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Soranib is belongs to the type of protein kinase inhibitor, Soranib is studied as synthetic compound targeting signal react for growth and angiogenesis.
Soranib also prohibits the VEGFR-2/PDGFR-beta signaling force, through blockade of tumor angiogenesis.
Soranib is a prescription drugs which is used under guidance of medical oncologist.
Soranib is indicated for the treatment for patients with Metastatic renal cell cancer
Soranib is indicated for the treatment for patients with Metastatic Hepatocellular cancer.
Soranib is indicated for the treatment for patients with Thyroid cancer.
Sorafenib combine with multiple intracellular (CRAF, BRAF and mutant BRAF) and cell surface kinases (KIT, FLT-3, VEGFR-2, VEGFR-3, and PDGFR-ß). Various of these kinases are thought to be including in angiogenesis, hence sorafenib decrease blood flow to the tumor. Sorafenib is specific in targeting the Raf/Mek/Erk pathway. By prohibiting these kinases, genetic transcription containing cell proliferation and angiogenesis is prohibited.
The oral bioavailability is 38 to 49%.
The high plasma concentration time of Soranib is 3 hours.
Sorafenib is largely bound to the human plasma protein at the range of 99.5%
Sorafenib is go through oxidative metabolism, intermediated by CYP3A4, in addition of Glucuronidation mediated by UGT1A9.
The excretion of Soranib occurs via urine, feces and biliary excretion also undergone.
The unchanged form of Sorafenib is around 51% should be recovered in feces and not in urine, biliary excretion also occurred.
The half-life period of Soranib is relatively 25 to 48 hours.
In HCC, RCC or TC condition:
The usual prescribed dosage of Soranib is 400mg tablet (200mg×2 tablets) should be taken as two times a day.
The dosage should be varied in HCC & RCC, if dose reduction is required. The dosage should be decreased to 400mg as a single dose. If further reduction is required, provide 400mg as a single dose for alternative day.
Grade 1 toxicity: Extend the Soranib therapy and provide with topical therapy for symptomatic relief.
Grade 2 toxicity: Extend the Soranib therapy and provide with topical therapy for symptomatic relief. If it occurs continuously, discontinue the Soranib therapy.
Grade 3 toxicity: Discontinue the Soranib therapy, if it is needed the dose should be reduced by two times a day into single dose.
First dose reduction: 600mg of Soranib should be recommend
Second dose reduction: 400mg of Soranib should be prescribed for two times a day
Third dose reduction: 200mg of Soranib should be prescribed as a single dose.
Hand foot skin reaction
Loss of weight
Increasing amylase & lipase
Interstitial lung disease
Stevens Johnson syndrome
Peripheral sensory neuropathy
Congestive heart failure
Gastro esophageal reflux
While co administration Soranib with antibiotic like neomycin causes depletion AUC of Sorafenib.
The solubility of Soranib is depends upon pH, if pH increases causes decreasing the solubility.
Soranib tablets while concomitant use with Midazolam, dextromethorphan, or Omeprazole causes no elevation of systemic exposure of these drugs.
Co administration of Soranib with other anti-neoplastic agents likes;
Paclitaxel or carboplatin: Causes elevation of exposure of Sorafenib
Capecitabine: Increase Capecitabine exposure.
Doxorubicin/Irinotecan: Elevation of AUC of doxorubicin and Irinotecan
Combination With neomycin: Intercede with enterohepatic recycling of Sorafenib, causes depletion of Sorafenib exposure.
Soranib tablets are concurrent use with strong CYP3A4 inhibitors like ketoconazole causes no variation in AUC of Sorafenib.
In patients with squamous cell lung cancer, are contraindicated in combination of Soranib with carboplatin & paclitaxel.
Some anaphylactic reactions occur, if patients are contraindicated to the component of Soranib tablets.
The pregnancy category of Soranib tablet: D
Soranib tablets should not be recommended in pregnancy conditions
Breast feeding should not be recommended
Soranib tablet stored at 25oC (77oF).
Protect the container from moisture, heat and light
If patients missed to take the dose of Soranib, must consult with medical practitioner and follow the instruction. or the missed dose should be skipped and follow the regular dosing schedule.
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