Sorafenib

Key facts

• Sorafenib (brand name Nexavar) is an oral kinase inhibitor used to treat certain advanced cancers.
• You take it on an empty stomach, usually twice daily, exactly as your oncologist directs.
• It commonly causes hand-foot skin reaction (pain, redness, and peeling on the palms and soles), raised blood pressure, and an increased risk of bleeding, all of which need regular checking.
• Seek urgent care for chest pain, a sudden severe headache, unusual bleeding, or yellowing of the skin or eyes.

What sorafenib treats

Sorafenib treats advanced hepatocellular carcinoma (liver cancer) that cannot be removed surgically, advanced renal cell carcinoma (kidney cancer) that has spread, and differentiated thyroid cancer that no longer responds to radioactive iodine. It is used when the cancer is too advanced for surgery or has stopped responding to other treatment.

How sorafenib works

Cancer cells rely on signalling proteins called kinases to keep dividing and to trigger growth of the new blood vessels that feed a tumour. Sorafenib blocks several of these kinases, including ones involved in forming new blood vessels (angiogenesis). This slows tumour growth and can shrink the blood supply the cancer needs.

Before you take it

• Tell your oncologist about high blood pressure, heart disease, a bleeding disorder, or a recent surgery or wound, since sorafenib affects blood pressure, clotting, and wound healing.
• Avoid it in pregnancy; it can harm the developing baby, and effective contraception is needed during treatment.
• Grapefruit, St John's wort, and some other cancer medicines can change sorafenib levels; tell your care team about all medicines and supplements you take.
• Liver and kidney function are checked before and during treatment.

Side effects

Common effects include diarrhoea, fatigue, hand-foot skin reaction, hair thinning, and nausea.

Stop and seek urgent medical care for:

• Chest pain, shortness of breath, or other signs of a heart problem.
• Unusual bleeding or bruising, or blood in stool or vomit.
• Yellowing of the skin or eyes, or dark urine.
• Severe blistering or peeling skin, or a sudden severe headache with vision changes.

Safety essentials

• Hand-foot skin reaction, raised blood pressure, and bleeding are sorafenib's most common serious effects; blood pressure is checked regularly, especially in the first weeks, and any new skin pain, blistering, or bleeding should be reported promptly.
• Sorafenib is paused before planned surgery because it slows wound healing.
• Do not stop or change your dose without medical advice; interruptions and reductions for side effects are managed by your care team.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.