Vismodegib

Used to treat both metastatic basal cell carcinoma and advanced basal cell carcinoma, Vismodegib is given orally, normally in tablet or capsule form.

Overview

Vismodegib works by preventing cancer cells from growing and dividing. Known as a cancer growth inhibitor, the medication blocks the protein in cells from sending signals. Normally, this protein would instigate the cell division but, when it’s inhibited, the cells do not divide and grow, thus preventing the spread of cancer.

Although basal cell carcinoma is typically a slow-growing cancer, it can spread into surrounding tissue. Even more rarely, this type of cancer is metastatic and spreads to other parts of the body. When the cancer is advanced, has spread locally or has become metastatic and symptomatic, Vismodegib may be given in order to treat the disease.

Normally, treatment with Vismodegib is given when surgery or radiotherapy is not viable for the patient. If the cancer has spread to a part of the body which does not allow for surgical removal, for example, Vismodegib can be a viable course of treatment. In addition to this, Vismodegib may be appropriate if the patient has previously undergone surgery for basal cell carcinoma but the cancer has since returned.

Vismodegib may also be offered to patients suffering from different forms of cancer. Although it is not routinely used for other types of cancers, it may be offered to patients as part of a clinical trial. Currently, the drug is being used in trials on patients with small-cell lung cancer, pancreatic cancer, advanced stomach cancer, medulloblastoma, chondrosarcoma and metastatic colorectal cancer.

Conditions Treated:

  • Metastatic basal cell carcinoma
  • Advanced basal cell carcinoma

Type of Medicine:

  • Cancer growth inhibitor

Side Effects:

Experiencing some side-effects when taking medication is not uncommon. Most patients experience relatively mild side-effects and are not likely to suffer from every known side-effect. In many cases, side-effects are reduced as the body adapts to the medication. If symptoms worsen or are particularly severe, however, patients should consult their physician and/or seek urgent medical attention.

Mild side-effects associated with Vismodegib may include:

  • Loss of appetite
  • Weight loss
  • Changes to taste
  • Nausea
  • Vomiting
  • Tiredness
  • Weakness
  • Fatigue
  • Hair loss
  • Constipation
  • Diarrhea
  • Muscle spasms
  • Itching
  • Pain
  • Changes to menstrual cycle

Whilst the following side-effects may also occur when taking Vismodegib, there are less common and do not affect as many patients:

  • Dehydration
  • Altered liver function
  • Stomach pain
  • Chest and back pain
  • Loss of eyelashes
  • Abnormal hair growth

When side-effects are particularly troublesome, doctors can prescribe additional medication to help reduce unpleasant or debilitating symptoms. Anti-emetic drugs can be given if patients report nausea or vomiting, for example. In addition to this, patients can implement self-care techniques in order to manage mild or moderate side-effects.

Patients may experience taste changes whilst taking Vismodegib, for example, and may need to change their diet as a result. Healthcare practitioners often recommend consuming well-seasoned food in order to mask unpleasant tastes caused by the medication. If patients experience a metallic taste due to Vismodegib, they may be advised to suck boiled sweets on a regular basis as this can help to remove the unpleasant taste.

Many patients receiving cancer treatment report a loss of appetite and subsequent weight loss. Eating smaller meals, more often, is often an easier way for patients to maintain their calorie intake. As well as this, food supplements and protein drinks may be prescribed so that weight loss is kept to a minimum.

When patients are taking Vismodegib, they will undergo a number of tests to monitor the efficacy of the medication. Blood tests can be used to determine whether the drug is having any effect on the function of the liver, for example. This type of monitoring ensures that doctors are aware of how the patient is reacting to the medication and that action can be taken to prevent any unnecessary damage from occurring.

Although Vismodegib is associated with a number of side-effects, these are normally reversed once the treatment is finished. Whilst side-effects of any drug can be unpleasant, they can be managed effectively. Furthermore, the benefits of taking Vismodegib will be balanced against the potential side-effects in order to determine whether the treatment regime is appropriate for the patient.

Dosage:

In most cases, Vismodegib is taken daily but it should be taken at approximately the same time each day, if possible. Whilst the medication should be taken with a glass of water, it can be taken with or without food, depending on the patient’s preference.

A typical dose for adults with advanced basal cell carcinoma is 150 milligrams daily but each patient will be given specific dosage instructions by their physician. As with all medications, Vismodegib should only be taken prior to the use-by date stated on the package.

If patients accidentally exceed the dose prescribed to them, they should contact their healthcare practitioner for immediate advice. If a dose is missed, however, patients are normally advised to simply take their next dose as normal and not to take two doses at once.

