Axitinib (Inlyta®)

Axitinib (Inlyta®) is a targeted therapy drug. It is used to treat kidney cancer that has spread outside the kidney.

What is axitinib (Inlyta®)?

Axitinib (Inlyta®) is used to treat kidney cancer that has spread outside the kidney (advanced kidney cancer). It is best to read this information with our general information about kidney cancer.

Axitinib is a type of targeted therapy drug called a cancer growth inhibitor and an angiogenesis inhibitor. Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

How axitinib is given

Axitinib comes in tablets, so you can take it at home. It may be given on its own, or with other cancer drugs. You usually take axitinib for as long as it is controlling the cancer.

During treatment, you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse, and a specialist pharmacist. This is who we mean when we mention a doctor, nurse or pharmacist in this information.

The nurse or pharmacist will give you the tablets to take home. Always take them exactly as explained. This is important to make sure they work as well as possible for you.

You may be given tablets of different strengths. The dose of axitinib may go up or down during treatment. Your doctor may change the dose you take depending on your blood pressure or other side effects you have. They do this to make sure the amount of axitinib you are taking is right for you.

Your nurse or pharmacist may also give you anti-sickness drugs and other medicines to take home. Take all your capsules or tablets exactly as they have been explained to you.

Taking axitinib tablets

You take axitinib twice a day, about 12 hours apart. Take the tablets with a glass of water. You can take axitinib with or without food. Do not take axitinib with grapefruit or drink grapefruit juice, as it may increase the risk of side effects.

Other things to remember about your tablets:

  • If you forget to take your tablet or are sick after taking it, just take your next dose at the usual time. Never take a double dose.
  • Keep them in the original package and at room temperature, away from heat and direct sunlight.
  • Keep them safe and out of sight and reach of children.
  • Get a new prescription before you run out of tablets and make sure you have plenty for holidays.
  • If your treatment is stopped return any unused tablets to the pharmacist.

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

Common side effects

Diarrhoea

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.

If you have diarrhoea:

  • try to drink at least 2 litres (3½ pints) of fluids each day
  • avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods
  • contact the hospital for advice.

Feeling sick

Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.

High blood pressure

This treatment can cause high blood pressure (hypertension). You will have your blood pressure checked regularly. If you have headaches, nosebleeds or feel dizzy, let your doctor know. They can prescribe tablets to control high blood pressure.

If you have high blood pressure before you start treatment, your doctor will monitor you closely during treatment.

Bleeding problems

Axitinib may cause bleeding problems because it can affect the cells which help your blood to clot (platelets). Tell your doctor straight away if you have:

  • a nosebleed
  • bleeding from your gums
  • blood in your urine.

Tiredness

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Underactive thyroid

Axitinib can make your thyroid work less than normal. This is called an underactive thyroid. Signs that you might have an underactive thyroid gland include:

  • tiredness
  • weight gain
  • constipation
  • aches
  • dry skin
  • dry hair.

During treatment, your doctor will monitor your thyroid function with blood tests. But if you have any symptoms, let them know.

Sore and red hands and feet

Having sore and red palms of hands and soles of feet is called palmar-plantar or hand-foot syndrome. Your doctor or nurse can give you advice and prescribe creams to improve the symptoms. It can help to keep your hands and feet cool and avoid tight-fitting socks, shoes and gloves. Tell your nurse about any changes in your hands or feet.

Joint and muscle pain

You may have pain and stiffness in your joints, and sometimes in your muscles. Tell your doctor or nurse if this happens. They can prescribe painkillers and give you advice.

Skin changes

This treatment may affect your skin. It can cause a rash, which may be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.

Always tell your doctor or nurse about any skin changes or if they get worse. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.

Weight loss and loss of appetite

You may lose your appetite and lose weight during your treatment. Try to eat small meals regularly. If your appetite doesn’t improve after a few days, let your doctor or nurse know. They can arrange for you to see a dietitian who can give you advice. You may be given food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.

Some people also notice that food tastes different. Your nurse or dietitian can give you advice on coping with this.

Tummy (abdominal) pain

Some people have pain or discomfort in their tummy when taking axitinib. Let your doctor know if this happens to you.

Very rarely, axitinib can cause a hole (perforation) in the small bowel. Contact your doctor immediately if you have severe pain in the tummy and sickness and vomiting. It is also very important to let them know if

  • you have bleeding from the back passage or black stools
  • you are vomiting up blood
  • your vomit looks like coffee grounds.

Breathlessness and a cough

You may feel more out of breath than normal or develop a cough. Let your doctor know if you notice this.

Headaches

This treatment may cause headaches. If you have headaches, tell your doctor. They may give you painkillers to help.

