Inlyta (axitinib) is usually started at 5mg taken twice a day, but the exact dose can shift up or down depending on how you feel and what your labs say. Your oncologist will decide the right strength, schedule, and any combotherapy based on your kidneycancer situation and overall health.
What Is Inlyta?
Definition & Drug Class
Inlyta is the brand name for axitinib, a VEGFtyrosinekinase inhibitor that blocks signals that help tumors grow new blood vessels. In plain language, think of it as putting a brake on the tumor's "water supply."
Approved Indication
The drug is approved for adults with advanced or metastatic renal cell carcinoma (kidney cancer) who have already tried at least one other systemic therapy. It's also cleared as part of firstline combos with immunotherapies like avelumab or pembrolizumab.
Why Dosage Matters
Getting the dose right is a balancing act. Too low, and the cancer may keep growing; too high, and sideeffects like high blood pressure or liver problems can become serious. That's why the label gives a clear starting point and a stepwise plan for adjustments.
Inlyta Strengths & Forms
Available Tablet Strengths
Pfizer markets Inlyta as filmcoated tablets in two strengths: 1mg and 5mg. The 5mg tablet is the one most patients start on.
Form Factors
Inlyta comes only as oral tablets. You can't crush, split, or chew them the coating is designed to release the medicine steadily. If swallowing is a problem, talk to your pharmacist about safe alternatives.
How to Identify Your Tablet
The 5mg tablet is orangebrown, imprinted with "5XNB." The 1mg tablet is white, marked "1XNB." Having this info handy can prevent mixups at the pharmacy.
Standard Inlyta Dosage
Monotherapy (SecondLine) Starting Dose
Most patients begin with 5mg by mouth twice daily (BID), taken about 12 hours apart. Food does not affect absorption, so you can take it with or without meals.
FirstLine Combination Regimens
When Inlyta is paired with immunotherapy, the starting dose stays the same, but the schedule of the partner drug adds extra visits:
- Avelumab combo: Inlyta 5mg BID+avelumab 800mg IV every two weeks.
- Pembrolizumab combo: Inlyta 5mg BID+pembrolizumab 200mg IV every three weeks (or 400mg every six weeks).
DoseEscalation Criteria
If you've tolerated the drug for at least two weeks without any grade2 or higher sideeffects, your doctor may increase the dose:
- From 5mg BID to 7mg BID.
- From 7mg BID to the maximum 10mg BID.
Escalation is slower when Inlyta is combined with avelumab (minimum 2weeks) than with pembrolizumab (minimum 6weeks).
Why the Stepwise Titration?
Clinical studies showed that slowly raising the dose improves tumor response while keeping hypertension and liver enzyme elevations manageable (Drugs.com).
When to Adjust Dose
Dose Reductions
If sideeffects become troublesome, the first reduction brings the dose down to 3mg BID. A second reduction can go to 2mg BID. Some patients even need a 1mg BID, but that's rare.
Managing Specific Adverse Events
Hypertension
High blood pressure is the most common issue (about 40% of patients). If your systolic pressure climbs above 150mmHg or diastolic over 100mmHg, your doctor will usually reduce the dose by one level and start or adjust antihypertensive meds.
Liver Enzyme Elevations
When ALT or AST rise to three times the upper limit of normal (ULN) plus bilirubin doubles, hold Inlyta until labs improve. If they jump to ten times ULN, the drug is stopped permanently.
Bleeding, Cardiac Failure, & RPLS
Serious bleeding or heart failure requires an immediate hold, and many clinicians choose to discontinue therapy if the event is grade3 or higher.
DrugInteraction Adjustments
Inlyta is metabolized mainly by CYP3A4. Strong inhibitors (like ketoconazole) can double drug levels, so the dose is cut roughly in half. Strong inducers (like rifampin) lower levels, and doctors often avoid using them together.
RealWorld Example
Jane, a 62yearold with metastatic RCC, started at 5mg BID. After three weeks she developed grade2 hypertension despite medication. Her oncologist reduced her dose to 3mg BID; her blood pressure settled, and the tumor continued to shrink. Jane's story illustrates how flexible dosing protects both effectiveness and safety.
Practical HowtoTake Guide
Timing & Food
Take Inlyta twice daily, roughly 12 hours apartmorning and evening works for most people. It can be swallowed with a glass of water, with or without food.
Swallowing Instructions
Don't split, chew, or crush the tablet. If you have trouble swallowing pills, ask your pharmacist about a liquid formulation (currently not available in the U.S., but future options may arise).
