Tivozanib is a tyrosine kinase inhibitor that primarily acts on vascular endothelial growth factor receptors (VEGFR-1), VEGFR-2, and VEGFR-3.

1、 Indications

Tivozanib is a kinase inhibitor used to treat adult patients with recurrent or refractory advanced renal cell carcinoma (RCC) who have received two or more systemic treatments. It blocks tumor angiogenesis by inhibiting targets such as vascular endothelial growth factor receptor (VEGFR), thereby inhibiting tumor growth.

2、 Usage and dosage

Recommended dosage:

Take 1.34mg orally daily (on an empty stomach or after meals), continue taking the medication for 21 days and stop for 7 days (28 days per cycle) until disease progression or intolerable toxicity occurs.

Dose adjustment:

Adverse reaction management: Discontinue administration or reduce dosage to 0.89mg/day (21 day medication+7-day discontinuation) based on the severity of adverse reactions.

Liver dysfunction: Patients with moderate liver injury need to reduce their dosage to 0.89mg/day; Patients with severe liver injury should avoid using it.

Medication precautions: Swallow the entire capsule to avoid damage. If missed, take the medication according to the original plan next time and do not take double the dose.

3、 Side effects

Common adverse reactions (≥ 20%) include fatigue, hypertension, diarrhea, decreased appetite, nausea, hoarseness, hypothyroidism, cough, and stomatitis. Be cautious of serious side effects:

Cardiovascular risks: hypertensive crisis, heart failure, arterial/venous thrombosis (such as myocardial infarction, stroke).

Bleeding events: may be severe or even fatal, such as gastrointestinal bleeding or cerebral hemorrhage.

Other: proteinuria, delayed wound healing, reversible posterior encephalopathy syndrome (RPLS), thyroid dysfunction.

Allergic reactions: 0.89mg capsules contain lemon yellow (FD&C Yellow No.5), which may cause asthma or allergic reactions.

4、 Precautions and taboos

Monitoring requirements:

Regularly monitor blood pressure, thyroid function, urinary protein, and liver function before and during medication.

Medication should be suspended before and after surgery: Medication should be stopped for at least 24 days before elective surgery, and restarted after the wound has fully healed after surgery.

Taboo population:

There are no absolute contraindications, but 0.89mg is contraindicated for individuals allergic to lemon yellow.

Special populations:

Pregnant women: May cause fetal malformation, strict contraception is required until one month after discontinuation of medication.

Breastfeeding period: Breastfeeding is prohibited during the treatment period and within one month of discontinuation of medication.

Fertility impact: May reduce male and female fertility.

5、 Drug interactions

Avoid using strong CYP3A inducers (such as rifampicin) in combination, as it may reduce the efficacy of tivozanib.

6、 Excessive processing

Excessive use may lead to severe hypertension, requiring immediate discontinuation of medication and symptomatic supportive treatment. There is no specific antidote.

Tivozanibinformation