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Vismodegib

(viz-moe-dej-ib)

Trade/other name(s): Erivedge®

Why would this drug be used?

This drug is used to treat advanced basal cell carcinoma, a type of skin cancer, when other treatments such as surgery and radiation are no longer good options. It is also being studied for use against other types of cancer.

How does this drug work?

Vismodegib is a type of targeted therapy known as a hedgehog pathway inhibitor. The hedgehog pathway is a group of proteins that transmit important signals to the cell's control center. This pathway is important for growth and development, especially early in life. Some types of cancer, such as basal cell carcinoma, may have defective hedgehog pathways in the cells, which can help the cells grow. Vismodegib inhibits a hedgehog protein known as Smoothened. By blocking this protein, vismodegib may help stop the growth of these cancers.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as liver disease, kidney disease, heart disease, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug can cause serious problems with the fetus if taken at the time of conception or during pregnancy. Please see the "Precautions" section for more information.
  • If you are breast-feeding. While no studies have been done, this drug may pass into breast milk and affect the baby. Breast-feeding is not recommended during treatment with this drug.
  • If you think you might want to have children in the future. This drug may affect fertility. Talk with your doctor about the possible risk with this drug.
  • About any other prescription or over-the-counter medicines or supplements you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Vismodegib may interact with some drugs and supplements, so it is very important to check with your health care team before taking any new medicines.

Drugs commonly used to treat heartburn, reflux, or ulcers reduce the acid levels in the stomach, which may lower the amount of vismodegib your body absorbs:

  • H2 blockers such as cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), or nizatidine (Axid)
  • Proton pump inhibitors such as omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), rabeprazole (Aciphex), or lansoprazole (Prevacid)
  • Antacids (Maalox, Mylanta, Tums, etc.)

Some drugs and supplements could cause vismodegib to build up in your blood, which might worsen side effects and other problems:

  • Some antibiotics, such as erythromycin, clarithromycin (Biaxin), azithromycin (Zithromax), and similar drugs

Do not start or stop taking any of these medicines while on vismodegib without talking with your doctor(s) about all of the medicines you take, including vismodegib.

Other medicines or supplements may affect blood levels of vismodegib, or levels of these drugs may be affected by taking vismodegib. Make sure your doctor is aware of all drugs and supplements you are taking.

Check with your doctor, nurse, or pharmacist about any other medicines, herbs, and supplements you are taking, and if alcohol can cause problems with this medicine.

Interactions with foods

No interactions between foods and vismodegib are known at this time, but this doesn't necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about whether any specific foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Vismodegib is taken by mouth as tablets. The usual starting dose is 150 mg (milligrams), taken once a day. The tablets should be swallowed whole (not chewed or crushed). They can be taken with or without food.

Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you. Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

Precautions

Avoid pregnancy while taking this drug. This drug may cause serious birth defects or even death of the fetus. Women who could get pregnant should have a pregnancy test within 7 days of starting treatment. Women should use a highly effective form of birth control during treatment and for at least 7 months after the last dose of this drug. Check with your doctor about what kinds of birth control can be used with this medicine. Men who are taking this drug should use condoms with spermicide (even if they have had a vasectomy) during treatment and for at least 2 months after the last dose. Call your doctor right away if you think you (or your partner) might be pregnant while taking this drug.

Do not donate blood or blood products during treatment with this drug and for at least 7 months after the last dose.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • Muscle spasms
  • Hair loss
  • Changes in how things taste
  • Weight loss
  • Feeling tired
  • Nausea
  • Diarrhea
  • Loss of appetite
  • Constipation
  • Loss of menstrual periods

Less common

  • Joint pain
  • Vomiting
  • Loss of taste

Rare

  • Lab test results showing abnormal levels of certain minerals in the blood (Your doctor will discuss the importance of this finding, if any.)

Other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 2012

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 02/06/2012
Last Revised: 02/06/2012