If prescribed in capsule format, the capsule should be swallowed whole and patients should not attempt to crush, break or open the capsule in order to swallow the medication.

Interactions:

There are a number of drugs which may interact with Vismodegib. In some instances the medications should not be prescribed together but, if your physician feels it is appropriate, the drugs may be taken at the same time with atypical dosage instructions.

The medications which may interact with Vismodegib include, but are not limited to:

  • Aluminum Hydroxide
  • Aluminum Phosphate
  • Basic Aluminum Carbonate
  • Calcium Carbonate
  • Cimetidine
  • Dexlansoprazole
  • Dihydroxyaluminum Aminoacetate
  • Dihydroxyaluminum Sodium Carbonate
  • Esomeprazole
  • Famotidine
  • Lansoprazole
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Oxide
  • Magnesium Trisilicate
  • Nizatidine
  • Omeprazole
  • Pantoprozole
  • Rabeprazole
  • Ranitidine

Patients should also avoid immunizations with live vaccines whilst they are receiving Vismodegib treatment and for a period of six months after finishing their treatment. Patients should also avoid people who have been immunized via live oral vaccines.

Before commencing treatment patients should inform their doctor of any other medication or supplement they are taking, including over-the-counter medications and herbal tinctures. As these may interact with Vismodegib, doctors will advise on an individual basis and treatment can be discontinued if necessary.

Warnings:

Despite being an effective treatment for basal cell carcinoma, Vismodegib may not be an appropriate medication for all patients. Pregnant women, for example, should not take Vismodegib as it may have adverse effects on the fetus. In many cases, doctors will perform a pregnancy test on women of child-bearing age prior to prescribing this medication. If the patient becomes pregnant whilst taking Vismodegib, they should contact their physician immediately.

Women are also advised not to breastfeed or nurse whilst receiving Vismodegib or for 24 months after discontinuing the drug. The medication can, in some instances, be passed to the child via breastmilk and could have harmful side-effects.

Similarly, male patients should not impregnate anyone whilst taking this medication, or for three months following their last dose. In all cases, patients are advised to use reliable methods of birth control whilst taking Vismodegib and even patients who have previously undergone a vasectomy are advised to use additional birth control methods whilst taking this medication.

Male patients should also refrain from donating sperm or semen whilst taking Vismodegib and for three months after stopping treatment.

Should they wish to, patients may be able to arrange to store sperm, eggs or ovarian tissue prior to treatment with Vismodegib. For patients who may wish to start a family in the near future, this can help to prevent the medication having an impact on any future children.

In many instances, patients will be required to sign a consent form before taking Vismodegib. This confirms that they are aware of the risks of taking the drug whilst pregnant, breastfeeding or fathering a child.

Patients will not be able to donate blood or plasma whilst receiving Vismodegib treatment. In most cases, they will be unable to donate blood or plasma for a period of 24 months once their treatment has finished.

When taking Vismodegib, patients should not take any other medications, unless it has been discussed with their doctor. This includes prescription drugs, over-the-counter medications, vitamins and supplements.

If the patient receives any other treatment whilst taking Vismodegib, they should inform their doctor, nurse, pharmacist and/or dentist that they are taking this medication. Failure to do so could result in unwanted drug interactions, allergic reactions and/or an increase in side effects.

Storage

In most cases, Vismodegib will be prescribed in tablet or capsule form. Whilst they may be given to the patient in a glass or plastic container, they are more commonly given in blister packs.

The medication should be kept in a secure location, out of reach of children and pets. Vismodegib also needs to be kept at room temperature and away from moisture, heat and direct light. The medication should not be frozen or refrigerated.

If medication is out of date or is no longer required, it should be disposed of carefully. The patient should seek advice from their pharmacist regarding the disposal of this medication.

Summary

Vismodegib can be extremely beneficial for patients in certain situations. If basal cell carcinoma is considered to be advanced or has returned after a period of remission, it can help to prevent the cancer from spreading. Similarly, metastatic basal cell carcinoma can be effectively treated by taking the medication.

As it is rare for basal cell carcinoma to spread to other tissue or areas of the body, Vismodegib will not need to be taken by the majority of patients with this condition. For patients who have experienced complications or advanced forms of the disease, however, Vismodegib is an appropriate form of treatment.

Despite its efficacy, Vismodegib can interact with other medications and can cause birth defects. Due to this, patients must discuss their medical history, current drug usage and fertility with their doctor prior to commencing treatment.

As with most cancer-related drugs, Vismodegib is associated with some side-effects. In most cases, however, these are relatively mild. Due to the effectiveness of the drug in treating advanced or metastatic basal cell carcinoma, most patients will benefit from taking Vismodegib, even if they experience some side-effects as a result.

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Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017
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