Stivarga - Regorafenib Tablets
What is this medication?
REGORAFENIB (RE goe RAF e nib) treats some types of cancer. It works by blocking a protein that causes cancer cells to grow and multiply. This helps to slow or stop the spread of cancer cells.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
COMMON BRAND NAME(S): Stivarga
What should I tell my care team before I take this medication?
They need to know if you have any of these conditions:
- Bleeding disorder
- Having or recent surgery
- Heart disease
- High blood pressure
- Liver disease
- An unusual or allergic reaction to regorafenib, other medications, foods, dyes, or preservatives
- If you or your partner are pregnant or trying to get pregnant
- Breastfeeding
How should I use this medication?
Take this medication by mouth with water. Take it as directed on the prescription label at the same time every day. Take it with food. Keep taking it unless your care team tells you to stop.
Do not take this medication with grapefruit juice.
Talk to your care team about the use of this medication in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What may interact with this medication?
- Certain medications for fungal infections, such as itraconazole, ketoconazole, posaconazole, voriconazole
- Certain medications for seizures, such as carbamazepine, phenobarbital, phenytoin
- Irinotecan
- Rifampin
- St. John's wort
- Telithromycin
- Warfarin
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medication?
Your condition will be monitored carefully while you are receiving this medication. You may need blood work while taking this medication.
This medication may make you feel generally unwell. This is not uncommon as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your care team tells you to stop.
Before having surgery, talk to your care team to make sure it is ok. This medication can increase the risk of poor healing of your surgical site or wound. You will need to stop this medication for 2 weeks before surgery. After surgery, wait at least 2 weeks before restarting this medication. Make sure the surgical site or wound is healed enough before restarting this medication. Talk to your care team if questions.
Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancer if you take this medication.
Talk to your care team if you may be pregnant. Serious birth defects can occur if you take this medication during pregnancy and for 2 months after the last dose. Contraception is recommended while taking this medication and for 2 months after the last dose. Your care team can help you find the option that works for you.
If your partner can get pregnant, use a condom during sex while taking this medication and for 2 months after the last dose.
Do not breastfeed while taking this medication and for 2 weeks after the last dose.
What side effects may I notice from receiving this medication?
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Increase in blood pressure
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Stomach pain that is severe, does not go away, or gets worse
- Sudden and severe headache, confusion, change in vision, seizures, which may be signs of Posterior reversible encephalopathy syndrome (PRES)
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Change in voice, hoarseness
- Diarrhea
- Loss of appetite with weight loss
- Nausea
- Pain, redness, or swelling with sores inside the mouth or throat
- Stomach pain
- Unusual weakness or fatigue
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medication?
Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the original container. Get rid of any unused medication 7 weeks after opening or after it expires, whichever is first.
To get rid of medications that are no longer needed or have expired:
- Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
- If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.
Additional Information From Chemocare.com About Stivarga
Self-Care Tips:
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
- You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your healthcare provider.
- Wash your hands often.
- Ask your doctor or nurse before scheduling dental appointments or procedures.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- If you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
- In general, drinking alcoholic beverages should be avoided completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- Keep your mouth clean with baking soda and salt rinses. You can mix 1/2 to 1 tsp. of baking soda and/or 1/2 to 1 tsp. salt in 8 ounces of water, and use as a mouthwash, to avoid or decrease the severity of mouth sores.
- Stivarga® can cause tiredness, weakness or blurred vision. If you have any of these symptoms, use caution when driving a car, using machinery, or anything that requires you to be alert.
- If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
- Fever of 100.4° F (38° or higher, chills)
- Signs of a very bad reaction (wheezing, chest tightness, fever, itching, bad cough, blue or grey skin color, seizures, or swelling or the face, lips, tongue or throat).
- Sudden change in eyesight, fast heartbeat, very bad headache, very bad dizziness or passing out.
Always inform your health care provider if you experience any unusual symptoms.
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
- Diarrhea (4-6 episodes in a 24-hour period).
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
- Skin or the whites of your eyes turn yellow
- Urine turns dark or brown (tea color)
- Decreased appetite
- Pain on the right side of your stomach
- Bleed or bruise more easily than normal
- Skin changes (rash, acne, itching, blisters, peeling, redness or swelling)
- Increase in blood pressure
- Feeling very tired or weak (unable to carry on self-care activities)
- Big weight gain or loss
- Black or tarry stools, or blood in your stools
- Blood in the urine
- Signs of infection (very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, wound that will not heal or anal itching or pain).
Always inform your health care provider if you experience any unusual symptoms.
