MANAGING MY
TREATMENT SIDE EFFECTS

High blood pressure (hypertension)
A common side effect of LENVIMA that can be serious.

• Your blood pressure should be well controlled before starting LENVIMA
• Your doctor should check your blood pressure regularly during your treatment with LENVIMA. If you develop blood pressure problems, your doctor may prescribe medicine to treat your high blood pressure

Heart problems
LENVIMA can cause serious heart problems that may lead to death. Call your doctor right way if you get symptoms of heart problems such as:

• Shortness of breath
• Swelling of your ankles

Problem with blood clots in your blood vessels (arteries)
Get emergency medical help right away if you get any of the following:

• Severe chest pain or pressure
• Pain in your arms, back, neck, or jaw
• Shortness of breath
• Numbness or weakness on one side of your body
• Trouble talking
• Sudden severe headache
• Sudden vision changes

Liver problems
LENVIMA may cause liver problems that may lead to liver failure and death.

• Your doctor will check your liver function before and during treatment with LENVIMA
• Tell your doctor right away if you have any of the following symptoms:
  
  • Your skin or the white part of your eyes turns yellow (jaundice)
  • Dark “tea-colored” urine
  • Light-colored bowel movements (stools)
  • Feeling drowsy, confused, or loss of consciousness

Kidney problems
Kidney failure, which can lead to death, has happened with LENVIMA treatment.

• Your doctor should do regular blood tests to check your kidneys

Increased protein in your urine (proteinuria)
It is a common side effect of LENVIMA and can be serious. Proteinuria is when protein is increased in your urine.

• Your doctor should check your urine for protein before and during your treatment with LENVIMA

Diarrhea
Diarrhea is a common side effect of LENVIMA and can be serious.

• If you get diarrhea, ask your doctor about what medicines you can take to treat your diarrhea
• It is important to drink more water when you get diarrhea
• Tell your doctor or go to the emergency room if you are unable to drink enough liquids and your diarrhea is not able to be controlled

An opening in the wall of your stomach or intestines (perforation), or an abnormal connection between 2 or more body parts (fistula)

• Get emergency medical help right away if you have severe stomach (abdomen) pain

Changes in the electrical activity of your heart (QT prolongation)
QT prolongation can cause irregular heartbeats that can be life-threatening.

• Your doctor will do blood tests before and during your treatment with LENVIMA to check the levels of potassium, magnesium, and calcium in your blood, and may check the electrical activity of your heart with an ECG

Low levels of blood calcium (hypocalcemia)

• Your doctor will check your blood calcium levels during treatment with LENVIMA
• If your calcium levels are low, your doctor may tell you to take a calcium supplement

A condition called reversible posterior leukoencephalopathy syndrome (RPLS)
Call your doctor right away if you get:

• Severe headache
• Seizures
• Weakness
• Confusion
• Blindness or change in vision

Bleeding
LENVIMA may cause serious bleeding problems that may lead to death.

Tell your doctor if you have any signs or symptoms of bleeding during treatment with LENVIMA, including:

• Severe and persistent nose bleeds
• Vomiting blood
• Red or black (looks like tar) stools
• Blood in your urine
• Coughing up blood or blood clots
• Heavy or new-onset vaginal bleeding

Change in thyroid hormone levels

• Your doctor should check your thyroid hormone levels before starting and every month during treatment with LENVIMA

Wound healing problems
Wound healing problems have happened in some people who take LENVIMA.

• Tell your doctor if you plan to have any surgery before or during treatment with LENVIMA
• You should stop taking LENVIMA at least 1 week before planned surgery
• Your doctor should tell you when you may start taking LENVIMA again after surgery

Severe jaw bone problems (also known as osteonecrosis)
Severe jaw bone problems have happened in some people who have taken LENVIMA.

• There are certain risk factors that may increase your risk of getting jaw bone problems, such as:
  • Taking a bisphosphonate medicine or the medicine denosumab
  • Having dental disease
  • An invasive dental procedure
• Your doctor should examine your mouth before you start and during treatment with LENVIMA. It’s important to tell your dentist that you’re taking LENVIMA and to practice good mouth care while taking LENVIMA
• Tell your doctor right away:
  • If you have any signs or symptoms of jaw bone problems during treatment with LENVIMA, including jaw pain, toothache, or sores on your gums
  • If you plan to have any dental procedures before or during your LENVIMA treatment. You should stop taking LENVIMA at least 1 week before planned dental surgery or invasive dental procedures. Your doctor should tell you when to resume taking LENVIMA. You should avoid having invasive dental procedures, if possible, during treatment with LENVIMA. Stopping your bisphosphonate medicine before an invasive dental procedure may help decrease your risk of getting these jaw problems