Lenvatinib – Uses, Dosage, Side Effects, Interaction Lenvatinib is orally available multi-kinase inhibitor and antineoplastic agent that is used in treatment of advanced, metastatic medullary thyroid cancer and refractory renal cell carcinoma. Lenvatinib is associated with a modest rate of serum enzyme elevations during treatment and has been implicated to rare instances of clinically apparent, acute liver injury some of which have been fatal. Lenvatinib is a member of the class of quinolines that is the carboxamide of 4-{3-chloro-4-[(cyclopropylcarbamoyl)amino]phenoxy}-7-methoxyquinoline-6-carboxylic acid. A multi-kinase inhibitor and orphan drug used (as its mesylate salt) for the treatment of various types of thyroid cancer that do not respond to radioiodine. It has a role as a vascular endothelial growth factor receptor antagonist, an orphan drug, an antineoplastic agent, an EC 2.7.10.1 (receptor protein-tyrosine kinase) inhibitor and a fibroblast growth factor receptor antagonist. It is a member of quinolines, an aromatic ether, a monocarboxylic acid amide, an aromatic amide, a member of monochlorobenzenes, a member of cyclopropanes and a member of phenylureas. It is a conjugate base of a lenvatinib(1+). Lenvatinib is a synthetic, orally available inhibitor of vascular endothelial growth factor receptor 2 (VEGFR2, also known as KDR/FLK-1) tyrosine kinase with potential antineoplastic activity. Lenvatinib blocks VEGFR2 activation by VEGF, resulting in inhibition of the VEGF receptor signal transduction pathway, decreased vascular endothelial cell migration and proliferation, and vascular endothelial cell apoptosis. Lenvatinib Mesylate is a synthetic, orally available inhibitor of vascular endothelial growth factor receptor 2 (VEGFR2, also known as KDR/FLK-1) tyrosine kinase with potential antineoplastic activity. E7080 blocks VEGFR2 activation by VEGF, resulting in inhibition of the VEGF receptor signal transduction pathway, decreased vascular endothelial cell migration and proliferation, and vascular endothelial cell apoptosis. Lenvatinib mesylate is a methanesulfonate salt obtained by reaction of lenvatinib with one molar equivalent of methanesulfonic acid. A multi-kinase inhibitor and orphan drug used (as its mesylate salt) for the treatment of various types of thyroid cancer that do not respond to radioiodine. It has a role as an EC 2.7.10.1 (receptor protein-tyrosine kinase) inhibitor, a fibroblast growth factor receptor antagonist, an orphan drug, a vascular endothelial growth factor receptor antagonist and an antineoplastic agent. It contains a lenvatinib(1+). Lenvatinib is approved (since 2015) for the treatment of differentiated thyroid cancer that is either locally recurrent or metastatic, progressive, and did not respond to treatment with radioactive iodine (radioiodine).[rx][rx] In May 2016, the U.S. Food and Drug Administration (FDA) approved it (in combination with everolimus) for the treatment of advanced renal cell carcinoma following one prior anti-angiogenic therapy.[rx] The drug is also approved in the US and in the European Union for hepatocellular carcinoma that cannot be removed surgically in patients who have not received cancer therapy by mouth or injection.[5][6] Mechanism of Action Lenvatinib is a receptor tyrosine kinase (RTK) inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4). Lenvatinib also inhibits other RTKs that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1, 2, 3, and 4; the platelet derived growth factor receptor alpha (PDGFRα), KIT, and RET. Lenvatinib acts as a multiple kinase inhibitor. It inhibits the three main vascular endothelial growth factor receptors VEGFR1, 2 and 3, as well as fibroblast growth factor receptors (FGFR) 1, 2, 3 and 4, platelet-derived growth factor receptor (PDGFR) alpha, c-Kit, and the RET proto-oncogene. Some of these proteins play roles in cancerogenic signalling pathways. VEGFR2 inhibition is thought to be the main reason for the most common side effect, hypertension.[rx] Based on x-ray crystallography and kinetic interaction studies, lenvatinib binds to the adenosine 5′-triphosphate binding site of VEGFR2 and to a neighbouring region via a cyclopropane ring and thereby inhibits tyrosine kinase activity and associated signalling pathways. Indications Lenvatinib is indicated for the treatment of the following cancerous conditions: **Differentiated Thyroid Cancer (DTC)** – Treatment of locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer **Renal Cell Carcinoma (RCC)** – First-line treatment, in combination with [pembrolizumab], in adult patients with advanced renal cell carcinoma (RCC) – Treatment of advanced renal cell carcinoma, in combination with [everolimus], in adult patients who have previously tried ≥1 anti-angiogenic therapy **Hepatocellular Carcinoma (HCC)** – First-line treatment of patients with unresectable hepatocellular carcinoma **Endometrial Carcinoma** – Treatment of advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), in combination with [pembrolizumab], in patients who have experienced disease progression following prior systemic therapy and are not candidates for curative surgery or radiation Lenvima is indicated as monotherapy for the treatment of adult patients with progressive, locally advanced or metastatic, differentiated (papillary/follicular/Hürthle cell) thyroid carcinoma (DTC), refractory to radioactive iodine (RAI). Lenvima is indicated as monotherapy for the treatment of adult patients with advanced or unresectable hepatocellular carcinoma (HCC) who have received no prior systemic therapy. Kisplyx is indicated for the treatment of adults with advanced renal cell carcinoma (RCC): in combination with pembrolizumab, as first-line treatment. in combination with everolimus, following one prior vascular endothelial growth factor (VEGF)-targeted therapy. Treatment of follicular thyroid cancer , Treatment of osteosarcoma, Treatment of papillary thyroid cancer Treatment of all conditions included in the category of malignant neoplasms except haematopoietic and lymphoid tissue neoplasms, papillary thyroid cancer , follicular thyroid cancer and osteosarcoma. Lenvima is indicated as monotherapy for the treatment of adult patients with progressive, locally advanced or metastatic, differentiated (papillary/follicular/Hürthle cell) thyroid carcinoma (DTC), refractory to radioactive iodine (RAI). Lenvima is indicated as monotherapy for the treatment of adult patients with advanced or unresectable hepatocellular carcinoma (HCC) who have received no prior systemic therapy. Lenvatinib mesylate is approved to be used alone or with other drugs to treat: Endometrial carcinoma that is advanced and got worse after other systemic therapies. It is used with pembrolizumab in patients whose cancer is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) and cannot be treated with surgery or radiation therapy. Hepatocellular carcinoma (a type of liver cancer). It is used as the first treatment in patients whose cancer cannot be removed by surgery. Renal cell carcinoma (a type of kidney cancer) that is advanced. It is used: With everolimus in adults who have received angiogenesis inhibitor therapy. With pembrolizumab as the first treatment in adults. Thyroid cancer in certain patients with progressive, recurrent, or metastatic cancer that does not respond to treatment with radioactive iodine. Lenvatinib, is an anti-cancer medication for the treatment of certain kinds of thyroid cancer and for other cancers as well. It was developed by Eisai Co. and acts as a multiple kinase inhibitor against the VEGFR1, VEGFR2 and VEGFR3 kinases. Advanced Renal Cell Carcinoma Endometrial Carcinoma Unresectable Hepatocellular Carcinoma (HCC) Progressive, locally advanced radioactive iodine-refractory Differentiated Thyroid Cancer (DTC) Progressive, metastatic radioactive iodine-refractory Differentiated Thyroid Cancer (DTC) Use in Cancer Lenvatinib mesylate is approved to be used alone or with other drugs to treat: Endometrial carcinoma is advanced and got worse after other systemic therapies. It is used with pembrolizumab in patients whose cancer is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) and cannot be treated with surgery or radiation therapy. Hepatocellular carcinoma (a type of liver cancer). It is used as the first treatment in patients whose cancer cannot be removed by surgery. Renal cell carcinoma (a type of kidney cancer) is advanced. It is used: With everolimus in adults who have received angiogenesis inhibitor therapy. With pembrolizumab as the first treatment in adults. Thyroid cancer in certain patients with progressive, recurrent, or metastatic cancer that does not respond to treatment with radioactive iodine. Lenvatinib mesylate is also being studied in the treatment of other types of cancer. Contraindications Bleeding, thyroid cancer. Hypertension. Cardiomyopathy, heart failure. Cardiac disease, coronary artery disease, myocardial infarction, stroke, thromboembolic disease. Hepatic disease, hepatotoxicity. Dehydration, hypovolemia, renal disease, renal failure, renal impairment a condition with low thyroid hormone levels low amount of calcium in the blood low amount of potassium in the blood high blood pressure prolonged QT interval on EKG chronic heart failure abnormal EKG with QT changes from birth a localized weakening and ballooning in an artery wall called an arterial aneurysm obstruction of a blood vessel by a blood clot bleeding a gastrointestinal tract fistula recent operation elevation of proteins in the urine pregnancy a patient who is producing milk and breastfeeding chronic kidney disease stage 4 (severe) kidney disease with likely reduction in kidney function dissection of artery Child-Pugh class C liver impairment Dosage Strengths: 4 mg daily-dose; 8 mg daily-dose; 10 mg daily-dose; 12 mg daily-dose; 14 mg daily-dose; 18 mg daily-dose; 20 mg daily-dose; 24 mg daily-dose Lenvaitnib is available in 4 mg and 10 mg capsule dosages for oral consumption.[rx] Radioactive Iodine-refractory Differentiated Thyroid Cancer (DTC) 24 mg orally once a day. Advanced Renal Cell Carcinoma (RCC) First-line treatment: 20 mg orally once a day in combination with pembrolizumab for up to two years; then can be given as monotherapy. Previously treated disease: 18 mg orally once daily in combination with everolimus. Unresectable Hepatocellular Carcinoma (HCC) The suggested dose should be determined based on the patient’s body weight: 12 mg orally once a day for patients’ body weight greater than or equal to 60 kg. 8 mg orally once a day for patients weighing less than 60 kg. Advanced Endometrial Carcinoma 20 mg orally once daily; for patients with non-microsatellite instability-high (MSI-H) or non-mismatch repair deficient (dMMR) progressive disease who are not candidates for X-ray therapy or curative surgery, use with pembrolizumab. or Thyroid Cancer 24 mg orally once a day Treatment should be continued until disease progression or unacceptable toxicity. For the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC) Renal Cell Carcinoma First-Line Treatment of Patients with Advanced Renal Cell Carcinoma: 20 mg orally once a day given in combination with 200 mg IV pembrolizumab over 30 minutes every 3 weeks Previously Treated Renal Cell Carcinoma: 18 mg orally once a day given in combination with 5 mg everolimus orally once a day Refer to everolimus prescribing information for recommended dosing information. Refer to pembrolizumab prescribing information for recommended dosing information Treatment with everolimus should be continued until disease progression or unacceptable toxicity. Treatment with pembrolizumab should be continued until disease progression or unacceptable toxicity or up to 2 years. After 2 years of combination with pembrolizumab, this drug may be administered as a single agent until disease progression