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Regorafenib: Comprehensive Cancer Treatment & Dosage Guide
Summary of Key Points
Regorafenib is a prescription medication used to treat specific cancers, including colorectal cancer, gastrointestinal stromal tumors (GIST), and hepatocellular carcinoma (liver cancer). It works by blocking enzymes that promote cancer cell growth. Regorafenib is taken orally, typically once a day. It’s important to follow your healthcare provider’s instructions carefully and report any side effects you experience.
Names of Medication
US Brand Name: Stivarga
Generic Name: Regorafenib
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Regorafenib is the generic name.
Pharmacologic Category
Tyrosine Kinase Inhibitor
Antiangiogenic Agent
Regorafenib Dosage
Regorafenib is prescribed to treat various cancers in adults. The dosage may vary depending on the specific condition being treated. Always consult your healthcare provider before making any changes to your dosage. You can also schedule a telemedicine appointment with one of our providers to discuss your treatment plan.
Regorafenib for Colorectal Cancer
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment continues as long as the patient benefits and tolerates the medication.
Regorafenib for Gastrointestinal Stromal Tumors (GIST)
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment is based on response and tolerance.
Regorafenib for Hepatocellular Carcinoma (Liver Cancer)
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment continues until disease progression or unacceptable toxicity.
Regorafenib for Thyroid Cancer
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). The duration of treatment is determined by your healthcare provider based on your response.
Regorafenib for Pancreatic Cancer
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment is based on response and tolerance.
Regorafenib for Sarcoma
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment continues as long as the patient benefits and tolerates the medication.
Regorafenib for Breast Cancer
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). The duration of treatment is determined by your healthcare provider.
Regorafenib for Lung Cancer
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment is based on response and tolerance.
Regorafenib for Esophageal Cancer
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment continues as long as the patient benefits and tolerates the medication.
Regorafenib for Biliary Tract Cancer
Dosage: 160 mg orally once daily for 21 days, followed by 7 days off (28-day cycle). Treatment is based on response and tolerance.
Dosage Forms and Strengths
Tablet: 40 mg
Administration Instructions for Regorafenib
Take Regorafenib exactly as prescribed by your healthcare provider. It is typically taken once a day with a low-fat meal. Swallow the tablets whole with water; do not crush or chew them. If you miss a dose, take it as soon as you remember, unless it’s close to your next dose. Do not take two doses at once. Always consult your healthcare provider if you have any questions about your medication.
Contraindications for Regorafenib Treatment
Contraindications are specific conditions where a treatment should not be used due to potential harm. For Regorafenib, these include:
- Severe liver impairment: Regorafenib is metabolized by the liver. If liver function is severely impaired, the medication may not be processed properly, increasing the risk of side effects or toxicity.
- Allergic reaction to Regorafenib: If you’ve had an allergic reaction to Regorafenib or its ingredients, taking it again could cause serious reactions, including anaphylaxis.
- Uncontrolled high blood pressure (hypertension): Regorafenib can raise blood pressure. If you already have uncontrolled hypertension, it could worsen your condition and increase cardiovascular risks.
- Recent surgery or open wounds: Regorafenib may interfere with wound healing, so it’s generally not recommended for patients who have recently undergone surgery or have open wounds.
If you have any of these conditions, consult your healthcare provider before starting Regorafenib. You can schedule a telemedicine appointment to discuss your medical history and determine if this medication is safe for you.
Drug-to-Drug Interactions with Regorafenib
Regorafenib can interact with other medications, potentially affecting its effectiveness or increasing the risk of side effects. Some medications that may interact with Regorafenib include:
- Rifampin (Rifadin): This antibiotic can reduce Regorafenib’s effectiveness by speeding up its breakdown in the body.
- Ketoconazole (Nizoral): This antifungal can increase Regorafenib levels in the body, raising the risk of side effects.
- Warfarin (Coumadin): Regorafenib may increase the risk of bleeding when taken with blood thinners like Warfarin.
- Phenytoin (Dilantin): This anti-seizure medication may reduce Regorafenib’s effectiveness by speeding up its metabolism.
- St. John’s Wort: This herbal supplement can reduce Regorafenib’s effectiveness by affecting its liver processing.
Always inform your healthcare provider about all medications, supplements, and herbal products you are taking before starting Regorafenib. If you are unsure about potential interactions, schedule a telemedicine consultation for personalized advice.
Regorafenib in Pregnancy
Is it Safe to Take Regorafenib When Pregnant?
