[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Kinase inhibitors (targeted oncology)](https://durgical.com/en/pharmacology/classes/kinase-inhibitors/) › Sorafenib

# Sorafenib

## Kinase inhibitors (targeted oncology)?

Kinase inhibitors (targeted oncology)

## High alert?

An error with this medicine can cause serious harm: double checks and protocols are used.

An oral multikinase inhibitor (RAF, VEGFR, PDGFR) for liver, kidney and iodine-refractory thyroid cancer; hand-foot skin reaction and hypertension are typical.

Updated Nov 1, 2026

Also called: sorafenib tosylate, BAY 43-9006

## Quick facts

**Group**
[Kinase inhibitors (targeted oncology)](https://durgical.com/en/pharmacology/classes/kinase-inhibitors/)

**Target**
VEGFR2 and other kinases (CRAF, BRAF, VEGFR1–3, PDGFR-β, KIT, FLT3, RET)

**Used for**
Unresectable hepatocellular carcinoma

**Key effects**
Hand-foot skin reaction · Diarrhoea · Fatigue

**Monitor**
Blood pressure weekly at first · Liver tests

**ATC**
L01EX02

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**VEGFR2 and other kinases (CRAF, BRAF, VEGFR1–3, PDGFR-β, KIT, FLT3, RET)**Sorafenib

ⓘ The crystal shows sorafenib in the kinase domain of human VEGFR2, one of its several targets.

**Target in 3D:** VEGFR2 and other kinases (CRAF, BRAF, VEGFR1–3, PDGFR-β, KIT, FLT3, RET). PDB structure 4ASD (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4ASD) · Drag to rotate · pinch to zoom

Sorafenib inhibits several kinases at once: inside the tumour cell the RAF kinases (CRAF, BRAF and mutant BRAF) of the MAPK pathway, and on the cell surface the angiogenic receptors VEGFR1–3 and PDGFR-β, as well as KIT, FLT3 and RET. The result is less tumour-cell proliferation and, above all, less new vessel formation, with more apoptosis.

- Blocks RAF kinases of the MAPK pathway
- Blocks angiogenic VEGFR and PDGFR receptors
- Less tumour proliferation and vessel growth
- More apoptosis; tumour growth slows

## Indications

- Unresectable hepatocellular carcinoma. [Hepatocellular carcinoma →](https://durgical.com/en/conditions/hepatocellular-carcinoma/)
- Advanced renal cell carcinoma. [Renal cell carcinoma →](https://durgical.com/en/conditions/renal-cell-carcinoma/)
- Progressive differentiated thyroid carcinoma refractory to radioactive iodine. [Thyroid cancer (papillary) →](https://durgical.com/en/conditions/thyroid-cancer/)

## Adverse effects

### Common

- Hand-foot skin reaction (painful redness and blisters on palms and soles)
- Diarrhoea
- Fatigue
- Hair loss
- Rash
- High blood pressure
- Weight loss and decreased appetite

### Serious (rare, important)

- Cardiac ischaemia and infarction
- Bleeding
- Severe hypertension
- Stevens-Johnson syndrome and toxic epidermal necrolysis
- Gastrointestinal perforation
- Impaired wound healing
- QT prolongation
- Drug-induced liver injury

## Contraindications

- Severe allergy to sorafenib
- Combination with carboplatin and paclitaxel in squamous cell lung cancer

## Key interactions

**Strong CYP3A4 inducers (e.g. rifampicin)**
Lower sorafenib levels; avoided.

**Warfarin**
Bleeding and raised INR have been reported; INR is checked.

**Levothyroxine in thyroid cancer**
Sorafenib impairs TSH suppression; TSH is checked monthly and the dose adjusted.

## What is monitored

- Blood pressure weekly at first, then regularly
- Skin of palms and soles
- Liver tests
- ECG and electrolytes in people at risk
- TSH in thyroid cancer
- Wound healing around surgery

## Administration and safety

- Oral; swallowed whole at about the same time each day.
- Check the name carefully: kinase inhibitors with similar «-tinib» names are not interchangeable.
- Taken without food; held before elective surgery and restarted only after the wound has healed.

## Pregnancy and breastfeeding

May harm the fetus; effective contraception is used and breastfeeding is not advised.

## Nursing care

- Check blood pressure at every visit.
- Inspect palms and soles; advise thick cotton socks, avoiding friction and heat, and moisturising creams.
- Ask about chest pain, bleeding and black stools.
- Teaching: report blistering of hands or feet, chest pain, bleeding or yellow skin; use contraception.

## Pharmacokinetics

**Absorption**
Oral; taken without food (at least an hour before or two hours after a meal); a high-fat meal lowers absorption.

**Distribution**
Almost completely bound to plasma proteins.

**Metabolism**
Liver, mainly by CYP3A4, to inactive products.

**Half-life**
About one to two days.

## Memory aid

«SoRAFenib = RAF + VEGF»: one drug, many kinases; it hurts Hands and feet, raises Hypertension and treats the HCC, kidney and thyroid cancers.

## Test yourself

Think of the answer, then tap the question to see it.

## Which kinases does sorafenib inhibit?

RAF kinases (CRAF, BRAF) and the angiogenic receptors VEGFR1–3 and PDGFR-β, plus KIT, FLT3 and RET.

## What is the classic skin toxicity of sorafenib?

Hand-foot skin reaction.

## Which liver cancer is treated with sorafenib?

Unresectable hepatocellular carcinoma.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/sorafenib/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**High alert**
An error with this medicine can cause serious harm: double checks and protocols are used.

## Connections

## Related drugs 2

- [Bevacizumab](https://durgical.com/en/pharmacology/bevacizumab/)
- [Vemurafenib](https://durgical.com/en/pharmacology/vemurafenib/)

## Related conditions 3

- [Hepatocellular carcinoma](https://durgical.com/en/conditions/hepatocellular-carcinoma/)
- [Renal cell carcinoma](https://durgical.com/en/conditions/renal-cell-carcinoma/)
- [Thyroid cancer (papillary)](https://durgical.com/en/conditions/thyroid-cancer/)

[← Back to the class: Kinase inhibitors (targeted oncology)](https://durgical.com/en/pharmacology/classes/kinase-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - SORAFENIB tablet, film coated](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dae598f7-823f-405c-ae31-f924594187b9) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01EX02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/sorafenib/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/sorafenib/