title: Common questions regarding clinical use of axitinib in advanced renal cell carcinoma.
abstract: OBJECTIVE
  An overview of the responses to some of the most frequently asked questions regarding axitinib administration and dosage modifications used in clinical practice are presented.
  
  
  CONCLUSIONS
  Axitinib was approved for second-line treatment of advanced renal cell carcinoma by the Food and Drug Administration on January 27, 2012. Inquiries received over the first six months after the approval date were reviewed. A large number of questions were related to administration of axitinib in different patient populations or in patients with various comorbidities, such as its (1) use in patients unable to swallow oral medication or administration of axitinib via a nasogastric tube, (2) use in patients with renal or hepatic impairment, (3) central nervous system penetration and use in patients with brain metastases, (4) drug interactions, particularly with anticoagulants, and (5) dosage modifications. Responses to these inquiries were provided based on the published literature or from data on file from the manufacturer. The dosage of axitinib can be adjusted for use in patients with hepatic impairment or in patients who cannot otherwise tolerate the usual regimen. Patients taking concomitant warfarin can also take axitinib, and patients who cannot swallow oral medications can receive a liquid formulation of the drug, though its efficacy and comparability to the tablet formulation has not been tested.
  
  
  CONCLUSIONS
  Based on the published literature and company data on file, the axitinib dosage may be modified to accommodate patients with renal or hepatic impairment, who cannot swallow oral medication, are receiving concomitant warfarin, or who cannot otherwise tolerate the standard dosage regimen. For patients who cannot swallow, an oral suspension can be prepared because crushing axitinib is not recommended.
authors.affiliation: Diane L. Borst, Pharm.D., is Director, Regional Medical Research Specialists, U.S. Medical Affairs, Pfizer, New York, NY. Lillian S. Arruda, Ph.D., is Associate Director, Oncology Medical Information, Pfizer, Collegeville, PA. Elizabeth MacLean, Pharm.D., is Director, U.S. Health Economics and Outcomes Research-Oncology, Pfizer, New York, NY. Yazdi K. Pithavala, Ph.D., is Senior Director, Clinical Pharmacology, Pfizer, San Diego, CA. James E. Morgado, B.Sc., is Principal Scientist, Chemistry-Analytics, Pfizer, Groton, CT. diane.l.borst@pfizer.com.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Borst
authors.affiliation: Diane L. Borst, Pharm.D., is Director, Regional Medical Research Specialists, U.S. Medical Affairs, Pfizer, New York, NY. Lillian S. Arruda, Ph.D., is Associate Director, Oncology Medical Information, Pfizer, Collegeville, PA. Elizabeth MacLean, Pharm.D., is Director, U.S. Health Economics and Outcomes Research-Oncology, Pfizer, New York, NY. Yazdi K. Pithavala, Ph.D., is Senior Director, Clinical Pharmacology, Pfizer, San Diego, CA. James E. Morgado, B.Sc., is Principal Scientist, Chemistry-Analytics, Pfizer, Groton, CT.
authors.forename: Lillian S
authors.initials: LS
authors.lastname: Arruda
authors.affiliation: Diane L. Borst, Pharm.D., is Director, Regional Medical Research Specialists, U.S. Medical Affairs, Pfizer, New York, NY. Lillian S. Arruda, Ph.D., is Associate Director, Oncology Medical Information, Pfizer, Collegeville, PA. Elizabeth MacLean, Pharm.D., is Director, U.S. Health Economics and Outcomes Research-Oncology, Pfizer, New York, NY. Yazdi K. Pithavala, Ph.D., is Senior Director, Clinical Pharmacology, Pfizer, San Diego, CA. James E. Morgado, B.Sc., is Principal Scientist, Chemistry-Analytics, Pfizer, Groton, CT.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: MacLean
authors.affiliation: Diane L. Borst, Pharm.D., is Director, Regional Medical Research Specialists, U.S. Medical Affairs, Pfizer, New York, NY. Lillian S. Arruda, Ph.D., is Associate Director, Oncology Medical Information, Pfizer, Collegeville, PA. Elizabeth MacLean, Pharm.D., is Director, U.S. Health Economics and Outcomes Research-Oncology, Pfizer, New York, NY. Yazdi K. Pithavala, Ph.D., is Senior Director, Clinical Pharmacology, Pfizer, San Diego, CA. James E. Morgado, B.Sc., is Principal Scientist, Chemistry-Analytics, Pfizer, Groton, CT.
authors.forename: Yazdi K
authors.initials: YK
authors.lastname: Pithavala
authors.affiliation: Diane L. Borst, Pharm.D., is Director, Regional Medical Research Specialists, U.S. Medical Affairs, Pfizer, New York, NY. Lillian S. Arruda, Ph.D., is Associate Director, Oncology Medical Information, Pfizer, Collegeville, PA. Elizabeth MacLean, Pharm.D., is Director, U.S. Health Economics and Outcomes Research-Oncology, Pfizer, New York, NY. Yazdi K. Pithavala, Ph.D., is Senior Director, Clinical Pharmacology, Pfizer, San Diego, CA. James E. Morgado, B.Sc., is Principal Scientist, Chemistry-Analytics, Pfizer, Groton, CT.
authors.forename: James E
authors.initials: JE
authors.lastname: Morgado
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000077784:Axitinib; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000188:drug therapy*; D002626:Chemistry, Pharmaceutical; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D007191:Indazoles / Q000008:administration & dosage*; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D019999:Pharmaceutical Solutions / Q000008:administration & dosage; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage*
chemical_list: D000970:Antineoplastic Agents; D007093:Imidazoles; D007191:Indazoles; D019999:Pharmaceutical Solutions; D047428:Protein Kinase Inhibitors; D000077784:Axitinib