble swallowing the Nexavar tablet, talk with your doctor or pharmacist about ways to make it easier or other medications you can take.

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

  • hepatocellular carcinoma (HCC), the most common type of liver cancer
  • advanced renal cell carcinoma (RCC), the most common type of kidney cancer
  • differentiated thyroid cancer (DTC), the most common type of thyroid cancer

These cancers all begin as cells that grow abnormally, or out of control. After a while, these cells can form tumors.

What Nexavar does

Nexavar works to stop the tumor from growing and helps your body kill the cancer cells.

Nexavar is a type of medication called a kinase inhibitor. Kinases are types of enzymes in your body that cause your cells to grow and multiply. Kinases also cause blood vessels to develop around the tumor. This gives it a blood supply, allowing it to grow.

By blocking kinases enzymes, Nexavar stops the cancer from growing and getting worse. It also decreases the blood supply to the tumor, which eventually can kill the cancer cells.

How long does it take to work?

Nexavar starts working after your first dose of medication. It can start working on your cancer right away. Never stop taking Nexavar without first talking to your doctor.

You shouldn’t take Nexavar if you’re pregnant or planning to become pregnant. There is no data on the use of Nexavar in pregnant women, so it’s not known if it’s safe to take during pregnancy.

In animal studies, Nexavar increased the risk of miscarriage and problems with bone formation in the fetus. These serious effects occurred in animals at doses lower than the recommended dose for humans.

Although animal studies don’t always represent what will happen in humans, Nexavar use is not recommended during pregnancy.

If you’re a woman who could become pregnant, your doctor will give you a pregnancy test before taking Nexavar to make sure you’re not pregnant. You’ll need to use birth control during your Nexavar treatment and for at least 6 months after your last dose.

Talk to your doctor before taking Nexavar if you’re pregnant or planning a pregnancy. They will likely recommend a different medication to treat your cancer.

It’s not safe to take Nexavar while pregnant. Women who can become pregnant should use an effective form of birth control while using Nexavar and for at least 6 months after their last dose.

Men taking Nexavar with female partners who could become pregnant should use contraception, such as a condom, during treatment. They should also continue using contraception for at least 3 months after their last Nexavar dose.

In some cases, Nexavar may decrease the fertility of men. This could make it harder to achieve a pregnancy with their partner.

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

For more information about taking Nexavar during pregnancy, see the “Nexavar and pregnancy” section above.

Due to the high risk of side effects, you shouldn’t breastfeed while taking Nexavar or for at least 2 weeks after your last dose.

There is currently no data on the use of Nexavar in breastfeeding women or the effect the drug may have on a breastfed child. However, in animal studies, Nexavar was present in milk. This means the offspring would be exposed to the drug.

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

Here are answers to some frequently asked questions about Nexavar.

Will Nexavar cure my cancer?

No, Nexavar won’t cure your cancer. There is currently no cure for cancer. However, Nexavar can slow the growth of the tumor and stop your cancer from getting worse. This can help you to live longer.

Talk with your doctor if you have questions about life expectancy with Nexavar.

Is it safe to have surgery while I’m taking Nexavar?

It depends. Nexavar can raise your risk for bleeding and may also make your wounds heal more slowly than usual.

You shouldn’t use Nexavar for 10 days before having a planned surgery. You also shouldn’t take it for at least 2 weeks after a major surgery.

Talk with your doctor before having any planned surgery during your Nexavar treatment. They will decide the best way to treat your cancer during and after surgery. Based on how well you heal after surgery, your doctor will let you know if and when you can restart Nexavar.

Can I take Nexavar if I have heart problems?

Yes, in most cases, you can take Nexavar if you have heart problems. However, your doctor may monitor your heart more often to be sure the drug isn’t causing your heart problems to get worse. Nexavar can raise your risk for heart attack or decreased blood flow to your heart.

Nexavar may also raise your risk for heart failure and prolonged QT interval (a type of abnormal heart rhythm).

If you already have heart problems, talk with your doctor about whether Nexavar is right for you.

Is Nexavar a chemotherapy drug?

No, Nexavar isn’t a chemotherapy drug. 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.

Nexavar is a type of medication called a kinase inhibitor. Nexavar works specifically on certain types of enzymes in your body called kinases, which are responsible for making your cells grow and reproduce.

By blocking these enzymes, Nexavar slows the growth of cancer and kills the cancer cells. It doesn’t have as many side effects as chemotherapy drugs because it works on specific enzymes in your body.

Does Nexavar treat liver cancer that’s caused by hepatitis C?

Yes, Nexavar can treat liver cancer caused by hepatitis C. In fact, a study was done to look at how people with hepatitis responded to treatment with Nexavar.

In the study, at least half of the people with hepatitis C and hepatocellular carcinoma (HCC) who took Nexavar lived for 14 months or longer after starting treatment. In comparison, at least half of the people with hepatitis C and HCC who took a placebo lived for 7.9 months or longer after starting treatment. (A placebo is a treatment with no active drug.)