or unacceptable toxicity. In combination with everolimus for the treatment of patients with advanced renal cell carcinoma following one prior anti-angiogenic therapy In combination with pembrolizumab for the first-line treatment of adult patients with advanced renal cell carcinoma Hepatocellular Carcinoma Weight less than 60 kg: 8 mg orally once a day Weight 60 kg or greater: 12 mg orally once a day Treatment should be continued until disease progression or unacceptable toxicity. For the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC) Endometrial Carcinoma 20 mg orally once daily in combination with pembrolizumab 200 mg IV over 30 minutes every 3 weeks Refer to the pembrolizumab prescribing information for other dosing information. Treatment should be continued until disease progression or unacceptable toxicity.65483 Renal Dose Adjustments Mild (CrCl 60-89 mL/min) or moderate renal impairment (CrCl 30-59 mL/min): No dose adjustment recommended Severe renal impairment (CrCl less than 30 mL/min): Differentiated thyroid cancer (DTC): Reduce the starting dose to 14 mg orally once a day Renal cell carcinoma (RCC): Reduce the starting dose to 10 mg orally once a day Endometrial carcinoma: Reduce the starting dose to 10 mg orally once a day Hepatocellular Carcinoma (HCC): Data not available End stage renal disease: Data not available Liver Dose Adjustments Mild (Child-Pugh A) to moderate (Child-Pugh B) hepatic impairment: No dose adjustment recommended Severe hepatic impairment (Child-Pugh C): Differentiated thyroid cancer (DTC): Reduce the starting dose to 14 mg orally once a day Renal cell carcinoma (RCC): Reduce the starting dose to 10 mg orally once a day Endometrial carcinoma: Reduce the starting dose to 10 mg orally once a day Hepatocellular Carcinoma (HCC): Data not available Dose Adjustments When administering this drug in combination with everolimus, reduce the dose of this drug first and then the everolimus dose for adverse reactions of both drugs. Refer to the everolimus prescribing information for additional dose modification information. When administering this drug in combination with pembrolizumab, modify the dosage of one or both drugs as appropriate, interrupt, or reduce of discontinue the dose of this drug as appropriate. Refer to pembrolizumab prescribing information for additional dose modification information. DOSE REDUCTION BASED ON THE PREVIOUS DOSE LEVEL: DIFFERENTIATED THYROID CANCER (DTC): Initial dose level of 24 mg orally once a day: First occurrence: Reduce dose to 20 mg orally once a day. Second occurrence: Reduce dose to 14 mg orally once a day. Third occurrence: Reduce dose to 10 mg orally once a day. RENAL CELL CARCINOMA (RCC): Initial dose level of 18 mg orally once a day: First occurrence: Reduce dose to 14 mg orally once a day. Second occurrence: Reduce dose to 10 mg orally once a day. Third occurrence: Reduce dose to 8 mg orally once a day. ENDOMETRIAL CARCINOMA: Initial dose level of 20 mg orally once a day: First occurrence: Reduce dose to 14 mg orally once a day. Second occurrence: Reduce dose to 10 mg orally once a day. Third occurrence: Reduce dose to 8 mg orally once a day. HEPATOCELLULAR CARCINOMA (HCC): Initial dose level of 12 mg orally once a day: First occurrence: Reduce dose to 8 mg orally once a day. Second occurrence: Reduce dose to 4 mg orally once a day. Third occurrence: Reduce dose to 4 mg orally every other day. Initial dose level of 8 mg orally once a day: First occurrence: Reduce dose to 4 mg orally once a day. Second occurrence: Reduce dose to 4 mg orally every other day. Third occurrence: Discontinue therapy. RECOMMENDED DOSE MODIFICATIONS FOR ADVERSE REACTIONS: HYPERTENSION: Grade 3: Withhold for Grade 3 that persists despite optimal antihypertensive therapy. Resume at reduced dose when hypertension is controlled at Grade 2 or less. Grade 4: Permanently discontinue therapy. CARDIAC DYSFUNCTION: Grade 3: Withhold until improves to Grade 0 to 1 or baseline. Resume at reduced dose or discontinue depending on the severity and persistence of adverse reaction. Grade 4: Permanently discontinue therapy. ARTERIAL THROMBOEMBOLIC EVENT: Any Grade: Permanently discontinue therapy. HEPATOTOXICITY: Grade 3 or 4: Withhold until improves to Grade 0 to 1 or baseline. Either resume at a reduced dose or discontinue depending on severity and persistence of hepatotoxicity. Permanently discontinue for hepatic failure. RENAL IMPAIRMENT OR FAILURE: Grade 3 or 4: Withhold until improves to Grade 0 to 1 or baseline. Resume at a reduced dose or discontinue depending on severity and persistence of renal impairment. PROTEINURIA: 2 grams or greater proteinuria in 24 hours: Withhold until less than or equal to 2 grams of proteinuria per 24 hours. Resume at a reduced dose. Permanently discontinue for nephrotic syndrome. GI PERFORATION: Any Grade: Permanently discontinue therapy. FISTULA FORMATION: Grade 3 or 4: Permanently discontinue therapy. QT PROLONGATION: Greater than 500 ms or greater than 60 ms increase from baseline: Withhold until improves to less than or equal to 480 ms or baseline. Resume at a reduced dose. REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME (RPLS): Any Grade: Withhold until fully resolved. Resume at a reduced dose or discontinue depending on severity and persistence of neurologic symptoms. OTHER ADVERSE REACTIONS: Persistent or intolerable Grade 2 or 3 adverse reaction or Grade 4 laboratory abnormality: Withhold until improves to Grade 0 to 1 or baseline. Resume at reduced dose. Grade 4 adverse reaction: Permanently discontinue therapy. Administration advice: Capsules can be swallowed whole or dissolved in a small glass of liquid. This drug can be given with or without food. This drug should be taken at the same time each day. If a dose is missed and cannot be taken within 12 hours, skip that dose and take the next dose at the usual time. Cardiovascular: Blood pressure, bleeding, signs and symptoms of cardiac dysfunction, ECG Endocrine: TSH levels Hepatic: ALT, AST Metabolic: Serum electrolytes, blood calcium levels Neurologic: New onset or worsening neurological function Renal: Proteinuria, regular laboratory renal tests Advise the patient to read the FDA-approved patient labeling. Advise patients regarding good oral hygiene practices and to have preventive dentistry performed prior to and throughout treatment. Advise patients that this drug can increase the risk for bleeding. Advise patients that this drug can increase the risk of fistula formation or gastrointestinal perforation and to seek immediate medical attention for severe abdominal pain. Advise patients that this drug to report any clinical symptom of cardiac dysfunction. Advise patients to inform their healthcare provider of any planned surgical procedure. Advise females of reproductive potential to use effective contraception during treatment and for at least 30 days after the last dose. Advise women to discontinue breastfeeding during treatment and for at least 1 week after the last dose. Side Effects The Most Common fatigue or tiredness rash, redness, itching, or peeling of skin on palms and sole(s) of the feet diarrhea nausea constipation heartburn decreased appetite weight loss change in ability to taste food cough hoarseness mouth sores dry mouth headache joint and muscle pain difficulty falling asleep or staying asleep hair loss fever burning during urination rash shortness of breath or trouble breathing swelling of legs and ankles chest pain numbness or weakness of the face, arm, or leg on one side of your body pain in arms, back, neck, or jaw sudden, severe headache slow or difficult speech sudden changes in vision yellowing of the skin or eyes stomach pain dark (tea-colored) urine light-colored stools seizures weakness confusion severe and persistent nose bleeds bloody vomit black, tarry, or bloody stools coughing up blood or blood clots heavy menstrual bleeding vomiting, diarrhea, or signs of dehydration wounds that do not heal More common Bladder pain bleeding gums bloating or swelling of the face, arms, hands, lower legs, or feet blood in the urine or stools blurred vision or other change in vision chest pain or discomfort chills cloudy urine confusion constipation cough coughing up blood decreased frequency or amount of urine depressed mood diarrhea difficulty with breathing or swallowing dilated neck veins dizziness, fainting, or lightheadedness when getting up suddenly from a lying or sitting position dry skin and hair feeling cold fever hair loss heavy jaw feeling hoarseness or husky voice increase in heart rate increased menstrual flow or vaginal bleeding loosening of a tooth lower back or side pain muscle cramps in the hands, arms, feet, legs, or face muscle stiffness nervousness nosebleeds numbness and tingling around the mouth, fingertips, or feet pain, swelling, or numbness in the mouth, or jaw painful or difficult urination pale skin paralysis pinpoint red spots on the skin pounding in the ears prolonged bleeding from cuts rapid or irregular breathing rapid weight gain red or black, tarry stools red or dark brown urine redness, swelling, or pain of the skin scaling of the skin on the hands and feet severe headache slow or fast heartbeat sore throat stomach pain and bloating swelling of the face, fingers, feet, or lower legs tingling of the hands or feet tremor ulceration of the skin ulcers, sores, or white spots in the mouth unusual bleeding or bruising unusual tiredness or weakness unusual weight gain or loss vomiting wrinkled skin Rare Clay-colored stools difficulty with speaking heartburn or indigestion inability to move the arms, legs, or facial muscles pain or discomfort in the arms, jaw, back, or neck severe stomach pain, cramping, or burning stomach tenderness vomiting of material that looks like coffee grounds yellow eyes or skin Abnormal small opening loss of appetite severe nausea or vomiting slow wound healing Belching change or loss of taste decreased weight dry mouth hair loss or thinning of the hair itching, skin rash muscle or joint pain swelling or inflammation of the mouth trouble sleeping voice changes Drug Interactions DRUG INTERACTION Abemaciclib Abemaciclib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Abrocitinib The serum concentration of Lenvatinib can be increased when it is combined with Abrocitinib. Acamprosate The excretion of Acamprosate can be decreased when combined with Lenvatinib. Acetaminophen The serum concentration of Acetaminophen can be increased when it is combined with Lenvatinib. Acrivastine The risk or severity of QTc prolongation can be increased when Acrivastine is combined with Lenvatinib. Acyclovir The excretion of Acyclovir can be decreased when combined with Lenvatinib. Adefovir dipivo The excretion of Adefovir dipivoxil can be decreased when combined with Lenvatinib. Adenosine The risk or severity of QTc prolongation can be increased when Adenosine is combined with Lenvatinib. Afatinib Afatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Ajmaline The risk or severity of QTc prolongation can be increased when Ajmaline is combined with Lenvatinib. Alectinib Alectinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Alfuzosin The risk or severity of QTc prolongation can be increased when Alfuzosin is combined with Lenvatinib. Alimemazine The risk or severity of QTc prolongation can be increased when Alimemazine is combined with Lenvatinib. Allopurinol The excretion of Allopurinol can be decreased when combined with Lenvatinib. Alprostadil The excretion of Alprostadil can be decreased when combined with Lenvatinib. Amantadine The serum concentration of Amantadine can be increased when it is combined with Lenvatinib. Ambrisentan The serum concentration of Lenvatinib can be increased when it is combined with Ambrisentan. Amifampridine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Amifampridine. Aminohippuric