Medications
Axitinib (Inlyta)
A cancer tablet taken twice a day for advanced kidney cancer (renal cell carcinoma), usually with an immunotherapy drug; it blocks signals that help tumors grow new blood vessels.
How Medicare covers it
Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.
| Coverage details | |
|---|---|
| Part B status | No axitinib row in the CMS Part B Spending by Drug HCPCS file (RY26, data through 2024) — no J-code basis; coverage path is Part D. |
| Medicare Advantage | Most Medicare Advantage plans that include drug coverage (MAPD plans) use the same formulary-and-tier system; the plan's own drug list decides coverage and copay — check the plan's formulary. |
| Medicare Supplement (Medigap) | Medicare Supplement (Medigap) plans sold today do not include prescription drug coverage; drug coverage comes from Part D or an MAPD plan. |
What it treats
Advanced renal cell carcinoma (RCC), a type of kidney cancer. It is used with avelumab or with pembrolizumab as first treatment, and alone after one earlier whole-body treatment has failed.
What it is for, in depth
Axitinib, sold as Inlyta, is a cancer medicine used to treat advanced renal cell carcinoma, a type of kidney cancer. The label uses it in two settings. It is used with avelumab or with pembrolizumab as the first treatment, and it is used alone after one earlier whole-body treatment has failed. It is therefore prescribed for people with advanced kidney cancer, either at the start of treatment in combination or after an earlier treatment did not work. It is a kinase inhibitor. It blocks vascular endothelial growth factor receptors called VEGFR-1, VEGFR-2, and VEGFR-3, which tumors use to grow new blood vessels, and this slows tumor growth. It comes as film-coated tablets, in 1 mg and 5 mg strengths in the input. Tablets are taken by mouth twice a day, about 12 hours apart, with or without food, starting at 5 mg twice a day. Tablets are swallowed whole with a full glass of water.
How it works
It is a kinase inhibitor. It blocks vascular endothelial growth factor receptors (VEGFR-1, VEGFR-2, and VEGFR-3), which tumors use to grow new blood vessels, and this slows tumor growth.
How it is taken
Tablets taken by mouth twice a day, about 12 hours apart, with or without food. The starting dose is 5 mg twice a day. Swallow the tablet whole with a full glass of water. If you vomit or miss a dose, do not take an extra dose — take the next dose at the usual time.
Common side effects
In at least 20% of patients taking it alone: diarrhea, high blood pressure, fatigue, decreased appetite, nausea, hoarseness (dysphonia), hand-foot syndrome (palmar-plantar erythrodysesthesia), weight loss, vomiting, weakness, and constipation.
Serious warnings
It commonly raises blood pressure and can cause hypertensive crisis, so blood pressure must be controlled before starting and checked during treatment. It can cause blood clots in arteries or veins, serious bleeding, heart failure, a tear in the stomach or bowel (perforation) or fistula, thyroid problems, poor wound healing, a brain condition called RPLS, protein in the urine, and liver injury — liver injury is more frequent and more severe when it is combined with avelumab or pembrolizumab. It can harm an unborn baby.
Who should be careful
People with uncontrolled high blood pressure, a recent blood clot, bleeding problems or an untreated brain metastasis or recent stomach or bowel bleeding, moderate liver problems (the dose is lowered; it has not been studied in severe liver problems), people planning surgery (stop at least 2 days before elective surgery and at least 2 weeks after major surgery until wounds heal), and females and males who could cause a pregnancy — effective birth control is needed during treatment and for 1 week after the last dose, and breastfeeding should be avoided during treatment and for 2 weeks after the last dose.
Major interactions
Avoid strong CYP3A4/5 inhibitors (such as ketoconazole, itraconazole, clarithromycin, ritonavir, and voriconazole, and grapefruit) — if one must be used, the axitinib dose is cut by about half. Avoid strong CYP3A4/5 inducers (such as rifampin, phenytoin, carbamazepine, and St. John's wort), which lower axitinib levels.
Why it is in its tier
This drug is most often placed on Tier 5. Tier 1 is the lowest cost tier, often $0-$15, and higher tiers mean a higher copay or coinsurance. Tier 5 is the specialty tier and carries the highest percentage coinsurance. In the CMS aggregation, 5495 plans list it, which is a listing share of 100.0%, and Tier 5 accounts for 96.91% of listing plans, with 5325 plans at that tier, so it is the clear majority placement. Even with listing in every plan, the specialty placement fits a single brand cancer product with very high program cost visible in the data. There is no generic form in the input. The CMS dashboard average spending per beneficiary in 2024 was 98298.98226. That figure is a CMS program average, not a patient's copay.
Sources
- INLYTA- axitinib tablet, film coated — DailyMed
- MedlinePlus — National Library of Medicine
- MedlinePlus — Axitinib
What official patient guides say
Axitinib comes as a tablet to take by mouth, usually with or without food two times a day, about 12 hours apart, at around the same times every day. Swallow the tablets whole with a glass of water; do not split, chew, or crush them. Take it exactly as directed, and do not take more, less, or more often than prescribed. If you vomit after taking a dose, do not take another dose — continue your regular dosing schedule. Your doctor may start you on a low dose and gradually increase it, not more than once every 2 weeks, depending on how well the medication works and any side effects. Continue to take axitinib even if you feel well, and do not stop without talking to your doctor. If you miss a dose, skip it and take the next dose at the regular time; do not take a double dose. Keep the medication in the container it came in, tightly closed, at room temperature away from excess heat and moisture (not in the bathroom), out of sight and reach of children, with safety caps locked. Dispose of unneeded medication through a medicine take-back program; do not flush it.
Source: MedlinePlus — Axitinib
Part D formulary coverage
| Formulary summary | |
|---|---|
| Most common tier | 5 |
| Plans listing this drug | 5495 |
| Total Part D plans | 5495 |
| Share of plans listing it | 100 |
| Formularies listing it | 286 |
| Tier | Plans |
|---|---|
| Tier 1 | 123 plans |
| Tier 2 | 1 plans |
| Tier 4 | 46 plans |
| Tier 5 | 5325 plans |
Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.
What you pay
| With Medicare Part D | |
|---|---|
| Most common tier | Tier 5 |
| Typical copay | $0 — half of plans charge between $0 and $0 |
| Typical coinsurance | 26.0% of the price |
| Based on | 5237 plans that cover this drug · 2027 plan year |
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07
Similar medications
Other medications in the same FDA pharmacologic class (Kinase Inhibitor):
Read next
Part D spending averages (2024)
| Brand name | Generic name | Total claims 2024 | Total spending 2024 | Total beneficiaries 2024 | Rank by beneficiaries 2024 |
|---|---|---|---|---|---|
| Inlyta | Axitinib | 24770 | 4.38905e+08 | 4465 | 1238 |
Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30
Companies covering this drug
5,495 plans from 509 companies list this drug on a formulary for 2027. Search by company or plan name, or filter by tier. Cost sharing is the plan's published amount for this drug's tier in the initial coverage stage (1-month retail supply), where the plan publishes it; a blank means the plan does not publish it.
| Company | Plan | Tier | Copay | Coinsurance |
|---|
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Coverage and costs change. Drug lists (formularies), tiers, and copays can change during the year and differ by plan. Always check with your insurance company or plan directly to confirm what is covered and what you will pay.
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