Indication: Tivoxen, containing Tivozanib as the International Nonproprietary Name (INN), is indicated for treating advanced renal cell carcinoma (RCC) in adult patients who have previously undergone systemic therapy without success.

Pharmacology: Tivozanib, a tyrosine kinase inhibitor (TKI), selectively targets vascular endothelial growth factor receptors (VEGFR-1, -2, and -3), disrupting angiogenesis and inhibiting tumor progression.

Dosage and Administration: The recommended dose of Tivoxen is 1.34 mg orally once daily, regardless of food intake. Treatment should continue until disease progression or intolerable adverse effects emerge, with possible dose adjustments based on individual tolerance.

Interactions: Tivoxen may interact with drugs affecting cytochrome P450 enzymes, notably CYP3A4. Caution is advised when co-administering with potent CYP3A4 inhibitors or inducers. Additionally, vigilance is warranted when combining Tivoxen with medications prolonging the QT interval.

Side Effects: Common side effects include fatigue, hypertension, diarrhea, nausea, decreased appetite, and dysphonia. Other potential adverse reactions encompass proteinuria, hypothyroidism, and hand-foot syndrome, while serious events like hemorrhagic and arterial thromboembolic events are possible.

Precautions and Warnings:

• Regular blood pressure monitoring is recommended during Tivoxen treatment, with antihypertensive therapy initiated or adjusted as necessary.
• Patients should be monitored for signs of proteinuria, thyroid dysfunction, and hand-foot syndrome, with treatment interruption or discontinuation if these occur.
• Effective contraception is crucial during and after treatment due to the potential for fetal harm.
• Patients with cardiac history or predisposition to QT prolongation should undergo electrocardiographic monitoring during Tivoxen therapy.

Overdose Effect: In the event of overdose, provide supportive care and closely monitor for adverse reactions. No specific antidote exists; therefore, appropriate symptomatic treatment should be initiated as required.