a The excretion of Aminohippuric acid can be decreased when combined with Lenvatinib. Amiodarone The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Amiodarone. Amisulpride The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Amisulpride. Amitriptyline The risk or severity of QTc prolongation can be increased when Amitriptyline is combined with Lenvatinib. Amodiaquine The risk or severity of QTc prolongation can be increased when Amodiaquine is combined with Lenvatinib. Amoxapine The risk or severity of QTc prolongation can be increased when Amoxapine is combined with Lenvatinib. Anagrelide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Anagrelide. Antazoline The risk or severity of QTc prolongation can be increased when Antazoline is combined with Lenvatinib. Apalutamide The serum concentration of Lenvatinib can be decreased when it is combined with Apalutamide. Apixaban The serum concentration of Lenvatinib can be increased when it is combined with Apixaban. Apomorphine The risk or severity of QTc prolongation can be increased when Apomorphine is combined with Lenvatinib. Arformoterol The risk or severity of QTc prolongation can be increased when Arformoterol is combined with Lenvatinib. Aripiprazole The risk or severity of QTc prolongation can be increased when Aripiprazole is combined with Lenvatinib. Aripiprazole lauroxil The risk or severity of QTc prolongation can be increased when Aripiprazole lauroxil is combined with Lenvatinib. Arsenic trioxide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Arsenic trioxide. Artemether The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Artemether. Articaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Articaine. Asciminib The serum concentration of Lenvatinib can be increased when it is combined with Asciminib. Asenapine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Asenapine. Astemizole The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Astemizole. Asunaprevir The serum concentration of Lenvatinib can be increased when it is combined with Asunaprevir. Atazanavir Lenvatinib may decrease the excretion rate of Atazanavir which could result in a higher serum level. Atenolol Lenvatinib may decrease the excretion rate of Atenolol which could result in a higher serum level. Atogepant The serum concentration of Atogepant can be increased when it is combined with Lenvatinib. Atomoxetine The risk or severity of QTc prolongation can be increased when Atomoxetine is combined with Lenvatinib. Atorvastatin Lenvatinib may decrease the excretion rate of Atorvastatin which could result in a higher serum level. Atropine Lenvatinib may decrease the excretion rate of Atropine which could result in a higher serum level. Avanafil Avanafil may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Avatrombopag Avatrombopag may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Avibactam The excretion of Avibactam can be decreased when combined with Lenvatinib. Axitinib The serum concentration of Axitinib can be increased when it is combined with Lenvatinib. Azatadine The risk or severity of QTc prolongation can be increased when Azatadine is combined with Lenvatinib. Azithromycin The risk or severity of QTc prolongation can be increased when Azithromycin is combined with Lenvatinib. Baricitinib The serum concentration of Baricitinib can be increased when it is combined with Lenvatinib. Beclomethasone d Beclomethasone dipropionate may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Bedaquiline The risk or severity of QTc prolongation can be increased when Bedaquiline is combined with Lenvatinib. Belantamab mafo Lenvatinib may decrease the excretion rate of Belantamab mafodotin which could result in a higher serum level. Belinostat The serum concentration of Lenvatinib can be increased when it is combined with Belinostat. Belumosudil Belumosudil may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Bendamustine The serum concentration of Bendamustine can be increased when it is combined with Lenvatinib. Benzatropine The risk or severity of QTc prolongation can be increased when Benzatropine is combined with Lenvatinib. Benzocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Benzocaine. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Benzyl alcohol. Benzylpenicillin The excretion of Benzylpenicillin can be decreased when combined with Lenvatinib. Bepridil The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Bepridil. Berotralstat The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Berotralstat. Betrixaban The serum concentration of Betrixaban can be increased when it is combined with Lenvatinib. Bilastine The risk or severity of QTc prolongation can be increased when Bilastine is combined with Lenvatinib. Binimetinib The serum concentration of Binimetinib can be increased when it is combined with Lenvatinib. Bisoprolol The serum concentration of Lenvatinib can be increased when it is combined with Bisoprolol. Bortezomib The serum concentration of Bortezomib can be increased when it is combined with Lenvatinib. Bosentan The risk or severity of liver damage can be increased when Bosentan is combined with Lenvatinib. Bosutinib The serum concentration of Bosutinib can be increased when it is combined with Lenvatinib. Brentuximab ve The serum concentration of Brentuximab vedotin can be increased when it is combined with Lenvatinib. Bretylium The risk or severity of QTc prolongation can be increased when Bretylium is combined with Lenvatinib. Brigatinib Brigatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Brincidofovir The serum concentration of Brincidofovir can be increased when it is combined with Lenvatinib. Brompheniram The risk or severity of QTc prolongation can be increased when Brompheniramine is combined with Lenvatinib. Buclizine The risk or severity of QTc prolongation can be increased when Buclizine is combined with Lenvatinib. Budesonide Lenvatinib may decrease the excretion rate of Budesonide which could result in a higher serum level. Bumetanide The excretion of Bumetanide can be decreased when combined with Lenvatinib. Bupivacaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Bupivacaine. Buprenorphine Buprenorphine may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Buserelin The risk or severity of QTc prolongation can be increased when Buserelin is combined with Lenvatinib. Butacaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Butacaine. Butamben The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Butamben. Butriptyline The risk or severity of QTc prolongation can be increased when Butriptyline is combined with Lenvatinib. Cabazitaxel Cabazitaxel may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Cabergoline The serum concentration of Cabergoline can be increased when it is combined with Lenvatinib. Caffeine Caffeine may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Canagliflozin The serum concentration of Lenvatinib can be increased when it is combined with Canagliflozin. Cannabidiol Cannabidiol may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Capmatinib The serum concentration of Lenvatinib can be increased when it is combined with Capmatinib. Capsaicin The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Capsaicin. Captopril The excretion of Captopril can be decreased when combined with Lenvatinib. Carbimazole The therapeutic efficacy of Carbimazole can be decreased when used in combination with Lenvatinib. Carbinoxamine The risk or severity of QTc prolongation can be increased when Carbinoxamine is combined with Lenvatinib. Carfilzomib The serum concentration of Lenvatinib can be increased when it is combined with Carfilzomib. Carvedilol The serum concentration of Lenvatinib can be increased when it is combined with Carvedilol. Caspofungin The excretion of Caspofungin can be decreased when combined with Lenvatinib. Cefaclor Lenvatinib may decrease the excretion rate of Cefaclor which could result in a higher serum level. Cefazolin The excretion of Cefazolin can be decreased when combined with Lenvatinib. You Might Also Read Bevacizumab; Uses, Dosage, Side Effects, Drug Interactions Cefdinir The excretion of Cefdinir can be decreased when combined with Lenvatinib. Cefotiam The excretion of Cefotiam can be decreased when combined with Lenvatinib. Ceftibuten The excretion of Ceftibuten can be decreased when combined with Lenvatinib. Ceftizoxime The excretion of Ceftizoxime can be decreased when combined with Lenvatinib. Celecoxib The risk or severity of liver damage can be increased when Celecoxib is combined with Lenvatinib. Celiprolol The risk or severity of QTc prolongation can be increased when Celiprolol is combined with Lenvatinib. Cephalexin The excretion of Cephalexin can be decreased when combined with Lenvatinib. Ceritinib The risk or severity of QTc prolongation can be increased when Ceritinib is combined with Lenvatinib. Cerivastatin Lenvatinib may decrease the excretion rate of Cerivastatin which could result in a higher serum level. Cetirizine The risk or severity of QTc prolongation can be increased when Cetirizine is combined with Lenvatinib. Chlorcyclizine The risk or severity of QTc prolongation can be increased when Chlorcyclizine is combined with Lenvatinib. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Chloroprocaine. Chloroquine The risk or severity of QTc prolongation can be increased when Chloroquine is combined with Lenvatinib. Chlorpheniramine The risk or severity of QTc prolongation can be increased when Chlorpheniramine is combined with Lenvatinib. Chlorpromazine The risk or severity of QTc prolongation can be increased when Chlorpromazine is combined with Lenvatinib. Chlorprothixene The risk or severity of QTc prolongation can be increased when Chlorprothixene is combined with Lenvatinib. Cholecystokinin The excretion of Cholecystokinin can be decreased when combined with Lenvatinib. Cholesterol Cholesterol may increase the excretion rate of Lenvatinib which could result in a lower serum level and potentially a reduction in efficacy. Cholic Acid Lenvatinib may decrease the excretion rate of Cholic Acid which could result in a higher serum level. Choline The serum concentration of Choline can be increased when it is combined with Lenvatinib. Choline salicylate The serum concentration of Choline salicylate can be increased when it is combined with Lenvatinib. Cidofovir The excretion of Cidofovir can be decreased when combined with Lenvatinib. Cilostazol The risk or severity of QTc prolongation can be increased when Cilostazol is combined with Lenvatinib. Cimetidine The excretion of Cimetidine can be decreased when combined with Lenvatinib. Cinchocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Cinchocaine. Cinnarizine The risk or severity of QTc prolongation can be increased when Cinnarizine is combined with Lenvatinib. Cinoxacin The risk or severity of QTc prolongation can be increased when Cinoxacin is combined with Lenvatinib. Ciprofloxacin The risk or severity of QTc prolongation can be increased when Ciprofloxacin is combined with Lenvatinib. Cisapride The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Cisapride. Cisplatin The serum concentration of Cisplatin can be increased when it is combined with Lenvatinib. Citalopram The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Citalopram. Clarithromycin Lenvatinib may decrease the excretion rate of Clarithromycin which could result in a higher serum level. Clemastine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Clemastine. Clobazam The serum concentration of Lenvatinib can be increased when it is combined with Clobazam. Clofarabine The serum concentration of Clofarabine can be increased when it is combined with Lenvatinib. Clofazimine Clofazimine may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Clomifene The serum concentration of Lenvatinib can be increased