Axitinib (Inlyta)

Axitinib is a targeted cancer drug. It is pronounced ak-sih-tih-nib. It is also called Inlyta.

It is a treatment for kidney cancer that has spread (advanced kidney cancer). You usually have it when other treatment (such as sunitinib) is no longer working. Some people may have it as a first treatment for advanced kidney cancer with a type of immunotherapy drug.

Or you might have it as part of a clinical trial for other types of cancer.

How does axitinib work?

Axitinib is a type of cancer growth blocker called a tyrosine kinase inhibitor (TKI).

Tyrosine kinase inhibitors work by blocking certain proteins (called tyrosine kinases) from acting on cells. Tyrosine kinases signal to cancer cells to grow.

Axitinib blocks different types of tyrosine kinase and is called a multi kinase inhibitor. As well as slowing down the growth of cancer cells it also stops cancer cells forming blood vessels, which the cancer needs to be able to grow. This is called anti angiogenesis treatment.

How do you take axitinib?

Axitinib is a red tablet. You swallow it whole with a glass of water. You can take axitinib with or without food.

Taking your tablets

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug, or if you miss a dose.

How often do you have axitinib?

You take axitinib tablets twice a day, about 12 hours apart. Your doctor may increase or decrease the dose, depending on how you feel.

You usually take axitinib for as long as it is working and you don’t have too many side effects.

Tests

You might have blood tests before starting treatment and during your treatment. They check your general health and might check your levels of blood cells and other substances in the blood.

What are the side effects of axitinib?

Side effects can vary from person to person. They also depend on what other treatment you are having. 

When to contact your team

Your doctor, nurse, or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Diarrhoea or constipation

Tell your healthcare team if you have diarrhoea or constipation. They can give you medicine to help. 

High blood pressure (hypertension)

Tell your doctor or nurse if you have headaches, nosebleeds, blurred or double vision or shortness of breath. You have your blood pressure checked regularly.

You might have medication to help control your blood pressure.

Tiredness and weakness

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Loss of appetite and weight loss

You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss. 

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Changes to your voice (hoarseness)

Your voice might sound husky or croaky and sound weaker. 

Redness and swelling of palms and soles of feet (hand foot syndrome)

The skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.

Moisturise your skin regularly. Your healthcare team will tell you what moisturiser to use.

Increased risk of bleeding

This might be due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds, bleeding gums after brushing your teeth, or blood in your urine. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Changes in thyroid hormones

The level of your thyroid hormones may drop (hypothyroidism). You may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen. You will have regular blood tests to check your thyroid hormone levels.

Less commonly the level of your thyroid hormones might increase (hyperthyroidism).

You might have medicines to control your thyroid hormone level.

Protein in your urine

Small amounts of protein in your urine may be found when your nurse tests your urine. This usually goes away on its own. If there are large amounts of protein you may have tests to check how well your kidneys are working.

Difficulty breathing or a cough

You may have shortness of breath or a cough. Let your doctor or nurse know if you have these symptoms.

Headaches

Tell your healthcare team if you keep getting headaches. They can give you painkillers to help.

Loss of taste

Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually returns to normal a few weeks after your treatment finishes.

Tummy (abdominal) pain

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Indigestion and heartburn

Contact your doctor or pharmacist if you have indigestion or heartburn. They can prescribe medicines to help.

Sore mouth and throat

It may be painful to swallow drinks or food. Painkillers and mouth washes can help to reduce the soreness and keep your mouth healthy. 

Rash or dry skin

Skin problems include a skin rash, dry skin and itching. Talk to your doctor or nurse about this as they might be able to help if it becomes too bad.

Pain in the joints, hands and feet

You might get pain in your joints, hands or feet. Talk to your doctor or nurse, or contact the hospital advice line to find out how to ease the pain. 

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• a rise or a drop in the number of red blood cells - you have regular blood tests during treatment to check this
• not enough fluid in your body (dehydration) - make sure you drink plenty
• an increase in the level of minerals, salts and enzymes in your blood - this might show up in blood tests
• dizziness
• ringing or other sounds in your ears (tinnitus)
• heart problems - tell your doctor if you feel very tired, short of breath or have swollen legs or ankles
• passing wind (fart)
• piles (haemorrhoids)
• a burning or hot feeling on your tongue, or in your mouth or lips (glossodynia)
• a hole (perforation) in your food pipe (oesophagus), stomach or bowel – this can cause severe abdominal pain and blood in your vomit or stools (poo)
• an abnormal channel (fistula) between your food pipe, stomach or bowel to another part of the body
• hair loss
• kidney problems
• inflammation of the gallbladder - this can cause sudden abdominal pain
• muscle pain
• blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms

Rare side effects

These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• a drop in the number of white blood cells – this can increase the risk of infection
• swelling of the brain that can be reversed - signs are headaches, confusion, fits, changes to your eyesight with or without high blood pressure. Contact your doctor straight away if you have any of these symptoms

Other side effects

There isn’t enough information at the moment to work out how often the following side effect happens:

• a weakness or tear in the walls of blood vessels called arteries (aneurysm or artery dissection)

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do you need to know?

Other medicines, food and drink

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Contraception and pregnancy

This drug may harm a baby developing in your womb. It is important not to become pregnant or get someone pregnant while you are having treatment with this drug and for at least 1 week afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisation

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.