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Same active ingredient — pay up to 49% less
These brands contain the same active ingredient (Lenvatinib Mesylate). Same strength and form. Confirm the switch with your doctor or pharmacist.
More from Enva
Other strengths and forms by Techno Drugs Ltd., Satipara, Narshingdi
Indications & Uses
Lenvatinib Mesylate (Lenvakin) is a kinase inhibitor, and it is indicated for four cancers. The first is differentiated thyroid cancer (DTC). Here it is used for patients whose disease is locally recurrent or metastatic, is progressive, and is refractory to radioactive iodine. For renal cell carcinoma (RCC), Lenvatinib Mesylate is given in combination with Everolimus. It is indicated for patients with advanced RCC who have already had one prior anti-angiogenic therapy. In hepatocellular carcinoma (HCC), the medicine is indicated as first-line treatment for patients whose disease is unresectable. The last indication is endometrial carcinoma. Lenvatinib Mesylate is used in combination with Pembrolizumab for patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR). These patients must have disease progression following prior systemic therapy and must not be candidates for curative surgery or radiation.
Pharmacology
Lenvatinib is a kinase inhibitor. It blocks the kinase activity of the vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR) and VEGFR3 (FLT4). It also blocks other kinases that are linked to pathogenic angiogenesis, tumor growth and cancer progression, besides their normal work in the cell. These include the fibroblast growth factor (FGF) receptors FGFR1, 2, 3 and 4, platelet-derived growth factor receptor alpha (PDGFR ), KIT and RET. In hepatocellular carcinoma cell lines that depend on activated FGFR signaling, Lenvatinib also showed antiproliferative activity, along with inhibition of FGF-receptor substrate 2 (FRS2 ) phosphorylation.
Absorption: The time to peak plasma concentration (Tmax) was typically 1 to 4 hours after the dose. A high-fat meal (approximately 900 calories, of which approximately 55% came from fat, 15% from protein and 30% from carbohydrates) did not change the extent of absorption. It did slow the rate of absorption, and the median Tmax moved from 2 hours to 4 hours.
Distribution: In vitro, Lenvatinib binding to human plasma proteins ranged from 98% to 99% at concentrations of 0.3 to 30 μg/mL. The blood-to-plasma concentration ratio ranged from 0.59 to 0.61 at concentrations of 0.1 to 10 μg/mL in vitro.
Metabolism: In humans, the main metabolic pathways for Lenvatinib were enzymatic (CYP3A and aldehyde oxidase) and non-enzymatic processes.
Excretion: Ten days after a single dose of radiolabeled Lenvatinib, approximately 64% of the radiolabel had left in the feces and approximately 25% in the urine.
Elimination: The terminal elimination half-life of Lenvatinib was approximately 28 hours.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Important Dosage Information
Some patients with renal or hepatic impairment need a reduced dose. Take Lenvatinib once daily at the same time each day, with or without food. If you miss a dose and can't take it within 12 hours, skip it and take the next dose at the usual time.
Recommended Dosage for Differentiated Thyroid Cancer (DTC)
The recommended dosage of Lenvatinib is 24 mg by mouth once daily, until the disease progresses or the toxicity becomes unacceptable.
Recommended Dosage for Renal Cell Carcinoma (RCC)
The recommended dosage is 18 mg of Lenvatinib together with 5 mg Everolimus, both taken by mouth once daily. This continues until disease progression or unacceptable toxicity.
Recommended Dosage for Hepatocellular Carcinoma (HCC)
Here the dosage depends on actual body weight. Patients weighing greater than or equal to 60 kg take 12 mg, and patients under 60 kg take 8 mg. Lenvatinib is taken by mouth once daily until disease progression or unacceptable toxicity.
Recommended Dosage for Endometrial Carcinoma
The recommended dosage of Lenvatinib is 20 mg by mouth once daily, given with Pembrolizumab 200 mg as an intravenous infusion over 30 minutes every 3 weeks. Treatment continues until unacceptable toxicity or disease progression.
Side Effects
Lenvatinib Mesylate can cause hypertension, cardiac dysfunction and arterial thromboembolic events. It can also cause hepatotoxicity, renal failure and impairment, and proteinuria. Diarrhea is another side effect, along with fistula formation and gastrointestinal perforation. Other effects include QT Interval Prolongation, hypocalcemia and reversible posterior leukoencephalopathy syndrome. Hemorrhagic events can occur too. So can impairment of thyroid stimulating hormone suppression or thyroid dysfunction, and wound healing complications.