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

If you’re living with hepatitis C and also have HCC, talk with your doctor about Nexavar.

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

  • Heart problems. Nexavar can cause problems with how well your heart works. These problems include heart failure, heart attack, and prolonged QT interval (a type of abnormal heart rhythm). If you already have heart problems, talk with your doctor about whether Nexavar is right for you. If you do take Nexavar, your doctor may want to monitor your heart closely during treatment. In some cases, your doctor may recommend a different medication to treat your cancer.
  • Hemorrhage. Nexavar can raise your risk for hemorrhage (severe bleeding), which in rare cases can lead to death. Your risk of bleeding may be higher if you have a bleeding condition, such as hemophilia, or if you’ve had a recent hemorrhage. (For more information on bleeding risk, see the “Nexavar side effects” section above.) If you’re at risk of bleeding, talk with your doctor about whether Nexavar is right for you.
  • High blood pressure. Nexavar can cause and worsen high blood pressure. This can raise your risk for serious events, such as heart attack or stroke. If you have high blood pressure, talk with your doctor before taking Nexavar. Your doctor may monitor your blood pressure more often. If it gets too high or can’t be controlled by medication, they may have you stop taking Nexavar.
  • Surgery. Nexavar can raise your risk for bleeding and can make it harder for your wounds to heal. You shouldn’t use Nexavar for 10 days before having a planned surgery. You also shouldn’t take it for at least 2 weeks after a major surgery. Talk with your doctor if you have questions about having surgery while taking Nexavar.
  • Abnormal levels of calcium, potassium, or magnesium in your blood. If you have abnormal levels of calcium, potassium, or magnesiumin your blood, it can raise your risk for heart problems with Nexavar. These problems include prolonged QT interval (a type of abnormal heart rhythm). Therefore, you’ll need treatment to correct these levels before you take Nexavar. Your doctor will check your blood before and during your treatment to make sure your levels are normal.
  • Pregnancy. It’s not safe to take Nexavar during pregnancy. For more information, see the “Nexavar and pregnancy” section above.
  • Breastfeeding. You shouldn’t breastfeed while taking Nexavar and for at least 2 weeks after your last dose. For more information, see the “Nexavar and breastfeeding” section above.

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

Using more than the recommended dosage of Nexavar can lead to serious side effects. Do not use more Nexavar than your doctor recommends.

Overdose symptoms

It’s not known what symptoms may occur due to an overdose of Nexavar. However, in clinical trials, the most common side effects seen at dosages of 800 mg twice a day (double the recommended dose) were:

  • diarrhea
  • skin reactions, such as a rash

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 Nexavar from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. 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.

Nexavar tablets should be stored at room temperature, from 68°F to 77°F (20°C to 25°C). Store them in a tightly sealed container away from light. The drug can also be temporarily stored between 59°F and 86°F (15°C and 30°C) for brief periods of time.

Avoid storing this medication in areas where it could get damp or wet, such as bathrooms. Nexavar should be kept in a dry place.

Disposal

If you no longer need to take Nexavar 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

Nexavar is indicated for use in the treatment of:

  • Hepatocellular carcinoma (HCC) that’s unable to be surgically removed.
  • Renal cell carcinoma (RCC) that’s in an advanced stage.
  • Differentiated thyroid carcinoma (DTC) that’s recurrent to the thyroid or metastatic and progressing. Before trying Nexavar, people should have tried and failed radioactive iodine treatment in the past.

Mechanism of action

Nexavar works as a kinase inhibitor. Specifically, it inhibits both intracellular kinases and kinases on the cell surface. It works by blocking tumor progression as well as angiogenesis. It may also play a role in the killing of tumor cells.

Nexavar stabilizes the disease and is not curative in nature.

Pharmacokinetics and metabolism

Peak blood levels of Nexavar are reached 3 hours after dosing. The drug reaches steady state within 7 days of the first dose. The half-life of Nexavar is between 25 and 48 hours.

High-fat meals decrease the overall bioavailability of the drug by 29%, which causes less exposure. This is why it’s recommended to take Nexavar in the fasted state.

Nexavar is mainly metabolized in the liver, by CYP3A4, where it’s oxidated. It’s also glucuronidated via UGT1A9. The majority of the drug is eliminated as fecal matter, and the remainder is urinated out.

CYP3A4 inducers may decrease sorafenib exposure.

Contraindications

Nexavar is contraindicated in the case of hypersensitivity reactions to Nexavar or to any of its components. It’s also contraindicated for use along with carboplatin and paclitaxel to treat squamous cell lung cancer.

Storage

Nexavar tablets should be stored at room temperature, from 68°F to 77°F (20°C to 25°C) in a tightly sealed container away from light. However, temperature excursions are allowed to between 59°F and 86°F (15°C and 30°C). Nexavar should be kept in a dry place.

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.