Medical Information

The usage and dosage of Sunitinib should be adjusted according to the indications, and special attention should be paid to dosage adjustment and risk avoidance when using it for special populations. The following provides a detailed explanation from three aspects: standard usage, dosage adjustment, and management of special populations.

1. Standard usage and dosage

(1) Conventional dosage

The recommended dosage is 50mg orally once daily, taken continuously for 4 weeks and stopped for 2 weeks (4/2 regimen). It can be taken with food or on an empty stomach.

(2) Formulation specifications

There are currently 12.5mg, 25mg and 50mg capsules available for adjusting dosage according to individual needs.

2. Principle of dose adjustment

(1) Toxic reaction adjustment

When grade 3-4 adverse reactions occur, medication should be suspended until it returns to ≤ grade 1. Subsequent treatment should be reduced in a gradient of 12.5mg, with a minimum reduction of 25mg/day.

(2) Liver dysfunction

Children Pugh A/B patients are recommended to reduce the initial dose to 37.5mg, while children Pugh C patients are contraindicated.

(3) Drug interactions

Strong CYP3A4 inhibitors (such as ketoconazole) need to be reduced to a minimum of 37.5mg, while strong inducers (such as rifampicin) need to be increased to a maximum of 87.5mg.

3. Medication for special populations

(1) Pregnancy period

Pregnant women are prohibited based on animal teratogenic data. Women of childbearing age should take effective contraceptive measures during and at least 4 weeks after discontinuing medication.

(2) Lactation period

Medications may be secreted through breast milk. Breastfeeding women should stop taking medication or breastfeeding, and breastfeeding should be prohibited for at least 4 weeks after the last dose.

(3) Children

The safety and efficacy of patients under 18 years old have not been established, and its use is not recommended.

(4) Elderly people

Patients over 65 years old do not need routine dose adjustments, but need to strengthen cardiovascular and liver function monitoring.

(5) Renal insufficiency

Mild to moderate damage does not require adjustment, and patients with end-stage renal disease should use it with caution and monitor for toxic reactions.