Nitnib 50 Capsule belongs to the class of medications called ‘antineoplastic agents’ used in treating gastrointestinal stromal tumors (cancer of the stomach, bowel, or esophagus) in which patients don’t respond to imatinib (another anticancer agent). It is also used to treat renal carcinoma (kidney cancer) that has spread to other parts of the body and advanced pancreatic neuroendocrine tumors (cancer that has affected hormone-producing cells in the pancreas).

Nitnib 50 Capsule contains sunitinib. It acts by slowing down the growth of cancer cells by two processes. It interferes with the action of a protein that promotes cell division and thereby decreases cancer cell production. It can inhibit a process called angiogenesis, the development of blood supply to the cancer cells. This effect inhibits the nutrient supply to the cancer cells, thereby causing cancer cell death eventually.

You should take this medicine exactly as prescribed by the doctor. The common side-effects of Nitnib 50 Capsule are difficulty breathing, increase in blood pressure, extreme tiredness, swelling caused by fluid under the skin and around the eye, pain or irritation in the mouth, mouth sores, dry mouth, taste disturbances, upset stomach, nausea, vomiting, diarrhea, constipation, abdominal pain, loss of appetite, decreased activity of thyroid gland (hypothyroidism), dizziness, headache, nose bleeding, back pain, joint pain, pain in arms and legs, yellowish discoloration of the skin, rash on the palms of the hands and soles of the feet, dryness of the skin, cough, fever, and difficulty to sleep. Inform your doctor immediately if any of these side-effects persist or get worse.

It is not recommended to take Nitnib 50 Capsule if you are allergic to any contents of it. Nitnib 50 Capsule should be used with caution in patients with high blood pressure, heart problems, diabetes, liver or kidney problems, skin disorders, pancreas or gallbladder problems, history of blood clots, aneurysm (weakening of blood vessel wall), problems with the thyroid gland, pancreas, and gallbladder, liver or kidney problems, and thrombotic microangiopathy (damage to the smallest blood vessels). It is not recommended for use in children and adolescents under 18 years of age. It should be used with caution in pregnant and breastfeeding women. Do not consume alcohol as it may increase the risk of side-effects. Nitnib 50 Capsule may cause dizziness, so do not drive or operate heavy machinery if you are not fully alert.

Nitnib 50 Capsule is a targeted therapy used to treat advanced kidney cancer. It is also used in patients with kidney cancer to prevent recurrence after having kidney surgery. It is used to treat gastrointestinal stromal cancer that cannot be treated with imatinib, another anti-cancer medicine. It is used to manage pancreatic neuroendocrine tumors (cancer of hormone-producing cells of the pancreas) that cannot be treated with surgery. Nitnib 50 Capsule can help to manage the above conditions if taken regularly as prescribed by the doctor.

• Tiredness
• Pain or irritation in the mouth
• Mouth sores
• Dry mouth
• Taste disturbances
• Upset stomach
• Nausea
• Vomiting
• Diarrhea or constipation
• Abdominal pain
• Loss of appetite
• Dizziness
• Headache
• Back pain
• Joint pain
• Yellowish discoloration of the skin
• Rash on the palms of the hands and soles of the feet
• Dryness of the skin
• Cough
• Fever
• Difficulty to sleep

Nitnib 50 Capsule may cause an increase in blood pressure. So, your doctor may monitor your blood pressure regularly and prescribe blood-pressure-lowering medicines if necessary. Nitnib 50 Capsule may increase the risk of bleeding, and the risk is high if you are taking any blood thinners such as warfarin and acenocoumarol. Nitnib 50 Capsule may cause heart problems, so notify your doctor if you experience extreme tiredness, shortness of breath, and swelling of the feet and ankles. Nitnib 50 Capsule may cause heart rhythm abnormalities, so inform your doctor if you experience dizziness or abnormal heartbeats. Nitnib 50 Capsule should be used with caution in patients with a recent history of blood clots, heart attack, or stroke as this medicine may cause chest pain, shortness of breath, difficulty speaking, weakness of one side of the body, or dizziness. Nitnib 50 Capsule should be used with caution in patients with aneurysm (weakening of blood vessel wall), thrombotic microangiopathy (damage to the small blood vessels), and liver or kidney problems. Nitnib 50 Capsule may cause inflammation of the pancreas or gallbladder and lead to symptoms such as abdominal pain (upper abdominal region), fever, and vomiting, in patients with a history of pancreatic or gallbladder disorders. Nitnib 50 Capsule may cause thyroid gland problems, so inform your doctor if you experience frequent fatigue and extreme cold than others. Nitnib 50 Capsule may cause skin ulceration (pyoderma gangrenosum) or infection (necrotizing fasciitis). So, inform your doctor if you notice symptoms of infection around a skin injury such as fever, pain, swelling, redness, and drainage of pus or blood from the wound. However, these effects are usually reversible after the discontinuation of therapy. If you develop severe skin rashes, especially with blistering or peeling of the skin, notify your doctor immediately as it can be a sign of a serious skin condition. Nitnib 50 Capsule may cause headaches, high blood pressure, and vision problems in patients with a history of fits or seizures. While using Nitnib 50 Capsule, blood sugar levels should be monitored regularly in patients with diabetes. In addition, notify your doctor immediately if you notice signs of low blood sugar such as fatigue, hunger, sweating, pounding heartbeat, and loss of consciousness.