when it is combined with Clomifene. Clomipramine The risk or severity of QTc prolongation can be increased when Clomipramine is combined with Lenvatinib. Clozapine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Clozapine. Cobicistat Cobicistat may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Cobimetinib The serum concentration of Cobimetinib can be increased when it is combined with Lenvatinib. Cocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Cocaine. Colchicine The serum concentration of Lenvatinib can be increased when it is combined with Colchicine. Conivaptan The serum concentration of Lenvatinib can be increased when it is combined with Conivaptan. Conjugated estr The excretion of Conjugated estrogens can be decreased when combined with Lenvatinib. Copanlisib The serum concentration of Copanlisib can be increased when it is combined with Lenvatinib. Crizotinib The risk or severity of QTc prolongation can be increased when Crizotinib is combined with Lenvatinib. Curcumin The serum concentration of Lenvatinib can be increased when it is combined with Curcumin. Cyclizine The risk or severity of QTc prolongation can be increased when Cyclizine is combined with Lenvatinib. Cyclosporine Cyclosporine may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Cyproheptadine The risk or severity of QTc prolongation can be increased when Cyproheptadine is combined with Lenvatinib. Dabigatran etexilate The serum concentration of Lenvatinib can be increased when it is combined with Dabigatran etexilate. Dabrafenib Dabrafenib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Daclatasvir Daclatasvir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Dacomitinib Dacomitinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Dactinomycin The serum concentration of Dactinomycin can be increased when it is combined with Lenvatinib. Dalfampridine The serum concentration of Dalfampridine can be increased when it is combined with Lenvatinib. Daptomycin The serum concentration of Lenvatinib can be increased when it is combined with Daptomycin. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Lenvatinib. Darolutamide The serum concentration of Lenvatinib can be increased when it is combined with Darolutamide. Darunavir The serum concentration of Lenvatinib can be increased when it is combined with Darunavir. Dasabuvir Dasabuvir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Dasatinib Dasatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Daunorubicin Lenvatinib may decrease the excretion rate of Daunorubicin which could result in a higher serum level. Degarelix The risk or severity of QTc prolongation can be increased when Degarelix is combined with Lenvatinib. Delafloxacin The risk or severity of QTc prolongation can be increased when Delafloxacin is combined with Lenvatinib. Delamanid Lenvatinib may increase the QTc-prolonging activities of Delamanid. Desflurane The risk or severity of QTc prolongation can be increased when Desflurane is combined with Lenvatinib. Desipramine The risk or severity of QTc prolongation can be increased when Desipramine is combined with Lenvatinib. Desloratadine The risk or severity of QTc prolongation can be increased when Desloratadine is combined with Lenvatinib. Deutetrabenazine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Deutetrabenazine. Dexamethasone The excretion of Dexamethasone can be decreased when combined with Lenvatinib. Dexamethasone ace The excretion of Dexamethasone acetate can be decreased when combined with Lenvatinib. Dexbromphenirami The risk or severity of QTc prolongation can be increased when Dexbrompheniramine is combined with Lenvatinib. Dexchlorphenirami The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Dexchlorpheniramine maleate. Diclofenac Lenvatinib may decrease the excretion rate of Diclofenac which could result in a higher serum level. Didanosine The excretion of Didanosine can be decreased when combined with Lenvatinib. Diethylstilbestrol Lenvatinib may decrease the excretion rate of Diethylstilbestrol which could result in a higher serum level. Digitoxin The serum concentration of Digitoxin can be increased when it is combined with Lenvatinib. Digoxin Lenvatinib may decrease the excretion rate of Digoxin which could result in a higher serum level. Dihydroergocrist Lenvatinib may decrease the excretion rate of Dihydroergocristine which could result in a higher serum level. Diltiazem The risk or severity of QTc prolongation can be increased when Diltiazem is combined with Lenvatinib. Dimenhydrinate The risk or severity of QTc prolongation can be increased when Dimenhydrinate is combined with Lenvatinib. Dinoprostone The excretion of Dinoprostone can be decreased when combined with Lenvatinib. Diosmin The serum concentration of Lenvatinib can be increased when it is combined with Diosmin. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Diphenhydramine. Dipyridamole Lenvatinib may decrease the excretion rate of Dipyridamole which could result in a higher serum level. Disopyramide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Disopyramide. Disulfiram Lenvatinib may decrease the excretion rate of Disulfiram which could result in a higher serum level. Dofetilide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Dofetilide. Dolasetron The risk or severity of QTc prolongation can be increased when Dolasetron is combined with Lenvatinib. Dolutegravir The serum concentration of Lenvatinib can be increased when it is combined with Dolutegravir. Domperidone The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Domperidone. Dopamine The serum concentration of Dopamine can be increased when it is combined with Lenvatinib. Doripenem The excretion of Doripenem can be decreased when combined with Lenvatinib. Dosulepin The risk or severity of QTc prolongation can be increased when Dosulepin is combined with Lenvatinib. Doxepin The risk or severity of QTc prolongation can be increased when Doxepin is combined with Lenvatinib. Doxorubicin Lenvatinib may decrease the excretion rate of Doxorubicin which could result in a higher serum level. Doxylamine The risk or severity of QTc prolongation can be increased when Doxylamine is combined with Lenvatinib. Dronedarone The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Dronedarone. Droperidol The risk or severity of QTc prolongation can be increased when Droperidol is combined with Lenvatinib. Duvelisib The serum concentration of Duvelisib can be increased when it is combined with Lenvatinib. Dyclonine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Dyclonine. Ebastine The risk or severity of QTc prolongation can be increased when Ebastine is combined with Lenvatinib. Edoxaban The serum concentration of Lenvatinib can be increased when it is combined with Edoxaban. Efavirenz Lenvatinib may decrease the excretion rate of Efavirenz which could result in a higher serum level. Elacestrant The serum concentration of Lenvatinib can be increased when it is combined with Elacestrant. Elagolix The serum concentration of Lenvatinib can be increased when it is combined with Elagolix. Elbasvir Elbasvir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Eliglustat The serum concentration of Lenvatinib can be increased when it is combined with Eliglustat. Eltrombopag Eltrombopag may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Eluxadoline The serum concentration of Eluxadoline can be increased when it is combined with Lenvatinib. Emedastine The risk or severity of QTc prolongation can be increased when Emedastine is combined with Lenvatinib. Enalapril The excretion of Enalapril can be decreased when combined with Lenvatinib. Enasidenib Enasidenib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Encainide The risk or severity of QTc prolongation can be increased when Encainide is combined with Lenvatinib. Encorafenib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Encorafenib. Enfortumab vedo The serum concentration of Enfortumab vedotin can be increased when it is combined with Lenvatinib. Enoxacin The risk or severity of QTc prolongation can be increased when Enoxacin is combined with Lenvatinib. Entrectinib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Entrectinib. Epinastine The risk or severity of QTc prolongation can be increased when Epinastine is combined with Lenvatinib. Epinephrine The serum concentration of Epinephrine can be increased when it is combined with Lenvatinib. Erdafitinib The serum concentration of Lenvatinib can be increased when it is combined with Erdafitinib. Eribulin The risk or severity of QTc prolongation can be increased when Eribulin is combined with Lenvatinib. Erlotinib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Erlotinib. Ertugliflozin The serum concentration of Ertugliflozin can be increased when it is combined with Lenvatinib. Erythromycin Lenvatinib may decrease the excretion rate of Erythromycin which could result in a higher serum level. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Lenvatinib. Escitalopram The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Escitalopram. Esmolol The risk or severity of QTc prolongation can be increased when Esmolol is combined with Lenvatinib. Estradiol The excretion of Estradiol can be decreased when combined with Lenvatinib. Estradiol acetate Estradiol acetate may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Estradiol benzoate Estradiol benzoate may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Estradiol cypionate Estradiol cypionate may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Estradiol dienanth Estradiol dienanthate may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Estradiol valerate Estradiol valerate may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Ethinylestradiol The risk or severity of liver damage can be increased when Ethinylestradiol is combined with Lenvatinib. Ethosuximide The risk or severity of QTc prolongation can be increased when Ethosuximide is combined with Lenvatinib. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Etidocaine. Etoposide The serum concentration of Etoposide can be increased when it is combined with Lenvatinib. Everolimus The serum concentration of Lenvatinib can be increased when it is combined with Everolimus. Ezetimibe Lenvatinib may decrease the excretion rate of Ezetimibe which could result in a higher serum level. Ezogabine The risk or severity of QTc prolongation can be increased when Ezogabine is combined with Lenvatinib. Famotidine The excretion of Famotidine can be decreased when combined with Lenvatinib. Favipiravir The serum concentration of Lenvatinib can be increased when it is combined with Favipiravir. Febuxostat The excretion of Lenvatinib can be decreased when combined with Febuxostat. Fedratinib Fedratinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Felbamate The risk or severity of QTc prolongation can be increased when Felbamate is combined with Lenvatinib. Felodipine Lenvatinib may decrease the excretion rate of Felodipine which could result in a higher serum level. Fenofibrate Lenvatinib may decrease the excretion rate of Fenofibrate which could result in a higher serum level. Fexinidazole The risk or severity of adverse effects can be increased when Lenvatinib is combined with Fexinidazole. Fexofenadine The excretion of Fexofenadine can be decreased when combined with Lenvatinib. Flecainide The risk or severity of QTc prolongation can be increased when Flecainide is combined with Lenvatinib. Flibanserin The serum concentration of Lenvatinib can be increased when it is combined with Flibanserin. Flucloxacillin Lenvatinib may decrease the excretion rate of Flucloxacillin which could result in a higher serum level. Fluconazole The serum concentration of Lenvatinib can be increased when it is combined with Fluconazole. Fluorescein Lenvatinib may decrease the excretion rate of