L01EX01 - Sunitinib |
Propably not porphyrinogenic |
PNP |
Rationale
Sunitinib and its primary active metabolite are metabolized principally by CYP3A4, however, in vitro studies indicate that the drug does not inhibit or induce major CYP isoenzymes. No evidense of sunitinib reducing or increasing the metabolism of other drugs in clinical use. However, side effects such as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Sunitinib malate is an inhibitor of multiple receptor tyrosine kinases. Contains secondary amino groups.
Therapeutic characteristics
Sunitinib is an antineoplastic agent used in the treatment of gastrointestinal stroma cell tumor (GIST) and in the treatment of renal cancer with metastases (MRCC). Administered orally. Common adverse reactions of sunitinib that can be confused with an acute porphyric attack are nausea, vomiting, diarrhoea, abdominal pain, dyspnoea, paresthesia, arthalgia, myalgia, and pain in the extremities. Side effects such as nausea, anorexia and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmacokinetics
Sunitinib is metabolised primarily by the cytochrome P450 isoenzyme CYP3A4 to produce an active metabolite, which is further metabolised by CYP3A4. In vitro studies indicate that the drug does not inhibit or induce major CYP isoenzymes.
IPNet drug reports
Uneventful use reported in 1 patient with acute porphyria.
References
- Drug reference publications
- McEvoy GK, editor. Sunitinib. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (03.06.10). #2061
- Sweetman SC, editor. Martindale: The complete drug reference. Sunitinib. Pharmaceutical Press 2009. #2063
- Summary of Product Characteristics
- Norwegian medicines agency. Summary of Product Characteristics (SPC). Sutent. #2062
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