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Fotivda

tivozanib
VEGFR Inhibitor (TKI)
1. Indications and Usage

Advanced renal cell carcinoma (RCC) — relapsed or refractory, after two or more prior systemic therapies

2. Dosage and Administration

1.34 mg orally once daily for 21 days followed by 7 days off treatment (28-day cycle)
Take with or without food
Dose reductions: 0.89 mg daily, then discontinue
Hepatic impairment (moderate): Reduce to 0.89 mg daily

3. Dosage Forms and Strengths

Capsules: 0.89 mg, 1.34 mg

4. Contraindications

None listed.

5. Warnings and Precautions
  • Hypertension: 45% (22% Grade ≥3). Control BP before initiation. Monitor every 2 weeks for first 2 months then monthly.
  • Cardiac Failure: 1.6% (Grade ≥3). Monitor for signs and symptoms.
  • Cardiac Ischemia Events: 4% including MI.
  • Arterial and Venous Thromboembolic Events: 4% arterial, 3% venous.
  • Hemorrhage: 11% (Grade ≥3: 3.3%).
  • Proteinuria: 8%. Monitor urinalysis periodically.
  • Thyroid Dysfunction: Hypothyroidism in 11%. Monitor TSH at baseline and periodically.
  • Wound Healing Complications: Withhold at least 24 days before elective surgery.
  • RPLS and GI Perforation
  • Embryo-Fetal Toxicity
6. Adverse Reactions
Most Common Adverse Reactions

Fatigue (44%), hypertension (45%), diarrhea (31%), decreased appetite (28%), nausea (24%), dysphonia (22%), hypothyroidism (11%), cough (11%), stomatitis (11%), vomiting (10%)

Hypertension
45%
Fatigue
44%
Diarrhea
31%
Decreased Appetite
28%
Nausea
24%
Dysphonia
22%
Hypothyroidism
11%
Cough
11%
Stomatitis
11%
Vomiting
10%

Consult the complete prescribing information for a comprehensive list of adverse reactions and their frequencies.

7. Drug Interactions

Consult the complete prescribing information for drug interactions, including effects on CYP enzymes, transporters, and concomitant medications that may require dose adjustments or monitoring.

8. Use in Specific Populations
Pregnancy

Consult the full prescribing information for pregnancy-related considerations.

Lactation

Refer to prescribing information for lactation guidance.

Pediatric Use

Pediatric safety and efficacy information is detailed in the full label.

Hepatic/Renal Impairment

Dose modifications for organ impairment are specified in the complete prescribing information.

12. Clinical Pharmacology
Mechanism of Action

Tivozanib is a potent and selective inhibitor of VEGFR-1, VEGFR-2, and VEGFR-3 at picomolar concentrations, with minimal off-target kinase activity. This selectivity for VEGFRs reduces off-target side effects seen with less selective multi-kinase inhibitors. By blocking VEGFR signaling, tivozanib inhibits tumor angiogenesis, vascular permeability, and tumor growth.

Pharmacokinetics

Tmax: 2-24 hours. Half-life: approximately 4.5 days. Protein binding: >99%. Metabolized by CYP3A4 and CYP1A1. Fecal excretion (79%), urinary excretion (12%).

14. Clinical Studies

Clinical efficacy and safety data supporting the approval are available in the full prescribing information and from the clinical trials listed below.

Pivotal Clinical Trials
Additional Resources
FDA-Approved Tumor Types

Fotivda has FDA-approved indications across the following cancer types covered on PipelineEvidence:

External Resources
Important Notice: This page is intended as a navigational reference to the FDA-approved prescribing information for Fotivda. It does not replace the full prescribing information. Healthcare professionals should consult the complete package insert available at DailyMed before making prescribing decisions. Patient-specific factors should always guide clinical decision-making.