Fluorescein which could result in a higher serum level. Fluorouracil The risk or severity of QTc prolongation can be increased when Fluorouracil is combined with Lenvatinib. Fluoxetine The risk or severity of QTc prolongation can be increased when Fluoxetine is combined with Lenvatinib. Flupentixol The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Flupentixol. Fluspirilene The risk or severity of QTc prolongation can be increased when Fluspirilene is combined with Lenvatinib. Fluvastatin The excretion of Fluvastatin can be decreased when combined with Lenvatinib. Fluvoxamine Lenvatinib may decrease the excretion rate of Fluvoxamine which could result in a higher serum level. Follitropin The therapeutic efficacy of Follitropin can be decreased when used in combination with Lenvatinib. Formoterol The risk or severity of QTc prolongation can be increased when Formoterol is combined with Lenvatinib. Foscarnet The risk or severity of QTc prolongation can be increased when Foscarnet is combined with Lenvatinib. Fostamatinib Fostamatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Fostemsavir Fostemsavir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Fusidic acid Fusidic acid may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Futibatinib The serum concentration of Futibatinib can be increased when it is combined with Lenvatinib. Gadobenic acid The risk or severity of QTc prolongation can be increased when Gadobenic acid is combined with Lenvatinib. Gadoxetic acid The excretion of Gadoxetic acid can be decreased when combined with Lenvatinib. Galantamine The risk or severity of QTc prolongation can be increased when Galantamine is combined with Lenvatinib. Gatifloxacin The risk or severity of QTc prolongation can be increased when Gatifloxacin is combined with Lenvatinib. Gefitinib Gefitinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Gemcitabine The serum concentration of Gemcitabine can be increased when it is combined with Lenvatinib. Gemifloxacin The risk or severity of QTc prolongation can be increased when Gemifloxacin is combined with Lenvatinib. Gentamicin The serum concentration of Gentamicin can be increased when it is combined with Lenvatinib. Gilteritinib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Gilteritinib. Glasdegib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Glasdegib. Glecaprevir Glecaprevir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Glimepiride Lenvatinib may decrease the excretion rate of Glimepiride which could result in a higher serum level. Glipizide Lenvatinib may decrease the excretion rate of Glipizide which could result in a higher serum level. Glyburide Lenvatinib may decrease the excretion rate of Glyburide which could result in a higher serum level. Glycyrrhizic acid Lenvatinib may decrease the excretion rate of Glycyrrhizic acid which could result in a higher serum level. Goserelin The risk or severity of QTc prolongation can be increased when Goserelin is combined with Lenvatinib. Granisetron The risk or severity of QTc prolongation can be increased when Granisetron is combined with Lenvatinib. Grazoprevir Grazoprevir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Grepafloxacin The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Grepafloxacin. Halofantrine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Halofantrine. Haloperidol The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Haloperidol. Histamine The serum concentration of Histamine can be increased when it is combined with Lenvatinib. Histrelin The risk or severity of QTc prolongation can be increased when Histrelin is combined with Lenvatinib. Hydrochlorothiazide The excretion of Hydrochlorothiazide can be decreased when combined with Lenvatinib. Hydrocortisone The excretion of Hydrocortisone can be decreased when combined with Lenvatinib. Hydroxychloroquine The risk or severity of QTc prolongation can be increased when Hydroxychloroquine is combined with Lenvatinib. Hydroxyzine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Hydroxyzine. Hyoscyamine The risk or severity of QTc prolongation can be increased when Hyoscyamine is combined with Lenvatinib. Ibandronate The risk or severity of QTc prolongation can be increased when Ibandronate is combined with Lenvatinib. You Might Also Read Aceclofenac Contraindications, Warning, Pregnancy Ibutilide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Ibutilide. Idelalisib The serum concentration of Lenvatinib can be increased when it is combined with Idelalisib. Iloperidone The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Iloperidone. Imatinib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Imatinib. Imipramine The risk or severity of QTc prolongation can be increased when Imipramine is combined with Lenvatinib. Indacaterol The serum concentration of Lenvatinib can be increased when it is combined with Indacaterol. Indapamide The risk or severity of QTc prolongation can be increased when Indapamide is combined with Lenvatinib. Indinavir Lenvatinib may decrease the excretion rate of Indinavir which could result in a higher serum level. Indocyanine green Lenvatinib may decrease the excretion rate of Indocyanine green acid form which could result in a higher serum level. Indomethacin Lenvatinib may decrease the excretion rate of Indomethacin which could result in a higher serum level. Inotersen The risk or severity of QTc prolongation can be increased when Inotersen is combined with Lenvatinib. Inotuzumab ozo The serum concentration of Inotuzumab ozogamicin can be increased when it is combined with Lenvatinib. Isavuconazole The serum concentration of Lenvatinib can be increased when it is combined with Isavuconazole. Isavuconazonium The serum concentration of Lenvatinib can be increased when it is combined with Isavuconazonium. Isoflurane The risk or severity of QTc prolongation can be increased when Isoflurane is combined with Lenvatinib. Isradipine Lenvatinib may decrease the excretion rate of Isradipine which could result in a higher serum level. Istradefylline Istradefylline may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Itraconazole Itraconazole may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Ivabradine Ivabradine may increase the QTc-prolonging activities of Lenvatinib. Ivacaftor The serum concentration of Lenvatinib can be increased when it is combined with Ivacaftor. Ivosidenib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Ivosidenib. Ixabepilone The serum concentration of Lenvatinib can be increased when it is combined with Ixabepilone. Ketoconazole Lenvatinib may decrease the excretion rate of Ketoconazole which could result in a higher serum level. Lacidipine The risk or severity of QTc prolongation can be increased when Lacidipine is combined with Lenvatinib. Lamivudine The serum concentration of Lamivudine can be increased when it is combined with Lenvatinib. Lamotrigine The risk or severity of QTc prolongation can be increased when Lamotrigine is combined with Lenvatinib. Lansoprazole Lansoprazole may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Lapatinib The serum concentration of Lenvatinib can be increased when it is combined with Lapatinib. Larotrectinib The serum concentration of Larotrectinib can be increased when it is combined with Lenvatinib. Lasmiditan The serum concentration of Lenvatinib can be increased when it is combined with Lasmiditan. Ledipasvir Ledipasvir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Lefamulin Lefamulin may increase the QTc-prolonging activities of Lenvatinib. Lemborexant The serum concentration of Lemborexant can be increased when it is combined with Lenvatinib. Letermovir Letermovir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Leucovorin The excretion of Leucovorin can be decreased when combined with Lenvatinib. Leuprolide The risk or severity of QTc prolongation can be increased when Leuprolide is combined with Lenvatinib. Levacetylmetha The risk or severity of QTc prolongation can be increased when Levacetylmethadol is combined with Lenvatinib. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Levobupivacaine. Levocabastine The risk or severity of QTc prolongation can be increased when Levocabastine is combined with Lenvatinib. Levocarnitine The excretion of Levocarnitine can be decreased when combined with Lenvatinib. Levocetirizine The risk or severity of QTc prolongation can be increased when Levocetirizine is combined with Lenvatinib. Levofloxacin The risk or severity of QTc prolongation can be increased when Levofloxacin is combined with Lenvatinib. Levoketoconazole The serum concentration of Lenvatinib can be increased when it is combined with Levoketoconazole. Levomenthol The risk or severity of QTc prolongation can be increased when Levomenthol is combined with Lenvatinib. Levosalbutamol The excretion of Levosalbutamol can be decreased when combined with Lenvatinib. Levosimendan The risk or severity of QTc prolongation can be increased when Levosimendan is combined with Lenvatinib. Levothyroxine The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Lenvatinib. Lidocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Lidocaine. Lidoflazine The risk or severity of QTc prolongation can be increased when Lidoflazine is combined with Lenvatinib. Linagliptin The serum concentration of Lenvatinib can be increased when it is combined with Linagliptin. Liothyronine The therapeutic efficacy of Liothyronine can be decreased when used in combination with Lenvatinib. Liotrix The therapeutic efficacy of Liotrix can be decreased when used in combination with Lenvatinib. Lofexidine The risk or severity of QTc prolongation can be increased when Lofexidine is combined with Lenvatinib. Lomefloxacin The risk or severity of QTc prolongation can be increased when Lomefloxacin is combined with Lenvatinib. Lomitapide The serum concentration of Lenvatinib can be increased when it is combined with Lomitapide. Lonafarnib The serum concentration of Lenvatinib can be increased when it is combined with Lonafarnib. Loncastuximab The serum concentration of Loncastuximab tesirine can be increased when it is combined with Lenvatinib. Loperamide The risk or severity of QTc prolongation can be increased when Loperamide is combined with Lenvatinib. Lopinavir The serum concentration of Lenvatinib can be increased when it is combined with Lopinavir. Loratadine Lenvatinib may decrease the excretion rate of Loratadine which could result in a higher serum level. Losartan Lenvatinib may decrease the excretion rate of Losartan which could result in a higher serum level. Lovastatin Lenvatinib may decrease the excretion rate of Lovastatin which could result in a higher serum level. Loxapine The serum concentration of Lenvatinib can be increased when it is combined with Loxapine. Lumacaftor The serum concentration of Lenvatinib can be decreased when it is combined with Lumacaftor. Lumefantrine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Lumefantrine. Lurasidone The risk or severity of QTc prolongation can be increased when Lurasidone is combined with Lenvatinib. Lusutrombopag The serum concentration of Lusutrombopag can be increased when it is combined with Lenvatinib. Macimorelin The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Macimorelin. Mannitol The serum concentration of Lenvatinib can be increased when it is combined with Mannitol. Maprotiline The risk or severity of QTc prolongation can be increased when Maprotiline is combined with Lenvatinib. Maribavir Maribavir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Mefloquine The serum concentration of Lenvatinib can be increased when it is combined with Mefloquine. Meloxicam The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Meloxicam. Memantine The serum concentration of Memantine can be increased when it is combined with