Missed Dose Rules
If you forget a dose, skip it and resume your regular schedule. Never double up; that could spike your blood levels and raise the risk of sideeffects.
Special Situations
Before Surgery
Stop Inlyta at least two days before any major operation, and wait at least two weeks after surgery before restarting.
Pregnancy & Breastfeeding
Inlyta is contraindicated during pregnancy. Use effective contraception and discuss familyplanning options with your doctor.
Grapefruit & St.John'sWort
Avoid these because they can dramatically increase axitinib levels.
Printable Checklist
Consider creating a simple daily checklist: "Inlyta5mgMorningWater; Inlyta5mgEveningWater." A visual cue can help you stay consistent.
Frequently Asked Questions
What is the recommended Inlyta dosage for kidney cancer?
Most adults start at 5mg twice daily; dose may be increased to 7mg or 10mg BID if tolerated, or reduced to 3mg/2mg BID for sideeffects.
Can I take Inlyta with food?
Yes. Food does not significantly affect absorption, so you can take it with breakfast, lunch, or on an empty stomachwhichever fits your routine.
How long does Inlyta stay in my system?
The halflife ranges from 2.5 to 6.1hours, reaching steadystate after about two to three days of consistent dosing.
What are the most common side effects?
High blood pressure, diarrhea, fatigue, nausea, and occasional liverenzyme elevations. Most are manageable with dose adjustments or supportive meds.
Is dose reduction safe if I develop hypertension?
Absolutely. Reducing from 5mg to 3mg BID is a standard response when blood pressure climbs; your doctor will monitor and adjust as needed.
Can Inlyta be combined with other cancer drugs?
Yes. FDAapproved combos include avelumab and pembrolizumab, each with its own dosing schedule and monitoring requirements.
Summary Table Quick Reference
| Scenario | Starting Dose | Max Dose | When to Reduce | When to Increase |
|---|---|---|---|---|
| Monotherapy (2ndline) | 5mg BID | 10mg BID | Grade2 adverse events, hypertension, liver | Tolerated 2weeks, no Grade2 AEs |
| Avelumab combo | 5mg BID + 800mg q2wks | 10mg BID | Same as monotherapy + ALT/AST 3ULN | Same as monotherapy; escalation every 2weeks |
| Pembrolizumab combo | 5mg BID + 200mg q3wks | 10mg BID | Same as monotherapy + immunerelated AEs | Same as monotherapy; escalation every 6weeks |
| Strong CYP3A4 inhibitor present | 23mg BID (50% reduction) | Resume original dose after inhibitor cleared (35t) |
Sources & Further Reading
For the most uptodate dosing details, consult the FDA prescribing information. Clinical insights are also summarized on Medscape and Drugs.com. The pivotal pharmacokinetic study by Rugo etal. in J Clin Oncol (2005) provides the scientific basis for dose titration.
Conclusion
Finding the right Inlyta dosage is a personalized journey. The standard start is 5mg twice daily, but your doctor can safely move the dose up to 10mg or bring it down to 3mg/2mg based on blood pressure, liver tests, drug interactions, and how well you tolerate the medicine. Understanding the tablet strengths, the "when to take" schedule, and the signs that call for an adjustment empowers you to stay on therapy longer while keeping sideeffects in check. Always keep an open line with your oncology teamask questions, share how you feel, and never hesitate to voice concerns. Your health, your voice, and the right doseall work together to give you the best possible outcome.
FAQs
What is the standard starting dose of Inlyta for kidney cancer?
The typical starting dose is 5 mg taken orally twice daily (BID), spaced about 12 hours apart.
How can the Inlyta dose be increased?
If the drug is tolerated for at least two weeks without grade 2 or higher side‑effects, the dose may be raised to 7 mg BID, and later to a maximum of 10 mg BID.
When should the Inlyta dose be reduced?
Reductions are advised for grade 2 or higher adverse events such as hypertension, significant liver‑enzyme elevations, or serious bleeding. The first reduction brings the dose to 3 mg BID, and a second can lower it to 2 mg BID.
Does food affect Inlyta absorption?
No. Inlyta can be taken with or without meals, allowing flexibility in scheduling the twice‑daily doses.
Can Inlyta be taken with other cancer therapies?
Yes. FDA‑approved combinations include avelumab (800 mg IV every two weeks) and pembrolizumab (200 mg IV every three weeks) while maintaining the same Inlyta starting dose.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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