This page tells you about the biological therapy, sunitinib and its possible side effects. There is information about
Sunitinib is pronounced sue-nit-i-nib. It is also known by its brand name Sutent (pronounced sue-tent).
Sunitinib is a treatment for
- Advanced kidney cancer
- A rare type of stomach cancer called gastrointestinal stromal tumour (GIST)
- Pancreatic neuroendocrine tumours
Sunitinib is a type of biological therapy called a protein kinase inhibitor. Protein kinase is a type of chemical messenger (an enzyme) that plays a part in the growth of cancer cells. Sunitinib blocks the protein kinase to stop the cancer growing. It can stop the growth of a tumour or shrink it down.
Sunitinib comes as capsules. You can take them with or without food.
For kidney cancer and GIST stomach cancer you take sunitinib once a day for 4 weeks and then have a 2 week break, when you don’t take the tablets. This 6 week period is called a cycle of treatment and is repeated for as long as the sunitinib works.
For pancreatic neuroendocrine tumours you take sunitinib once a day without any breaks for as long as it works.
It is very important that you take capsules according to the instructions your doctor or pharmacist gave you. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first. If you have accidentally taken too many capsules, talk to your doctor or nurse straight away. If you forget to take your capsules don't take a double dose to make up for a forgotten dose.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with sunitinib below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having sunitinib with other drugs.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of these.
- Tiredness and weakness (fatigue) occurs in almost 8 out of 10 people (80%) during and after treatment. Most people find their energy levels are back to normal by 6 months to a year after treatment ends
- Diarrhoea happens in around 6 out of 10 people (60%) but is usually mild. Tell your doctor or nurse if you have this as they can give you medicines to control it
- Skin changes – your skin may be drier, crack, become red, or have a rash. 3 out of 10 people (30%) have yellowing of their skin, which goes back to normal once treatment finishes
- Swelling around the eyes caused by a build up of fluid there
- Hair colour changes – your hair may become grey while you are having treatment
- Hands and feet become red and blistered in about 3 out of 10 people (30%)
- A sore or dry mouth occurs in about 1 out of 10 people (10%)
- Raised blood pressure occurs in about 3 out of 10 people (33%) – if your blood pressure goes up you may need to take tablets to control it
- A slower heart rate
- Loss of appetite
- A change in taste affects about 1 in 4 people (25%)
- Feeling or being sick happens in about 1 in 3 people (36%) – this is usually well controlled with anti sickness medicines
- Weight loss
- Indigestion and tummy (abdominal) pain
- Constipation – drink plenty of fluids. Let your doctor or nurse know if you have this for more than 3 days as you can have laxatives to control it
- A mild effect on the liver and kidneys, which is unlikely cause any symptoms. This will almost certainly go back to normal after the treatment finishes
- Loss of fertility – you may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
- Swollen hands and feet may occur due to fluid build up
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae). Let your doctor or nurse know if you have this
- Pains in back, joints, arms or legs
- A drop in the level of thyroid hormones (hypothyroidism) – this may cause tiredness, feeling cold and weight gain. You will have regular blood tests to check your hormone levels
- Difficulty falling asleep
Between 1 and 10 in every 100 people have one or more of these.
- Watery eyes from over production of tears – your doctor or nurse can give you eye drops to help
- Chest pain
- Piles (haemorrhoids), causing pain in the back passage (rectum)
- Problems swallowing or speaking due to a swollen voice box
- A stuffy nose
- Pain in the back, joints or muscles
- Muscle weakness
- Increased sensitivity to touch in hands and feet
- High levels of uric acid in the blood
- Hot flushes and sweats
- Changes in urine colour – this lasts for a couple of days and won't harm you
- Changes in nail colour and nails may fall out
- Low blood sugar levels causing feeling hungry, sweating, dizziness, tiredness, blurred vision, shakiness, and tingling lips. Let your doctor or nurse know straight away if you have these effects. If your blood sugar gets too low you could become drowsy and lose consciousness
Fewer than 1 in 100 people have these effects.
- Seizures (fits) – these are very rare
- Changes to how the heart works – let your doctor or nurse know if you feel very tired and breathless, or have swollen feet or ankles
- Blood clots in the brain – let your nurse or doctor know straight away if you suddenly feel ill, dizzy or confused
- Blood clots in the lung – let your nurse or doctor know straight away if you suddenly have a cough, chest pain, breathlessness, or cough up blood
- Damage to the jaw bone (osteonecrosis) – have a dental check up before you start treatment and tell your dentist that you are having sunitinib. It is important to clean your teeth regularly. Tell your doctor or nurse if you have any pain or a heavy feeling in the mouth, teeth or jaw
- Pain in the tummy (abdomen) caused by inflammation of the pancreas, liver or gallbladder
- A hole in the bowel wall caused by a bowel tumour shrinking – let your doctor or nurse know straight away if you have sudden tummy (abdominal) pain
- Changes in the brain causing headaches, confusion, fits (seizures), and loss of eyesight – let your doctor or nurse know straight away if you have these
- An abnormal join between 2 body cavities or from a body cavity on to the skin (fistula)
- Infection of the soft tissue (including around the genitals or anal area – let your doctor or nurse know straight away if you have any skin injury with pain, redness, swelling, or drainage of pus or blood
- Higher levels of thyroid hormones (hyperthyroidism).You may lose weight or feel hot, anxious, or hyperactive
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Other medicines and foods
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together. Sunitinib can also react with grapefruit juice so avoid this while you are having treatment.
Pregnancy and contraception
This drug may 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.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
Slow wound healing
Sunitinib can slow wound healing so if you need to have an operation your doctor will normally advise you to stop taking it for a while beforehand. They will let you know when you can start taking it again.
You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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