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Regorafenib (Stivarga)

Find out what regorafenib is, how you have it and other important information about taking regorafenib.

You might have regorafenib to treat:

  • bowel cancer that has spread to other parts of the body
  • gastro intestinal stromal cancer (GIST) – a rare type of soft tissue sarcoma of the stomach or intestines

You will only have this treatment when other treatments are no longer working or are unsuitable.

How it works

Regorafenib is a targeted cancer drug (biological therapy). It works by blocking particular proteins on cancer cells that encourage the cancer to grow. These proteins are called protein kinases. So regorafenib is called a protein kinase inhibitor (TKI) or cancer growth blocker. 

It also stops the cancer cells from growing blood vessels that they need. Blocking blood vessel growth is called anti angiogenesis treatment. 

Regorafenib may shrink the cancer or stop it growing for a time.  

How you have it

Regorafenib are tablets you take once a day. 

The usual dose is 4 tablets. But your doctor may change the dose. 

You take regorafenib at the same time, each day. You swallow the tablets with a drink of water and after a low fat meal. An example of a low fat meal includes:

  • 1 portion of cereal (about 30g)
  • 1 glass of skimmed milk
  • 1 slice of toast with jam
  • 1 glass of apple juice
  • 1 cup of coffee or tea

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have it

You usually take regorafenib every day, for 3 weeks. Then you have a week with no treatment. This 4 week period is called a cycle of treatment. 

Then you start the cycle again. 

You usually take regorafenib for as long as it is helping you. Your doctor will tell you:

  • what dose of regorafenib you need to take
  • when to take it
  • how long to take it for

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Slow wound healing

This drug can slow wound healing. If you need to have an operation you may need to stop taking it for a while beforehand. Your doctor will let you know when you can start taking it again.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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