Lenvatinib. Mepivacaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Mepivacaine. Mepyramine The risk or severity of QTc prolongation can be increased when Mepyramine is combined with Lenvatinib. Mercaptopurine The excretion of Mercaptopurine can be decreased when combined with Lenvatinib. Mesalazine The excretion of Mesalazine can be decreased when combined with Lenvatinib. Mesoridazine The risk or severity of QTc prolongation can be increased when Mesoridazine is combined with Lenvatinib. Metformin The serum concentration of Metformin can be increased when it is combined with Lenvatinib. Methadone The risk or severity of QTc prolongation can be increased when Methadone is combined with Lenvatinib. Methimazole The therapeutic efficacy of Methimazole can be decreased when used in combination with Lenvatinib. Methotrexate The excretion of Methotrexate can be decreased when combined with Lenvatinib. Methotrimeprazine The risk or severity of QTc prolongation can be increased when Methotrimeprazine is combined with Lenvatinib. Methoxy p The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Lenvatinib. Methsuximide The risk or severity of QTc prolongation can be increased when Methsuximide is combined with Lenvatinib. Methylene blue The serum concentration of Lenvatinib can be increased when it is combined with Methylene blue. Metoclopramide The risk or severity of QTc prolongation can be increased when Metoclopramide is combined with Lenvatinib. Metronidazole The risk or severity of QTc prolongation can be increased when Metronidazole is combined with Lenvatinib. Mifepristone The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Mifepristone. Mirabegron The serum concentration of Lenvatinib can be increased when it is combined with Mirabegron. Mirtazapine The risk or severity of QTc prolongation can be increased when Mirtazapine is combined with Lenvatinib. Mitapivat The serum concentration of Lenvatinib can be increased when it is combined with Mitapivat. Mizolastine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Mizolastine. Mobocertinib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Mobocertinib. Moexipril The risk or severity of QTc prolongation can be increased when Moexipril is combined with Lenvatinib. Moricizine The risk or severity of QTc prolongation can be increased when Moricizine is combined with Lenvatinib. Morphine The serum concentration of Lenvatinib can be increased when it is combined with Morphine. Moxifloxacin The risk or severity of QTc prolongation can be increased when Moxifloxacin is combined with Lenvatinib. Mycophenolate The excretion of Mycophenolate mofetil can be decreased when combined with Lenvatinib. Nalidixic acid The risk or severity of QTc prolongation can be increased when Nalidixic acid is combined with Lenvatinib. Naproxen Lenvatinib may decrease the excretion rate of Naproxen which could result in a higher serum level. Nefazodone Lenvatinib may decrease the excretion rate of Nefazodone which could result in a higher serum level. Nelfinavir Lenvatinib may decrease the excretion rate of Nelfinavir which could result in a higher serum level. Neratinib The serum concentration of Lenvatinib can be increased when it is combined with Neratinib. Netupitant The serum concentration of Lenvatinib can be increased when it is combined with Netupitant. Nicardipine Lenvatinib may decrease the excretion rate of Nicardipine which could result in a higher serum level. Nifedipine Lenvatinib may decrease the excretion rate of Nifedipine which could result in a higher serum level. Nilotinib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Nilotinib. Nilvadipine The risk or severity of QTc prolongation can be increased when Nilvadipine is combined with Lenvatinib. Nimodipine The risk or severity of QTc prolongation can be increased when Nimodipine is combined with Lenvatinib. Nintedanib The serum concentration of Nintedanib can be increased when it is combined with Lenvatinib. Nitrendipine Lenvatinib may decrease the excretion rate of Nitrendipine which could result in a higher serum level. Nitrofurantoin Lenvatinib may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level. Norepinephrine The serum concentration of Norepinephrine can be increased when it is combined with Lenvatinib. Norfloxacin The risk or severity of QTc prolongation can be increased when Norfloxacin is combined with Lenvatinib. Norgestimate The serum concentration of Lenvatinib can be increased when it is combined with Norgestimate. Nortriptyline The serum concentration of Nortriptyline can be increased when it is combined with Lenvatinib. Novobiocin Novobiocin may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Obeticholic acid The risk or severity of adverse effects can be increased when Lenvatinib is combined with Obeticholic acid. Octreotide The risk or severity of QTc prolongation can be increased when Octreotide is combined with Lenvatinib. Ofloxacin Lenvatinib may decrease the excretion rate of Ofloxacin which could result in a higher serum level. Olanzapine The risk or severity of QTc prolongation can be increased when Olanzapine is combined with Lenvatinib. Olmesartan The risk or severity of liver damage can be increased when Olmesartan is combined with Lenvatinib. Olodaterol The risk or severity of QTc prolongation can be increased when Olodaterol is combined with Lenvatinib. Omadacycline The serum concentration of Omadacycline can be increased when it is combined with Lenvatinib. Ombitasvir The serum concentration of Ombitasvir can be increased when it is combined with Lenvatinib. Ondansetron The risk or severity of QTc prolongation can be increased when Ondansetron is combined with Lenvatinib. Orphenadrine The risk or severity of QTc prolongation can be increased when Orphenadrine is combined with Lenvatinib. Oseltamivir The excretion of Oseltamivir can be decreased when combined with Lenvatinib. Osimertinib Osimertinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Oteseconazole The serum concentration of Lenvatinib can be increased when it is combined with Oteseconazole. Ouabain The excretion of Ouabain can be decreased when combined with Lenvatinib. Oxaliplatin The serum concentration of Oxaliplatin can be increased when it is combined with Lenvatinib. Oxatomide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Oxatomide. Oxetacaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Oxetacaine. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Oxybuprocaine. Oxytetracycline The excretion of Oxytetracycline can be decreased when combined with Lenvatinib. Oxytocin The risk or severity of QTc prolongation can be increased when Oxytocin is combined with Lenvatinib. Paclitaxel Lenvatinib may decrease the excretion rate of Paclitaxel which could result in a higher serum level. Pacritinib The serum concentration of Lenvatinib can be increased when it is combined with Pacritinib. Palbociclib Palbociclib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Paliperidone The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Paliperidone. Panobinostat The risk or severity of QTc prolongation can be increased when Panobinostat is combined with Lenvatinib. Pantoprazole Pantoprazole may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Papaverine The risk or severity of QTc prolongation can be increased when Papaverine is combined with Lenvatinib. Parathyroid hormo The therapeutic efficacy of Parathyroid hormone can be decreased when used in combination with Lenvatinib. Paritaprevir Paritaprevir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Pasireotide The risk or severity of QTc prolongation can be increased when Pasireotide is combined with Lenvatinib. Pazopanib The risk or severity of QTc prolongation can be increased when Pazopanib is combined with Lenvatinib. Pefloxacin The risk or severity of QTc prolongation can be increased when Pefloxacin is combined with Lenvatinib. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Lenvatinib. Pemetrexed Lenvatinib may decrease the excretion rate of Pemetrexed which could result in a higher serum level. Penicillamine The excretion of Penicillamine can be decreased when combined with Lenvatinib. Pentamidine The risk or severity of QTc prolongation can be increased when Pentamidine is combined with Lenvatinib. Perflutren The risk or severity of QTc prolongation can be increased when Perflutren is combined with Lenvatinib. Perhexiline The risk or severity of QTc prolongation can be increased when Perhexiline is combined with Lenvatinib. Pheniramine The risk or severity of QTc prolongation can be increased when Pheniramine is combined with Lenvatinib. Phenol The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Phenol. Pibrentasvir Pibrentasvir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Pimozide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Pimozide. Pinaverium The risk or severity of QTc prolongation can be increased when Pinaverium is combined with Lenvatinib. Piperacillin The excretion of Piperacillin can be decreased when combined with Lenvatinib. Pitavastatin Lenvatinib may decrease the excretion rate of Pitavastatin which could result in a higher serum level. Pitolisant Lenvatinib may increase the QTc-prolonging activities of Pitolisant. Polythiazide The excretion of Polythiazide can be decreased when combined with Lenvatinib. Pomalidomide The serum concentration of Pomalidomide can be increased when it is combined with Lenvatinib. Ponatinib Ponatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Ponesimod The risk or severity of bradycardia can be increased when Ponesimod is combined with Lenvatinib. Posaconazole The serum concentration of Lenvatinib can be increased when it is combined with Posaconazole. Potassium Iodide The therapeutic efficacy of Potassium Iodide can be decreased when used in combination with Lenvatinib. Potassium perchlor The therapeutic efficacy of Potassium perchlorate can be decreased when used in combination with Lenvatinib. Pralsetinib Pralsetinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Pramipexole The serum concentration of Pramipexole can be increased when it is combined with Lenvatinib. Pramocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Pramocaine. Pravastatin Lenvatinib may decrease the excretion rate of Pravastatin which could result in a higher serum level. Prazosin The serum concentration of Prazosin can be increased when it is combined with Lenvatinib. Prednisolone phe The excretion of Prednisolone phosphate can be decreased when combined with Lenvatinib. Pregabalin The risk or severity of QTc prolongation can be increased when Pregabalin is combined with Lenvatinib. Prenylamine The risk or severity of QTc prolongation can be increased when Prenylamine is combined with Lenvatinib. Pretomanid The serum concentration of Lenvatinib can be increased when it is combined with Pretomanid. Prilocaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Prilocaine. Primaquine The risk or severity of QTc prolongation can be increased when Primaquine is combined with Lenvatinib. Probucol The risk or severity of QTc prolongation can be increased when Probucol is combined with Lenvatinib. Procainamide The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Procainamide. Procaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Procaine. Prochlorperazine The risk or severity of QTc prolongation can be increased when Prochlorperazine is combined with Lenvatinib. Progesterone Progesterone may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Promazine The risk or severity of QTc prolongation can be increased when Promazine is combined with Lenvatinib. Promethazine The risk or severity of QTc prolongation can be increased when Promethazine is combined with Lenvatinib. Propafenone The risk or severity of QTc prolongation can be increased when Propafenone is combined with Lenvatinib. Proparacaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Proparacaine. Propofol