Nexavar (sorafenib)

Detailed View: Safety Labeling Changes Approved By FDA Center for Drug Evaluation and Research (CDER) – October 2011

 

Summary View

 

WARNINGS AND PRECAUTIONS

Increased Mortality Observed with Nexavar Administered in Combination with Carboplatin/Paclitaxel and Gemcitabine/Cisplatin in Squamous Cell Lung Cancer

• In a subset analysis of two randomized controlled trials in chemo-naive patients with Stage IIIB-IV non-small cell lung cancer...

Risk of QT Interval Prolongation

• Nexavar can prolong the QT/QTc interval and increase the risk

 

ADVERSE REACTIONS

Additional Data from Multiple Clinical Trials

The following additional drug-related adverse reactions and laboratory abnormalities were reported from clinical trials of Nexavar (very common 10% or greater, common 1 to less than 10%, uncommon 0.1% to less than 1%):

• Cardiovascular: Common: congestive heart failure*, myocardial ischemia and/or infarction Uncommon: hypertensive crisis* Rare: QT prolongation*

Postmarketing Experience

• Dermatologic: Stevens-Johnson syndrome and toxic epidermal necrolysis(TEN)

 

DRUG INTERACTIONS

Drug Metabolism

• Effect of Cytochrome P450 on Sorafenib : Rifampicin, a strong CYP3A4 inducer, administered......

Neomycin

• Neomycin administered at a dose of 1g three times daily for 5 days decreased.....

 

USE IN SPECIAL POPULATIONS

Patients With Hepatic Impairment

• In a trial of HCC patients with mild (Child-Pugh A) or moderate (Child-Pugh B) hepatic impairment, the systemic exposure (AUC) of sorafenib was .....

Patients With Renal Impairment

• No correlation between sorafenib exposure and renal function was observed following administration of a single 400 mg dose.....

 

PATIENT COUNSELING INFORMATION

QT Interval Prolongation

• Inform patients with a history of prolonged QT interval that Nexavar can worsen the condition [see Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)].