Stivarga

Risk of severe liver injury (may be fatal). Obtain LFTs before initiation, at least every 2 weeks during first 2 months of treatment, and monthly or more frequently thereafter as indicated. Interrupt, reduce or discontinue if persistent hepatotoxicity or hepatocellular necrosis occurs. Severe hepatic impairment: not recommended. Increased risk of infections; withhold if Grade 3/4 occurs or infection of any grade worsens; resume when resolved. Permanently discontinue if severe or life-threatening hemorrhage occurs. Interrupt and reduce or permanently discontinue if dermatological toxicity occurs (eg, hand-foot skin reaction [a.k.a. palmar-plantar erythrodysesthesia], rash). Ensure BP is controlled before starting; monitor weekly for the first 6 weeks then every cycle or as clinically indicated; withhold if severe or uncontrolled. Increased risk of myocardial ischemia/infarction: withhold if new or acute onset develops; resume when resolved. Discontinue if reversible posterior leukoencephalopathy syndrome (RPLS) or GI perforation/fistula develops. Impaired wound healing: withhold for ≥2 weeks prior to elective surgery; do not give for ≥2 weeks after major surgery and until adequate healing. Asian patients (monitor). Dialysis. Embryo-fetal toxicity. Advise females and males of reproductive potential to use effective contraception during treatment and up to 2 months after completion. Pregnancy. Nursing mothers: not recommended (during and for 2 weeks after final dose).