Lenvatinib can cause adverse reactions ranging from manageable effects to potentially serious complications. The likelihood and severity can vary according to the treatment indication, dose, combination therapy and individual patient factors.
Commonly reported adverse reactions
Reported reactions can include:
- Hypertension
- Fatigue
- Diarrhea
- Decreased appetite
- Weight loss
- Nausea
- Stomatitis
- Proteinuria
- Hand-foot syndrome
- Vomiting
- Hypothyroidism or thyroid-function abnormalities
- Musculoskeletal symptoms
- Headache
The exact frequency differs between clinical trials and indications, so a single frequency table should not be generalized to every patient population.
Serious adverse reactions
The prescribing information identifies important risks involving:
| Risk | Clinical concern |
|---|---|
| Hypertension | Blood pressure can become significantly elevated |
| Cardiac dysfunction | Reduced cardiac function can occur |
| Arterial thromboembolism | Arterial blood clots can cause serious events |
| Hepatotoxicity | Liver injury or impaired liver function |
| Renal impairment | Kidney dysfunction or renal failure |
| Proteinuria | Increased urinary protein |
| Diarrhea | Can become clinically significant |
| GI perforation/fistula | Rare but serious gastrointestinal complications |
| QT prolongation | Can increase risk of abnormal cardiac rhythms |
| Hypocalcemia | Low blood calcium |
| PRES/RPLS | Neurologic syndrome associated with brain edema |
| Hemorrhage | Serious bleeding |
| Wound-healing impairment | Delayed healing |
| Osteonecrosis of the jaw | Jaw-bone injury |
| Embryo-fetal toxicity | Potential fetal harm |
When urgent medical attention may be required
Prompt medical assessment may be appropriate for symptoms suggesting severe hypertension, chest pain, severe shortness of breath, neurologic changes, significant bleeding, severe abdominal symptoms, seizures, confusion, visual disturbance or other potentially serious reactions.
Monitoring
Monitoring may include blood pressure, renal and hepatic function, urine protein, thyroid function, electrolytes and clinical assessment for cardiovascular or neurologic complications.