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 this medication.
Bleeding problems: 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: 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 this medication.
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 this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Gastrointestinal problems: On rare occasions, 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 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: 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 this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver problems: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. Sorafenib has not been studied in people who have severe liver problems and may itself cause liver problems. If you have decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Lung inflammation: Lung inflammation (interstitial lung disease) causing difficulty breathing has occurred on rare occasions in some people taking this medication. 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 sorafenib contact your doctor immediately.
QT prolongation: This medication 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 hearth 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 this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, 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: 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 sorafenib. Your doctor will suggest when you can restart the medication.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Sorafenib may reduce fertility in men and women. Effective contraception must be used while taking this medication and for at least 2 weeks after stopping this medication.
Breast-feeding: It is not known if sorafenib passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.