The risk or severity of QTc prolongation can be increased when Propofol is combined with Lenvatinib. Propoxycaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Propoxycaine. Propylthiouracil The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Lenvatinib. Protirelin The therapeutic efficacy of Protirelin can be decreased when used in combination with Lenvatinib. Protriptyline The risk or severity of QTc prolongation can be increased when Protriptyline is combined with Lenvatinib. Quetiapine The risk or severity of QTc prolongation can be increased when Quetiapine is combined with Lenvatinib. Quinapril The excretion of Quinapril can be decreased when combined with Lenvatinib. Quinidine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Quinidine. Quinine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Quinine. Rabeprazole Rabeprazole may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Raloxifene The excretion of Raloxifene can be decreased when combined with Lenvatinib. Ranitidine The excretion of Ranitidine can be decreased when combined with Lenvatinib. Ranolazine The serum concentration of Lenvatinib can be increased when it is combined with Ranolazine. Regorafenib Regorafenib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Relebactam The excretion of Relebactam can be decreased when combined with Lenvatinib. Relugolix The serum concentration of Relugolix can be increased when it is combined with Lenvatinib. Repaglinide Lenvatinib may decrease the excretion rate of Repaglinide which could result in a higher serum level. Reserpine The serum concentration of Lenvatinib can be increased when it is combined with Reserpine. Revefenacin Lenvatinib may decrease the excretion rate of Revefenacin which could result in a higher serum level. Ribociclib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Ribociclib. Rifampicin The risk or severity of liver damage can be increased when Rifampicin is combined with Lenvatinib. Rifamycin The serum concentration of Lenvatinib can be increased when it is combined with Rifamycin. Rilpivirine Rilpivirine may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Rimegepant The serum concentration of Rimegepant can be increased when it is combined with Lenvatinib. Riociguat The serum concentration of Lenvatinib can be increased when it is combined with Riociguat. Ripretinib Ripretinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Risperidone The risk or severity of QTc prolongation can be increased when Risperidone is combined with Lenvatinib. Ritonavir Lenvatinib may decrease the excretion rate of Ritonavir which could result in a higher serum level. Rivaroxaban The serum concentration of Lenvatinib can be increased when it is combined with Rivaroxaban. Rolapitant Rolapitant may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Romidepsin The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Romidepsin. Ropivacaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Ropivacaine. Rosiglitazone Lenvatinib may decrease the excretion rate of Rosiglitazone which could result in a higher serum level. Rosoxacin The risk or severity of QTc prolongation can be increased when Rosoxacin is combined with Lenvatinib. Rosuvastatin Lenvatinib may decrease the excretion rate of Rosuvastatin which could result in a higher serum level. Roxadustat The serum concentration of Lenvatinib can be increased when it is combined with Roxadustat. Roxithromycin The risk or severity of QTc prolongation can be increased when Roxithromycin is combined with Lenvatinib. Rucaparib Rucaparib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Rupatadine The risk or severity of QTc prolongation can be increased when Rupatadine is combined with Lenvatinib. Safinamide Safinamide may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Salbutamol The risk or severity of QTc prolongation can be increased when Salbutamol is combined with Lenvatinib. Salmeterol The risk or severity of QTc prolongation can be increased when Salmeterol is combined with Lenvatinib. Salmon calcitonin The therapeutic efficacy of Salmon calcitonin can be decreased when used in combination with Lenvatinib. Sapropterin The serum concentration of Lenvatinib can be increased when it is combined with Sapropterin. Saquinavir Lenvatinib may decrease the excretion rate of Saquinavir which could result in a higher serum level. Sarecycline The serum concentration of Lenvatinib can be increased when it is combined with Sarecycline. Saxagliptin The excretion of Saxagliptin can be decreased when combined with Lenvatinib. Selexipag The serum concentration of Selexipag can be increased when it is combined with Lenvatinib. Selumetinib The serum concentration of Selumetinib can be increased when it is combined with Lenvatinib. Sevoflurane The risk or severity of QTc prolongation can be increased when Sevoflurane is combined with Lenvatinib. Sildenafil The serum concentration of Lenvatinib can be increased when it is combined with Sildenafil. Silodosin The serum concentration of Lenvatinib can be increased when it is combined with Silodosin. Simeprevir Simeprevir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Simvastatin Lenvatinib may decrease the excretion rate of Simvastatin which could result in a higher serum level. Sirolimus The serum concentration of Sirolimus can be increased when it is combined with Lenvatinib. Sitagliptin The excretion of Sitagliptin can be decreased when combined with Lenvatinib. Sofosbuvir The serum concentration of Lenvatinib can be increased when it is combined with Sofosbuvir. Solifenacin The risk or severity of QTc prolongation can be increased when Solifenacin is combined with Lenvatinib. Solriamfetol The serum concentration of Solriamfetol can be increased when it is combined with Lenvatinib. Sorafenib The serum concentration of Lenvatinib can be increased when it is combined with Sorafenib. Sotagliflozin Sotagliflozin may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Sotalol The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Sotalol. Sotorasib The serum concentration of Lenvatinib can be increased when it is combined with Sotorasib. Sparfloxacin The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Sparfloxacin. Spironolactone Lenvatinib may decrease the excretion rate of Spironolactone which could result in a higher serum level. Stavudine The excretion of Stavudine can be decreased when combined with Lenvatinib. Stiripentol The excretion of Lenvatinib can be decreased when combined with Stiripentol. Succinic acid The excretion of Succinic acid can be decreased when combined with Lenvatinib. Sulfamethoxazole Lenvatinib may decrease the excretion rate of Sulfamethoxazole which could result in a higher serum level. Sulfasalazine Sulfasalazine may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Sulfinpyrazone Lenvatinib may decrease the excretion rate of Sulfinpyrazone which could result in a higher serum level. Sulfisoxazole The risk or severity of QTc prolongation can be increased when Sulfisoxazole is combined with Lenvatinib. Sulpiride The risk or severity of QTc prolongation can be increased when Sulpiride is combined with Lenvatinib. Sultopride The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Sultopride. Sumatriptan The excretion of Sumatriptan can be decreased when combined with Lenvatinib. Sunitinib Sunitinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Suvorexant The serum concentration of Lenvatinib can be increased when it is combined with Suvorexant. Tacrolimus The serum concentration of Lenvatinib can be increased when it is combined with Tacrolimus. Tafamidis The serum concentration of Lenvatinib can be increased when it is combined with Tafamidis. Talazoparib The serum concentration of Talazoparib can be increased when it is combined with Lenvatinib. Tamoxifen The serum concentration of Lenvatinib can be increased when it is combined with Tamoxifen. Taurocholic acid Lenvatinib may decrease the excretion rate of Taurocholic acid which could result in a higher serum level. Tazemetostat The serum concentration of Tazemetostat can be increased when it is combined with Lenvatinib. Tazobactam The excretion of Tazobactam can be decreased when combined with Lenvatinib. Technetium Tc The excretion of Technetium Tc-99m mebrofenin can be decreased when combined with Lenvatinib. Technetium T The serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Lenvatinib. Tegaserod The serum concentration of Lenvatinib can be increased when it is combined with Tegaserod. Telaprevir The serum concentration of Lenvatinib can be increased when it is combined with Telaprevir. Telavancin The risk or severity of QTc prolongation can be increased when Telavancin is combined with Lenvatinib. Telithromycin The risk or severity of QTc prolongation can be increased when Telithromycin is combined with Lenvatinib. Telmisartan Lenvatinib may decrease the excretion rate of Telmisartan which could result in a higher serum level. Temsirolimus The serum concentration of Lenvatinib can be increased when it is combined with Temsirolimus. Tenofovir alafena The excretion of Tenofovir alafenamide can be decreased when combined with Lenvatinib. Tenofovir disoproxil The excretion of Tenofovir disoproxil can be decreased when combined with Lenvatinib. Tepotinib The serum concentration of Lenvatinib can be increased when it is combined with Tepotinib. Terbutaline The risk or severity of QTc prolongation can be increased when Terbutaline is combined with Lenvatinib. Terfenadine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Terfenadine. Teriflunomide Teriflunomide may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Teriparatide The therapeutic efficacy of Teriparatide can be decreased when used in combination with Lenvatinib. Terlipressin The risk or severity of QTc prolongation can be increased when Terlipressin is combined with Lenvatinib. Tetrabenazine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Tetrabenazine. Tetracaine The risk or severity of methemoglobinemia can be increased when Lenvatinib is combined with Tetracaine. Tetracycline The excretion of Tetracycline can be decreased when combined with Lenvatinib. Tezacaftor The serum concentration of Tezacaftor can be increased when it is combined with Lenvatinib. Thioridazine The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Thioridazine. Thiothixene The risk or severity of QTc prolongation can be increased when Thiothixene is combined with Lenvatinib. Thyroid, porcine The therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Lenvatinib. Thyrotropin alfa The therapeutic efficacy of Thyrotropin alfa can be decreased when used in combination with Lenvatinib. You Might Also Read Avanafil Indications Contraindications, Warning Ticagrelor The serum concentration of Lenvatinib can be increased when it is combined with Ticagrelor. Timolol The risk or severity of QTc prolongation can be increased when Timolol is combined with Lenvatinib. Tinidazole Lenvatinib may decrease the excretion rate of Tinidazole which could result in a higher serum level. Tipiracil The excretion of Tipiracil can be decreased when combined with Lenvatinib. Tipranavir Lenvatinib may decrease the excretion rate of Tipranavir which could result in a higher serum level. Tivozanib Tivozanib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Tizanidine The risk or severity of QTc prolongation can be increased when Tizanidine is combined with Lenvatinib. Tolterodine The risk or severity of QTc prolongation can be increased when Tolterodine is combined with Lenvatinib. Tolvaptan The serum concentration of Tolvaptan can be increased when it is combined with Lenvatinib. Topotecan The serum concentration of Topotecan can be increased when it is combined with Lenvatinib. Torasemide The excretion of Torasemide can be decreased when combined