Nexavar

The recommended adult dose is 400 mg taken by mouth twice daily, with a large glass of water. Take Nexavar (Sorafenib) without food or with a meal that is low-to-moderate in fat content. If you experience certain side effects, your doctor may suggest a lower dose of 400 mg once daily for 28 days or indefinitely.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Nexavar (Sorafenib) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Nexavar (Sorafenib) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Each red, round, film-coated tablet, with the Bayer cross logo stamped on one side and "200" on the other, contains 200 mg of Nexavar (Sorafenib). Nonmedicinal ingredients: croscarmellose sodium, microcrystalline cellulose, hydroxypropyl methylcellulose, sodium lauryl sulfate, magnesium stearate, macrogol, titanium dioxide, and ferric oxide red.

Do not take Nexavar (Sorafenib) if you are allergic to Nexavar (Sorafenib) or any ingredients of the medication.

There may be an interaction between Nexavar (Sorafenib) and any of the following:

• Acetaminophen
• antiarrhythmics (e.g., amiodarone, disopyramide, Dronedarone, procainamide, quinidine, sotalol)
• anticancer mediations (e.g., Carboplatin, Docetaxel, Doxorubicin, Irinotecan, Paclitaxel)
• Apalutamide
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• Baricitinib
• BCG
• bisphosphonates (e.g., Alendronate, etidronate)
• Chlorpromazine
• Clozapine
• Cobicistat
• conivaptan
• Deferiprone
• echinacea
• Enzalutamide
• Fingolimod
• Glyburide
• haloperidol
• Hepatitis C antivirals (e.g., dasabuvir, ombitasvir, paritaprevir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Leflunomide
• lumacaftor and Ivacaftor
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Mesalamine
• methadone
• mifepristone
• Mitotane
• neomycin
• Ocrelizumab
• Pimecrolimus
• other protein kinase inhibitors (e.g., Ceritinib, Lapatinib, Pazopanib, Sunitinib, Tofacitinib)
• proton pump inhibitors (e.g., Esomeprazole, Lansoprazole, Omeprazole)
• rifampin
• Roflumilast
• St. John's wort
• seizure medications (e.g., Carbamazepine, Phenobarbital, Phenytoin, primidone)
• Tacrolimus
• tofacitinib
• upadacitinib
• vaccines
• warfarin
• Ziprasidone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Nexavar (Sorafenib). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Nexavar (Sorafenib).

Bleeding problems: Nexavar (Sorafenib) may increase your risk of bleeding. This risk may be greater if you are taking medications such as Warfarin or if you have bleeding problems. If you develop unexplained bruising, nosebleeds, dark or tarry stools, or start coughing up blood, contact your doctor immediately or seek immediate medical attention.

Blood pressure: Nexavar (Sorafenib) may increase blood pressure. The increase in blood pressure is usually mild-to-moderate and can be treated with blood pressure lowering medications. You and your doctor should monitor your blood pressure regularly while you are taking Nexavar (Sorafenib).

Electrolyte imbalances: If you have electrolyte imbalances (e.g., low potassium, magnesium, or calcium), an eating disorder, or vomiting or diarrhea, you should discuss with your doctor how Nexavar (Sorafenib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nexavar (Sorafenib), and whether any special monitoring is needed.

Gastrointestinal problems: On rare occasions, Nexavar (Sorafenib) can cause perforation of the stomach or intestines. If you experience severe abdominal pain, fever, vomiting, or nausea, contact your doctor immediately.

Hand-foot skin reaction: A rash on the palms of your hands as well as the soles of your feet may occur, usually within the first 12 weeks of using Nexavar (Sorafenib). It can vary in redness and itchiness, but it is possible that blistering and pain can develop. Speak to your doctor immediately if you develop a rash, pain, or blistering on your hands or feet.

Heart problems: Nexavar (Sorafenib) may affect your heart function and cause heart problems such as heart attack, decreased oxygen supply to the heart, heart failure, and a slow heart rate. Get immediate medical attention if you experience shortness of breath, sudden chest pain, or an extremely slow heart rate. If you have a history of heart problems discuss with your doctor how Nexavar (Sorafenib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nexavar (Sorafenib), and whether any special monitoring is needed.

Infection: Nexavar (Sorafenib) can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people who have contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Liver problems: Liver disease or reduced liver function may cause Nexavar (Sorafenib) to build up in the body, causing side effects. Nexavar (Sorafenib) has not been studied for use by people who have severe liver problems and may itself cause liver problems. Nexavar (Sorafenib) may reduce liver function and can cause liver failure. If you have liver problems, discuss with your doctor how Nexavar (Sorafenib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nexavar (Sorafenib), and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Lung inflammation: Lung inflammation (interstitial lung disease) causing difficulty breathing has occurred on rare occasions for some people taking Nexavar (Sorafenib). This complication can be serious and sometimes fatal. If you experience new or worsening shortness of breath or cough (with or without fever) at any time while you are taking Nexavar (Sorafenib), contact your doctor immediately.

QT prolongation: Nexavar (Sorafenib) can affect the electrical activity of the heart causing QT prolongation. You are more at risk for QT prolongation and its complications (e.g., abnormal heartbeat, fainting, or death) if you:

• are female
• are older than 65 years of age
• are taking other medications that prolong the QT interval (e.g., quinidine, Sotalol, Amiodarone, Disopyramide, Haloperidol, Amitriptyline, Methadone, clarithromycin, erythromycin, moxifloxacin, fluconazole)
• have a family history of sudden death related to heart problems
• have a history of heart disease or abnormal heart rhythms
• have a slow heart rate
• have congenital prolongation of the QT interval
• have Diabetes
• have had a Stroke
• have low potassium, magnesium, or calcium levels
• have nutritional deficiencies
• have reduced liver function

If you have any of these risk factors you should discuss with your doctor how Nexavar (Sorafenib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nexavar (Sorafenib), and whether any special monitoring is needed. If you experience dizziness, fainting, a seizure, or a rapid and pounding or irregular heartbeat, get immediate medication attention.

Wound healing: Nexavar (Sorafenib) may affect the way wounds heal. If you are having surgery, a dental procedure, or have recently had surgery, let your doctor know. You may need to temporarily stop taking Nexavar (Sorafenib). Your doctor will suggest when you can restart the medication.

Pregnancy: Nexavar (Sorafenib) should not be used during pregnancy unless the benefits outweigh the risks. Nexavar (Sorafenib) may reduce fertility in men and women. Effective contraception must be used while taking Nexavar (Sorafenib) and for at least 2 weeks after stopping Nexavar (Sorafenib).

Breast-feeding: It is not known if Nexavar (Sorafenib) passes into breast milk. If you are a breast-feeding mother and are taking Nexavar (Sorafenib), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Nexavar (Sorafenib) have not been established for children.