Drug-Drug Interactions: Nitnib 50 Capsule may interact with antifungal agents (ketoconazole and itraconazole), antibiotics (erythromycin, clarithromycin, and rifampicin), blood thinners (warfarin and acenocoumarol), a steroid medicine (dexamethasone), medicines used to treat fits (phenytoin, carbamazepine, and phenobarbital), and a herbal antidepressant (hypericum perforatum).

Drug-Food Interactions: It is not advised to take grapefruit juice while using Nitnib 50 Capsule.

Drug-Disease Interactions: Nitnib 50 Capsule should be used with caution in patients with high blood pressure, bleeding problems, heart problems, abnormal heart rhythm, the recent history of blood clots, aneurysm (weakening of blood vessel wall), problems with the thyroid gland, pancreas, and gallbladder, liver or kidney problems, and thrombotic microangiopathy (damage to the smallest blood vessels).

• KETOCONAZOLE
• ITRACONAZOLE
• ERYTHROMYCIN
• CLARITHROMYCIN
• RIFAMPICIN
• DEXAMETHASONE
• PHENYTOIN
• CARBAMAZEPINE
• PHENOBARBITAL
• HYPERICUM PERFORATUM
• WARFARIN
• ACENOCOUMAROL

• Eat a healthy diet that includes fresh fruits and vegetables.
• Include leafy vegetables, citrus fruits, fatty fish, berries, yogurt, apples, peaches, cauliflower, cabbage, broccoli, beans, herbs in your diet.
• Avoid fast food, fried food, processed meats, refined carbs, and added sugars.
• Maintain a healthy weight.
• Avoid smoking and alcohol consumption.
• Manage stress and use relaxation techniques such as meditation and yoga.
• Get optimal sleep, rest well.
• Limit exposure to environmental toxins such as smoke, asbestos, or other chemicals.

• Let your doctor know before undergoing any surgery that you are taking Nitnib 50 Capsule as this medicine may delay wound healing.
• Your doctor may advise you to undergo a dental check-up before starting treatment with Nitnib 50 Capsule. In addition, inform your doctor that you are taking Nitnib 50 Capsule if you are undergoing any dental treatment or surgery, especially if you are taking bisphosphonates (medications used to prevent bone complications.
• Use reliable contraception while using Nitnib 50 Capsule to prevent pregnancy.

Gastrointestinal stromal tumor: It is cancer that affects the stomach and small intestine. It shows no or mild symptoms during the initial stages. It may cause blood in the stool or vomit as the disease progresses. In general, surgery is preferred for the treatment. However, imatinib or sunitinib (targeted therapy) can be given to shrink the tumor or if the tumor cannot be removed by surgery. 

Kidney cancer: It is also called renal cell carcinoma. It is the most common type of cancer seen in adults. Symptoms include red, orange, or pink-colored urine due to the presence of blood in the urine. In advanced kidney cancer (that has spread to other parts of the body), treatment is given to improve the survival rate.

Pancreatic neuroendocrine tumors: It is a type of endocrinal tumor that arises in the pancreas. Symptoms include yellowish skin or whites of the eyes, diarrhea, indigestion, stomach pain, and weight loss. Surgery, hormonal therapy, chemotherapy, and targeted therapy can be given to treat this type of tumor.