No, Regorafenib is not safe to use during pregnancy. This medication can harm an unborn baby, potentially leading to birth defects or pregnancy loss. If you are pregnant or planning to become pregnant, it is important to avoid taking Regorafenib. Women of childbearing age should use reliable contraception while on this medication and for at least two months after stopping treatment. If you become pregnant while taking Regorafenib, contact your healthcare provider immediately to discuss your options.
Regorafenib While Breastfeeding
Is it Safe to Take Regorafenib While Breastfeeding?
No, Regorafenib is not safe to use while breastfeeding. The medication can pass into breast milk and may harm a nursing infant. Women should avoid breastfeeding while taking Regorafenib and for at least two weeks after the last dose. If you are currently breastfeeding or planning to breastfeed, consult your healthcare provider to explore alternative treatments.
Estimated Cost of Regorafenib Medication
The cost of a 30-day supply of Regorafenib (typically 40 mg tablets) without insurance can be significant. With a GoodRx coupon, the price is estimated to range between $18,000 and $20,000 for a 30-day supply. Prices may vary depending on the pharmacy and location. If you’re concerned about the cost of Regorafenib, speak with your healthcare provider or pharmacist about financial assistance programs that may be available to you.
Possible Alternatives to Regorafenib
If Regorafenib is not suitable for you, or if you’re considering other treatment options, there are alternative medications and lifestyle changes for the following conditions:
Colorectal Cancer
Alternatives to Regorafenib for colorectal cancer include chemotherapy agents such as Capecitabine (Xeloda) or Oxaliplatin (Eloxatin). Immunotherapy drugs like Pembrolizumab (Keytruda) may also be considered. Maintaining a balanced diet and engaging in regular physical activity can help support your overall health during treatment.
Gastrointestinal Stromal Tumors (GIST)
Imatinib (Gleevec) is a common first-line treatment for GIST. If Imatinib is not effective, Sunitinib (Sutent) may be used as an alternative. In some cases, surgery may also be an option.
Hepatocellular Carcinoma (Liver Cancer)
Sorafenib (Nexavar) is another targeted therapy for liver cancer. In certain cases, liver transplantation or surgical resection may be considered. Avoiding alcohol and maintaining a healthy weight can help support liver health.
Thyroid Cancer
Alternatives to Regorafenib for thyroid cancer include radioactive iodine therapy or targeted therapies such as Lenvatinib (Lenvima). Surgery is often the first treatment option for thyroid cancer.
Pancreatic Cancer
Chemotherapy options for pancreatic cancer include Gemcitabine (Gemzar) or the FOLFIRINOX regimen. Surgery may be an option for early-stage pancreatic cancer. Maintaining a nutritious diet and managing blood sugar levels can support overall health during treatment.
Sarcoma
Doxorubicin (Adriamycin) and Ifosfamide (Ifex) are common chemotherapy options for sarcoma. Depending on the type and stage of the sarcoma, surgery and radiation therapy may also be considered.
Breast Cancer
Hormonal therapies such as Tamoxifen or targeted therapies like Trastuzumab (Herceptin) may be considered for breast cancer. Regular screenings and maintaining a healthy lifestyle are important for both prevention and management of breast cancer.
Lung Cancer
Alternatives to Regorafenib for lung cancer include targeted therapies like Erlotinib (Tarceva) or immunotherapies such as Nivolumab (Opdivo). Quitting smoking and avoiding exposure to secondhand smoke can significantly improve lung health and reduce cancer risk.
Esophageal Cancer
Chemotherapy options for esophageal cancer include Cisplatin or 5-Fluorouracil (5-FU). Surgery may also be an option for some patients. Avoiding smoking and alcohol can help reduce the risk of developing esophageal cancer.
Biliary Tract Cancer
Chemotherapy options for biliary tract cancer include Gemcitabine (Gemzar) or Cisplatin. In certain cases, surgery may be considered. Maintaining a healthy diet and avoiding alcohol can support liver and biliary health.
Always discuss alternative treatments with your healthcare provider before making any changes to your treatment plan. You can schedule a telemedicine appointment with one of our providers to explore these options in more detail.
Recent Updates on Regorafenib Research
Recent studies are focused on improving the effectiveness of Regorafenib when used in combination with other therapies. For example, clinical trials are investigating the use of Regorafenib alongside immunotherapy drugs like Pembrolizumab (Keytruda) to enhance the immune system’s ability to fight cancer. Additionally, ongoing research is exploring biomarkers that may help predict which patients will respond best to Regorafenib, allowing for more personalized treatment plans.
While these studies are promising, they are still in the early stages, and more research is needed to confirm their findings. If you’re interested in participating in a clinical trial or learning more about the latest research, speak with your healthcare provider. You can also schedule a telemedicine consultation with one of our providers to discuss whether these new developments may be relevant to your treatment plan.