with Lenvatinib. Toremifene The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Toremifene. Trastuzumab emtan The serum concentration of Trastuzumab emtansine can be increased when it is combined with Lenvatinib. Trazodone The risk or severity of QTc prolongation can be increased when Trazodone is combined with Lenvatinib. Treprostinil The risk or severity of QTc prolongation can be increased when Treprostinil is combined with Lenvatinib. Triclabendazole The risk or severity of QTc prolongation can be increased when Triclabendazole is combined with Lenvatinib. Trifluridine The excretion of Trifluridine can be decreased when combined with Lenvatinib. Trilaciclib The serum concentration of Trilaciclib can be increased when it is combined with Lenvatinib. Trimebutine The risk or severity of QTc prolongation can be increased when Trimebutine is combined with Lenvatinib. Trimethadione The risk or severity of QTc prolongation can be increased when Trimethadione is combined with Lenvatinib. Trimipramine The serum concentration of Trimipramine can be increased when it is combined with Lenvatinib. Triprolidine The risk or severity of QTc prolongation can be increased when Triprolidine is combined with Lenvatinib. Triptorelin The risk or severity of QTc prolongation can be increased when Triptorelin is combined with Lenvatinib. Troglitazone The risk or severity of liver damage can be increased when Troglitazone is combined with Lenvatinib. Trovafloxacin The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Trovafloxacin. Tucatinib Tucatinib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Ubrogepant The serum concentration of Ubrogepant can be increased when it is combined with Lenvatinib. Umbralisib The serum concentration of Lenvatinib can be increased when it is combined with Umbralisib. Umeclidinium The serum concentration of Lenvatinib can be increased when it is combined with Umeclidinium. Ursodeoxycholic Lenvatinib may decrease the excretion rate of Ursodeoxycholic acid which could result in a higher serum level. Valaciclovir The excretion of Valaciclovir can be decreased when combined with Lenvatinib. Valproic acid The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Valproic acid. Valsartan The excretion of Valsartan can be decreased when combined with Lenvatinib. Vandetanib The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Vandetanib. Vardenafil The serum concentration of Lenvatinib can be increased when it is combined with Vardenafil. Varenicline The excretion of Varenicline can be decreased when combined with Lenvatinib. Velpatasvir Velpatasvir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Vemurafenib The serum concentration of Lenvatinib can be increased when it is combined with Vemurafenib. Venetoclax Venetoclax may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Venlafaxine Venlafaxine may increase the excretion rate of Lenvatinib which could result in a lower serum level and potentially a reduction in efficacy. Verapamil The serum concentration of Lenvatinib can be increased when it is combined with Verapamil. Vernakalant The risk or severity of QTc prolongation can be increased when Vernakalant is combined with Lenvatinib. Vilanterol The risk or severity of QTc prolongation can be increased when Vilanterol is combined with Lenvatinib. Vinblastine Lenvatinib may decrease the excretion rate of Vinblastine which could result in a higher serum level. Vincristine Lenvatinib may decrease the excretion rate of Vincristine which could result in a higher serum level. Vinflunine The serum concentration of Vinflunine can be increased when it is combined with Lenvatinib. Vismodegib Vismodegib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Voclosporin The serum concentration of Lenvatinib can be increased when it is combined with Voclosporin. Vorapaxar The serum concentration of Lenvatinib can be increased when it is combined with Vorapaxar. Voriconazole The serum concentration of Lenvatinib can be increased when it is combined with Voriconazole. Vorinostat The risk or severity of QTc prolongation can be increased when Vorinostat is combined with Lenvatinib. Voxilaprevir Voxilaprevir may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Zalcitabine The excretion of Zalcitabine can be decreased when combined with Lenvatinib. Zidovudine The excretion of Zidovudine can be decreased when combined with Lenvatinib. Ziprasidone The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Ziprasidone. Zonisamide The serum concentration of Lenvatinib can be increased when it is combined with Zonisamide. Zuclopenthixol The risk or severity of QTc prolongation can be increased when Lenvatinib is combined with Zuclopenthixol Pregnancy and Lactation AU TGA pregnancy category: D US FDA pregnancy category: Not assigned. Pregnancy Based on its mechanism of action and data from animal reproduction studies, LENVIMA can cause fetal harm when administered to a pregnant woman. In animal reproduction studies, oral administration of lenvatinib during organogenesis at doses below the recommended human doses resulted in embryotoxicity, fetotoxicity, and teratogenicity in rats and rabbits (see Data). There are no available human data informing the drug-associated risk. Advise pregnant women of the potential risk to a fetus. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Lactation No information is available on the clinical use of lenvatinib during breastfeeding. Because lenvatinib is more than 98% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is about 28 hours and it might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during lenvatinib therapy and for at least 1 week after the last dose. Why is this medication prescribed? Lenvatinib is used to treat a certain type of thyroid cancer that has returned or that has spread to other parts of the body and cannot be treated with radioactive iodine. Lenvatinib is also used along with everolimus (Afinitor, Zortress) to treat renal cell carcinoma (RCC, a type of cancer that begins in the kidney) in people who have previously received treatment with another chemotherapy medication. Lenvatinib is also used along with pembrolizumab (Keytruda) as an initial treatment for advanced renal cell carcinoma. Lenvatinib is also used to treat hepatocellular carcinoma (HCC; a type of liver cancer) that cannot be treated with surgery. Lenvatinib is also used along with pembrolizumab (Keytruda) to treat a certain type of cancer of the endometrium (lining of the uterus) that has spread to other parts of the body or worsened during or after treatment with chemotherapy medications or that cannot be treated with surgery or radiation therapy. Lenvatinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps stop the spread of cancer cells. How should this medicine be used? Lenvatinib comes as a capsule to take by mouth. It is usually taken once daily with or without food. Take lenvatinib at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lenvatinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the capsules whole; do not open, chew, or crush them. If you are unable to swallow the capsules, put them into a small glass and add about one tablespoon of water or apple juice. Do not break or crush the capsules. Leave the capsules in the liquid for at least 10 minutes and then stir the contents for at least 3 minutes. Drink the mixture. After drinking the mixture, add another 1 tablespoon of water or apple juice to the glass. Swirl the contents a few times and swallow the mixture. Your doctor may decrease your dose of lenvatinib or tell you to stop taking the medication for a time or permanently if you experience serious side effects. Be sure to talk to your doctor about how you are feeling during your treatment with lenvatinib. The length of your treatment depends on how well you respond to the medication and the side effects you experience. Continue to take lenvatinib even if you feel well. Do not stop taking lenvatinib without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow? Before taking lenvatinib, tell your doctor and pharmacist if you are allergic to lenvatinib, any other medications, or any of the ingredients in lenvatinib capsules. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain medications for irregular heartbeat including amiodarone (Nexterone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), procainamide, quinidine (in Nuedexta), and sotalol (Betapace, Betapace AF, Sorine, Sotylize), ketoconazole, or rifampin (Rifadin,Rimactane). Also tell your doctor if you are taking or have taken alendronate (Binosto, Fosamax), denosumab (Prolia, Xgeva), ibandronate (Boniva), pamidronate, romosozumab-aqqg (Evenity), risedronate (Actonel, Atelvia), or zoledronic acid injection (Reclast, Zometa). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had seizures; high blood pressure; a stroke; a heart attack; headaches; changes in vision, especially those due to blood clots; a fistula (abnormal connection between 2 organs inside your body or between an organ and the outside of your body); a tear in the wall of your stomach or intestine; QT interval prolongation (an irregular heart rhythm that can lead to fainting, loss of consciousness, seizures, or sudden death); heart failure; low levels of calcium, potassium, or magnesium in your blood; bleeding problems; problems with your mouth, teeth, or gums; thyroid problems; or heart, kidney, or liver disease. Also tell your doctor if you have severe diarrhea or vomiting or you think you may be dehydrated. you should know that lenvatinib may decrease fertility in men and women. However, you should not assume that you or your partner cannot become pregnant. Tell your doctor if you are pregnant or plan to become pregnant. You will need to have a pregnancy test before you begin treatment with lenvatinib. If you can become pregnant, you should use birth control during your treatment with lenvatinib and for at least 30 days after your final dose. If you become pregnant while you are taking lenvatinib, call your doctor immediately. Lenvatinib may harm the fetus. tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while taking lenvatinib tell your doctor if you are planning to have any surgery, including dental surgery. Your doctor will probably tell you to stop your treatment with lenvatinib at least 7 days before your scheduled surgery because it can affect wound healing. Your doctor will tell you when to start taking lenvatinib again after your surgery. you should know that your blood pressure may increase during your treatment with lenvatinib. Your doctor will probably monitor your blood pressure during your treatment. you should know that lenvatinib may cause osteonecrosis of the jaw (ONJ, a serious condition of the jaw bone), especially if you have dental surgery or treatment while you are taking the medication. A dentist should examine your teeth and perform any needed treatments, including cleaning or fixing ill-fitted dentures, before you start to take lenvatinib. Be sure to brush your teeth and clean your mouth properly while you are taking lenvatinib. Tell your doctor or dentist if you have or have had mouth, teeth, or jaw pain; mouth sores or swelling; numbness or a feeling of heaviness in the jaw; or any loose teeth. Talk to your doctor before having any dental treatments while you are taking this medication. Your doctor will probably tell you to stop your treatment with lenvatinib at least 7 days before your scheduled dental procedure. What special dietary instructions should I follow? Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose? If your next dose is due in 12 hours or more, take the missed dose as soon as you remember it. However, if the next dose will be taken in less than 12 hours, skip the missed dose and continue your regular dosing schedule. 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