Hoarse voice

You may notice your voice sounds hoarse or you may feel like you have a lump in your throat. Tell your doctor if you experience this. It will usually go back to normal when treatment stops.

Constipation

This treatment can cause constipation. Constipation means that you are not able to pass stools (poo) as often as you normally do. It can become difficult or painful. Here are some tips that may help:

  • Drink at least 2 litres (3½ pints) of fluids each day.
  • Eat high-fibre foods, such as fruit, vegetables and wholemeal bread.
  • Do regular gentle exercise, like going for short walks.

If you have constipation, contact the hospital for advice. Your doctor can give you drugs called laxatives to help.

Sore mouth and throat

This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get a mouth or throat infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth or throat is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco, and foods that irritate your mouth and throat.

Sucking ice chips may sometimes help relieve mouth or throat pain. But if you are having radiotherapy to the head or neck, do not suck on ice. It can cause damage.

Indigestion and wind

This treatment may cause indigestion or heartburn and wind. If you have these side effects, tell your doctor or nurse. They can give you medicines to help.

Less common side effects

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:

  • throbbing pain, redness or swelling in a leg or arm
  • suddenly feeling breathless or coughing
  • sharp chest pain, which may be worse when you cough or take a deep breath.

If you have any of these symptoms, contact the hospital straight away on the 24-hour contact number you have been given. If you cannot get through to your doctor, call the NHS urgent advice number on 111.

A blood clot is serious, but it can be treated with drugs that thin the blood (anticoagulants). Your doctor or nurse can give you more information.

You can help reduce the risk of developing a blood clot by:
  • staying active during treatment
  • drinking plenty of fluids, especially water.

You may be given anticoagulants to help prevent a clot.

Effects on the heart

Axitinib can affect the way the heart works. Let your doctor know if you feel breathless and tired or have swollen legs or ankles.

Contact a doctor straight away if you:

  • have pain or tightness in your chest
  • feel breathless or dizzy
  • feel your heart is beating too fast or too slowly.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor.

Confusion, fits (seizures) or changes in vision

Rarely, axitinib can cause you to become confused, have a seizure or have changes in your vision. Contact your doctor immediately if you have any of these symptoms.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may have symptoms such as:

  • pale skin
  • lack of energy
  • feeling breathless
  • feeling dizzy and light-headed.

Tell your doctor or nurse if you have these symptoms.

If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Overactive thyroid

Axitinib can make your thyroid work more than normal. This is called an overactive thyroid. Signs that you may have an overactive thyroid gland include:

  • losing weight
  • feeling anxious
  • mood swings
  • tiredness
  • difficulty sleeping.

During treatment, your doctor will monitor your thyroid function with blood tests. But if you have any symptoms, let them know.

Effects on the liver or kidneys

Axitinib can change how well the liver or kidneys work. Your doctor will take blood and urine samples regularly to check how well they are working.

Hearing changes

This treatment may cause hearing changes, including hearing loss. You may have ringing in the ears. This is called tinnitus. You may also become unable to hear some high-pitched sounds. Hearing changes usually get better after this treatment ends. But some can be permanent. Tell your doctor if you notice any changes in your hearing.

Hair thinning

Your hair may become thinner when you are taking this treatment. This is usually mild. Ask your nurse for advice if you are worried about this.

Other information

Other medicines

Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:

  • medicines you have been prescribed
  • medicines you buy in a shop or chemist
  • vitamins, herbal drugs and complementary therapies.

Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.

You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.

Lactose

This drug contains lactose. If you have a lactose intolerance, talk to your doctor before you start taking this treatment.

Fertility

Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Contraception

Your doctor will advise you not to get pregnant or make someone pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for a while after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.

Breastfeeding

You are advised not to breastfeed while having this treatment, or for some time after treatment finishes. This is because the drugs could be passed to the baby through breast milk.

Your doctor or nurse can give you more information.

Vaccinations

Vaccinations can reduce your risk of getting certain infections. Your doctor or nurse may talk to you about having vaccinations.

Doctors usually recommend that people with cancer have a flu vaccination and a coronavirus vaccination. These are both inactivated vaccinations that can help reduce the risk of infection. People with weak immune systems can have these, as they are not live vaccinations.

If your immune system is weak, you need to avoid live vaccinations. This is because they can make you unwell. Live vaccines, such as shingles, contain a very weak version of the illness they are vaccinating you against. Your cancer doctor or GP can tell you more about live and inactivated vaccinations.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

Slow healing of wounds

Wounds often take longer to heal while you are having treatment with axitinib. If you need surgery, you may need to stop taking axitinib before the operation and not start taking it again for a few weeks afterwards. You may also need to stop taking axitinib for a few days if you are having dental treatment. Talk to your doctor if you need to have surgery or dental treatment.