Cautions & Contraindications
Warnings & Precautions
Hypertension: Get blood pressure under control before starting Lenvatinib Mesylate. Check it after 1 week, then every 2 weeks for the first 2 months, and after that at least monthly during treatment. Depending on severity, the medicine is withheld and restarted at a reduced dose once blood pressure is controlled, or it is stopped permanently. Cardiac Dysfunction: Serious and fatal cardiac dysfunction can occur with Lenvatinib Mesylate. Watch patients for clinical symptoms or signs of cardiac dysfunction. Depending on severity, withhold the medicine and restart at a reduced dose once the patient recovers, or stop it permanently. Arterial Thromboembolic Events: If an arterial thrombotic event happens, stop the medicine permanently. Nobody has established that it is safe to restart after an arterial thromboembolic event, and it has not been studied in patients who had one within the previous 6 months. Hepatotoxicity: Check liver function before starting, then every 2 weeks for the first 2 months, and at least monthly after that during treatment. Patients with HCC need close monitoring for signs of hepatic failure, including hepatic encephalopathy. Depending on severity, withhold the medicine and restart at a reduced dose on recovery, or stop it permanently. Renal Failure or Impairment: For renal failure or impairment, withhold the medicine and restart at a reduced dose on recovery, or stop it permanently, depending on severity. Proteinuria: Test for proteinuria before starting and periodically during treatment. If a urine dipstick shows proteinuria greater than or equal to 2+, get a 24-hour urine protein. Depending on severity, withhold and restart at a reduced dose on recovery, or stop permanently. Diarrhea: Diarrhea was the most frequent cause of dose interruption/reduction, and it came back even after the dose was reduced. Start managing diarrhea promptly. Depending on severity, withhold the medicine and restart at a reduced dose on recovery, or stop it permanently. Fistula Formation and Gastrointestinal Perforation: Stop Lenvatinib Mesylate permanently in patients who develop gastrointestinal perforation of any severity or a Grade 3 or 4 fistula. QT Interval Prolongation: Check for electrolyte abnormalities and correct them at baseline and periodically during treatment. Monitor electrocardiograms in patients with congenital long QT syndrome, congestive heart failure or bradyarrhythmias, and in those taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics. Withhold the medicine and restart at a reduced dose on recovery, based on severity. Hypocalcemia: Hypocalcemia improved or resolved with calcium supplementation, with or without dose interruption or dose reduction. Reversible Posterior Leukoencephalopathy Syndrome: Depending on the severity and persistence of neurologic symptoms, withhold the medicine and restart at a reduced dose on recovery, or stop it permanently. Hemorrhagic Events: Consider the risk of severe or fatal hemorrhage linked to tumor invasion or infiltration of major blood vessels (e.g. carotid artery). Depending on severity, withhold the medicine and restart at a reduced dose on recovery, or stop it permanently. Impairment of Thyroid Stimulating Hormone Suppression/Thyroid Dysfunction: Check thyroid function before starting and at least monthly during treatment. Treat hypothyroidism according to standard medical practice. Wound Healing Complications: Wound healing complications, including fistula formation and wound dehiscence, can occur with Lenvatinib Mesylate. Withhold it for at least 6 days before scheduled surgery. After surgery, restart it based on clinical judgment of whether the wound has healed adequately. In patients who develop wound healing complications, stop the medicine permanently.
Contraindications
Lenvatinib Mesylate must not be given to anyone who is known to be hypersensitive to Lenvatinib or to any other component of the formulation.
Pregnancy & Breastfeeding
Use in Pregnancy: Going by how Lenvatinib works, it can harm the embryo and fetus when given to a pregnant woman. Pregnant women should be told about the possible risk to the baby. Women who could become pregnant should be advised to use effective contraception while taking Lenvatinib and for at least 30 days after the last dose.
Use in Lactation: It isn't known whether Lenvatinib passes into human milk. Because breastfed infants could have serious adverse reactions, women should be advised to stop breastfeeding during treatment with Lenvatinib and for at least 1 week after the last dose.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Dosage modifications for severe renal impairment: the recommended dosage of Lenva (lenvatinib mesylate) for patients with DTC, RCC or endometrial carcinoma and severe renal impairment is given below. Severe renal impairment means creatinine clearance less than 30 mL/min, calculated by the Cockcroft-Gault equation using actual body weight. For differentiated thyroid cancer the dosage is 14 mg orally once daily. For renal cell carcinoma it is 10 mg orally once daily, and for endometrial carcinoma it is also 10 mg orally once daily.
Dosage modifications for severe hepatic impairment: patients with DTC, RCC or endometrial carcinoma and severe hepatic impairment (Child-Pugh C) have their own recommended dosage of Lenva. Differentiated thyroid cancer: 14 mg taken orally once daily. Renal cell carcinoma: 10 mg taken orally once daily. Endometrial carcinoma: 10 mg orally once daily. Or as directed by the registered physician.
Pediatric use: safety and effectiveness have not been established in pediatric patients.
Overdose
Lenva binds strongly to plasma proteins, so dialysis is not expected to remove it from the blood. One patient who took a single oral dose of Lenva 120 mg died from multiorgan dysfunction.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Lenvatinib Mesylate below 30°C in a dry place, and protect it from light. Keep it out of the reach of children.
Common questions about Enva 4 mg
What is Enva 4 mg Capsule?
Enva 4 mg Capsule is a medicine that contains Lenvatinib Mesylate. It is made by Techno Drugs Ltd., Satipara, Narshingdi. It belongs to the Cytotoxic Chemotherapy group of medicines.
What is Enva used for?
Lenvatinib Mesylate (Lenvakin) is a kinase inhibitor, and it is indicated for four cancers. The first is differentiated thyroid cancer (DTC).
What are the side effects of Enva?
Lenvatinib Mesylate can cause hypertension, cardiac dysfunction and arterial thromboembolic events. It can also cause hepatotoxicity, renal failure and impairment, and proteinuria.
Can I take Enva during pregnancy or while breastfeeding?
Use in Pregnancy: Going by how Lenvatinib works, it can harm the embryo and fetus when given to a pregnant woman. Pregnant women should be told about the possible risk to the baby. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Enva?
Lenva binds strongly to plasma proteins, so dialysis is not expected to remove it from the blood. One patient who took a single oral dose of Lenva 120 mg died from multiorgan dysfunction. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Enva?
Keep Lenvatinib Mesylate below 30°C in a dry place, and protect it from light. Keep it out of the reach of children.
Is there a cheaper medicine with the same ingredient?
Lenvaxen by Everest Pharmaceuticals Ltd. has the same ingredient and strength for ৳333.00 per unit, compared with ৳650.00 for Enva. Ask your doctor or pharmacist before switching.
Do I need a prescription for Enva?
Enva is a prescription (Rx) medicine. Take it as your doctor advises.