This page tells you about the biological therapy vismodegib and its possible side effects. You can read about
Vismodegib is pronounced vis-mo-dej-ib. It also has the brand name Erivedge (pronounced eh-rih-vej). It used to be called GDC-0449. It is a type of biological therapy called a cancer growth blocker.
Vismodegib is a treatment for advanced basal cell skin cancer. Advanced basal cell skin cancers include those that
- Have spread to another part of the body
- Have come back after surgery and cannot be removed
- Are in a position where they cannot be removed by surgery
You may also have vismodegib as part of clinical trials for other cancers.
Most basal cell skin cancers have a change in certain proteins that send a particular signal within the cells. This signal makes the cells become cancerous and grow more quickly than usual. The proteins are called the hedgehog pathway. Vismodegib aims to block the signals so that the cancer stops growing. This type of drug is called a hedgehog pathway blocker.
Vismodegib is a capsule that you take every day. You can take it with or without food. You keep taking the treatment until it stops working or the side effects become too great.
It is very important that you take the capsules according to the instructions your doctor or pharmacist gives you. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.
If you accidentally take too much vismodegib, see a doctor or go to a hospital straight away. If you forget to take your tablet, skip the missed dose and take the next dose at the usual time. Don't take a double dose to make up for the missed one.
Vismodegib can cause birth defects in children. So you must not become pregnant or father a child if you are taking this drug. Your doctor or nurse will talk to you about reliable contraception before you have the treatment. You will need to sign a consent form and register with the company who make vismodegib. This is to make sure you understand the risks of taking vismodegib and shows that you agree to use contraception for a specified period of time.
Women should continue using contraception for 2 years after finishing treatment. Vismodegib can have an effect on the body during that time.
After starting treatment men must use a condom during intercourse. They need to continue to use condoms for 2 months after finishing treatment even if they have had a vasectomy.
Vismodegib’s side effects are listed below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
More than 10 in every 100 people have one or more of these side effects.
- Muscle spasms affect 7 out of 10 people (70%)
- Taste changes or loss of taste happen in more than half of people
- Hair loss
- Loss of weight occurs in about half of people (50%)
- Tiredness affects 4 in 10 people (40%) during and after treatment. Most people find their energy levels are back to normal within 6 months to a year
- Diarrhoea happens in 3 out of 10 people (30%). Drink plenty of water. Tell your doctor or nurse if you are worried about how bad it is or if it continues for more than 3 days
- Feeling or being sick happens in about 3 out of every 10 people (30%). This is usually well controlled with anti sickness medicines but tell your doctor or nurse if you feel sick
- Loss of appetite happens in a quarter of people (25%)
- Constipation affects 2 out of 10 people (20%). Your doctor or nurse may give you medicines to help prevent this but tell them if you are constipated for more than 3 days
- Aching joints or joint pains affect around 1 out of 10 people (10%)
- Changes to your periods – if you haven’t had your menopause your periods may become irregular. Some women find that their periods stop
- Loss of fertility – you may not be able to become pregnant or father a child after having this treatment. Talk to your doctor before starting treatment if you think you will want to have a baby in the future
Between 1 and 10 in every 100 people have one or more of these side effects.
- Feeling weak
- Changes in your liver that are mild and unlikely to cause symptoms. The liver will almost certainly go back to normal when treatment is finished. You will have regular blood tests to check how well your liver is working
- Loss of water from the body (dehydration)
- You may have low levels of sodium in your blood, which will almost certainly go back to normal when treatment ends. You will have regular blood tests to check the levels
- Stomach pain
- Skin changes such as a rash, which may be itchy
- Eye lash loss
- Back pain and chest pain
- Non harmful skin cancers called squamous cell cancers happen in some people – let your doctor know if you notice any skin changes
You may get a few of the side effects mentioned above. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
We don’t list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect that we don’t mention here and you think may be due to this treatment, you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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