Sunitinib

The Basics

What is Sunitinib?

Approved for the treatment of renal cell carcinoma (RCC) and imatinib-resistant gastrointestinal stromal tumor.

Brand names for Sunitinib

Sutent

How Sunitinib is classified

Antineoplastic Agents, Enzyme Inhibitors, Protein Kinase Inhibitors, Signal Transduction Inhibitors, Tyrosine Kinase Inhibitors

Sunitinib During Pregnancy

Sunitinib pregnancy category

Category Not AssignedNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Sunitinib while pregnant

Based on animal reproduction studies and its mechanism of action, SUTENT can cause fetal harm when administered to a pregnant woman [see CLINICAL PHARMACOLOGY]. There are no available data in pregnant women to inform a drug-associated risk. In animal developmental and reproductive toxicology studies, oral administration of sunitinib to pregnant rats and rabbits throughout organogenesis resulted in teratogenicity (embryolethality, craniofacial and skeletal malformations) at 5.5 and 0.3 times the AUC in patients administered the recommended daily doses (RDD), respectively (see Data). Advise pregnant women or females of reproductive potential of the potential hazard to a fetus. The background risk of major birth defects and miscarriage for the indicated populations are unknown. However, the estimated background risk in the United States (U.S.) general population of major birth defects is 2%-4% and of miscarriage is 15%-20% of clinically recognized pregnancies. Data Animal Data In a female fertility and early embryonic development study, female rats were administered oral sunitinib (0.5, 1.5, 5 mg/kg/day) for 21 days prior to mating and for 7 days after mating. Embryolethality was observed at 5 mg/kg/day (approximately 5 times the AUC in patients administered the RDD of 50 mg/day). In embryo-fetal developmental toxicity studies, oral sunitinib was administered to pregnant rats (0.3, 1.5, 3, 5 mg/kg/day) and rabbits (0.5, 1, 5, 20 mg/kg/day) during the period of organogenesis. In rats, embryolethality and skeletal malformations of the ribs and vertebrae were observed at the dose of 5 mg/kg/day (approximately 5.5 times the systemic exposure [combined AUC of sunitinib + primary active metabolite] in patients administered the RDD). No adverse fetal effects were observed in rats at doses ≤3 mg/kg/day (approximately 2 times the AUC in patients administered the RDD). In rabbits, embryolethality was observed at 5 mg/kg/day (approximately 3 times the AUC in patients administered the RDD), and craniofacial malformations (cleft lip and cleft palate) were observed at ≥1 mg/kg/day (approximately 0.3 times the AUC in patients administered the RDD of 50 mg/day). Sunitinib (0.3, 1, 3 mg/kg/day) was evaluated in a pre-and postnatal development study in pregnant rats. Maternal body weight gains were reduced during gestation and lactation at doses ≥1 mg/kg/day (approximately 0.5 times the AUC in patients administered the RDD). At 3 mg/kg/day (approximately 2 times the AUC in patients administered the RDD), reduced neonate body weights were observed at birth and persisted in the offspring of both sexes during the preweaning period and in males during postweaning period. No adverse developmental effects were observed at doses ≤1 mg/kg/day.

Taking Sunitinib While Breastfeeding

What are recommendations for lactation if you're taking Sunitinib?

No information is available on the clinical use of sunitinib during breastfeeding. Because sunitinib and its metabolite are over 90% bound to plasma proteins, the amount in milk is likely to be low. However, one of its metabolites has a half-life of up to 110 hours, and might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during sunitinib therapy and for at least 4 weeks after the last dose.

Maternal / infant drug levels

No information is available on the clinical use of sunitinib during breastfeeding. Because sunitinib and its metabolite are over 90% bound to plasma proteins, the amount in milk is likely to be low. However, one of its metabolites has a half-life of up to 110 hours, and might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during sunitinib therapy and for at least 4 weeks after the last dose.

Possible effects of Sunitinib on milk supply

Relevant published information was not found as of the revision date.

Possible alternatives to Sunitinib

None listed