Axitinib is a targeted cancer drug and is also known by its brand name Inlyta.
It is a treatment for advanced kidney cancer. You might also have it as part of a clinical trial for other types of cancer.
How it works
Axitinib is a tyrosine kinase inhibitor (TKI) which is a cancer growth blocker. Tyrosine kinase inhibitors work by blocking certain proteins called tyrosine kinases from acting on cells. Tyrosine kinases signal to cancer cells to grow.
Axitinib blocks different types of tyrosine kinase and is called a multi kinase inhibitor. It stops cancer cells forming blood vessels, which the cancer needs in order to grow. This is called anti angiogenesis treatment.
How you have it
Axitinib comes as red tablets. You take them twice a day, about 12 hours apart. You should swallow the tablets whole with a glass of water. You can take them with or without food.
Taking your tablets
You should take the right dose, not more or less.
Talk to your specialist or advice line before you stop taking a cancer drug.
If you miss a dose or are sick (vomit) after taking axitinib, take the next dose at the usual time.
When you have it
You start on a low dose and your doctor may increase the dose after 2 weeks, depending on how you feel.
You usually carry on taking axitinib for as long as it works.
You might have blood tests before starting treatment and during your treatment. They check your general health and might check your levels of blood cells and other substances in the blood.
We haven't listed all the side effects. It is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.
When to contact your team
Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Common side effects
These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:
Diarrhoea or constipation
Tell your doctor or nurse if you have diarrhoea or constipation. They can give you medicine to help.
Low levels of thyroid hormones (hypothyroidism)
The level of your thyroid hormones may drop (hypothyroidism). You may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen. You will have regular blood tests to check your thyroid hormone levels.
Less common the level of your thyroid hormones might increase (hyperthyroidism).
You might have medication to control your thyroid hormone level.
Loss of appetite and weight loss
You might not feel like eating and may lose weight. It is important to eat as much as you can. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Tell your doctor or nurse if you keep getting headaches. They can give you painkillers to help.
Loss of taste
Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually goes back to normal a few weeks after your treatment finishes.
High blood pressure (hypertension)
Tell your doctor or nurse if you have headaches, nose bleeds, blurred or double vision or shortness of breath. Your nurse will check your blood pressure regularly.
You might have medication to help control your blood pressure.
Increased risk of bleeding
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. 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).
Contact your health advice line if any of these happen.
Difficulty breathing and coughing
You may have difficulty breathing with wheezing and coughing. Let your doctor or nurse know straight away if this happens.
Changes to your voice (hoarseness)
Your voice might husky or croaky and sound weaker.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
Indigestion and heartburn
Contact your doctor or pharmacist if you have indigestion or heartburn. They can prescribe medicines to help.
You might get a stinging or burning sensation in your mouth.
Less common you might get pain in the back of your mouth and throat.
Redness and swelling of palms and soles of feet (hand foot syndrome)
The skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.
Moisturise your skin regularly. Your doctor or nurse will tell you what moisturiser to use.
Using a moisturising cream regularly can help with this.
Rash, dry skin
Skin problems include a skin rash, dry skin and itching. Talk to your doctor or nurse they might be able to help if this becomes too bad.
Pain in the joints, hands and feet
You might get pain in your joints, hands or feet. Talk to your doctor, nurse or contact the advice line to find out how to ease the pain.
Protein and blood in your urine
Small amounts of blood and protein in your urine may be found when your nurse tests your urine. This usually goes away on its own. If there are large amounts of protein you may have tests to check how well your kidneys are working.
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Lack of energy and feeling weak
This is usually mild. You can do things to help yourself, including some gentle exercise. It’s important not to push yourself too hard and eat a well balanced diet.
Talk to your doctor or nurse if this effect is stopping you from doing your usual daily activities.
Inflammation of the mouth, throat, nose and lining of the bowel
Your mouth, throat, nose and lining of the bowel might become swollen and irritated. Talk to your doctor, nurse or contact the advice line if this happens.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:
- a rise or a drop in the number of red blood cells
- not enough fluid in your body (dehydration) - make sure you drink plenty of fluids
- an increase in the level of minerals, salts and enzymes in your blood - this might show up in blood tests
- ringing or other sounds in your ears (tinnitus)
- heart problems - tell your doctor if you feel very tired, short of breath or have swollen legs or ankles
- upper tummy (abdominal) pain, wind (flatulence), haemorrhoids
- a hole (perforation) in your food pipe (oesophagus) stomach or bowel
- an abnormal channel (fistula) between your food pipe, stomach or bowel to another part of the body
- hair loss
- kidney problems
- inflammation of the gallbladder, this is usually caused by gall stones and can cause sudden tummy pain
- blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms
Rare side effects
These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:
- a drop in the white blood cells
- swelling of the brain that can be reversed - signs are headaches, confusion, fits, changes to your eyesight with or without high blood pressure. Contact your doctor straight away if you have any of these symptoms
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Other medications, food 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.
This drug contains lactose (milk sugar). If you have an intolerance to lactose, contact your doctor before taking this medicine.
You should not eat grapefruit or drink grapefruit juice when you are taking this drug because it can react with the drug.
Loss of fertility
It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Contraception and pregnancy
This drug may harm a baby developing in your womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 1 week afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
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.