Erivedge
Erivedge (vismodegib) is a targeted cancer medication used to treat a specific kind of skin cancer called basal cell carcinoma that has spread and can’t be removed by surgery. It’s convenient to take because you take it by mouth, but it can have side effects such as muscle spasms and hair loss. Erivedge (vismodegib) is very harmful to an unborn baby and can cause pregnancy loss (miscarriage). People who take Erivedge (vismodegib) who are able to have children must use effective birth control.
What is Erivedge (vismodegib)?
What is Erivedge (vismodegib) used for?
- Basal cell carcinoma that has spread to other parts of the body (metastatic) or that can’t be removed by surgery
How Erivedge (vismodegib) works
There’s a certain pathway in your body called the Hedgehog pathway. It sends signals to help cells grow. It plays an important role in helping unborn babies develop, but it’s not always active in adults. Some people have a mutation in the Hedgehog pathway that makes it active when it shouldn’t be, and this can cause cancer cells to grow, including skin cancer cells.
Erivedge (vismodegib) is a Hedgehog pathway inhibitor, meaning it blocks the Hedgehog pathway. It treats skin cancer by turning this pathway off so that the cancer cells can’t grow or spread as well.
Drug facts
Side effects of Erivedge (vismodegib)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Muscle spasms (72%)
- Hair loss (64%)
- Taste changes (55%)
- Weight loss (45%)
- Tiredness (40%)
- Nausea (30%)
- Diarrhea (29%)
- Lower appetite (25%)
- Constipation (21%)
- Joint pain (16%)
Less Common Side Effects
- Vomiting
- Taste loss
Erivedge (vismodegib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious skin reactions: painful blisters, skin wounds, peeling skin, fever, sore throat, body aches
The following Erivedge (vismodegib) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bloody or cloudy urine
confusion
decreased urine output
dizziness
fast or irregular heartbeat
headache
increased thirst
loss of consciousness
muscle pain or cramps
pain in the lower back or side
seizures
swelling of the face, ankles, or hands
thirst
unusual tiredness or weakness
vomiting
Incidence not known
Black, tarry stools
blistering, peeling, loosening of the skin
chills
itching skin
joint or muscle pain
painful or difficult urination
red irritated eyes
red skin lesions, often with a purple center
sores, ulcers, or white spots in the mouth or on the lips
swollen glands
trouble breathing
unusual bleeding or bruising
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Absent, missed, or irregular menstrual periods
change in taste
decreased appetite
difficulty having a bowel movement
difficulty with moving
hair loss or thinning
loss of taste
muscle spasm or stiffness
pain in the joints
stopping of menstrual bleeding
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Erivedge (vismodegib)
Pros
- Taken by mouth and only taken once a day
- Recommended treatment option for people with basal cell carcinoma that has spread and can’t be removed by surgery
- Works in a more specific, targeted way than traditional chemotherapy
Cons
- Causes hair loss in most people
- Can cause muscle spasms and taste changes
- Not safe in pregnancy
Pharmacist tips for Erivedge (vismodegib)
- You can take Erivedge (vismodegib) with or without food.
- If you miss a dose of Erivedge (vismodegib), don’t take two doses to make up for it. Just skip the missed dose and start taking it again at the next scheduled time.
- Because Erivedge (vismodegib) is so unsafe to an unborn baby, it’s important to make sure other people aren’t exposed to the medication. You shouldn’t donate blood or blood products while taking Erivedge (vismodegib) or for 2 years after the last dose.
- Some pre-menopausal females taking Erivedge (vismodegib) stopped menstruating while taking Erivedge (vismodegib). Menstruation usually starts up again after you stop the medication. Talk with your provider if you've more questions about how Erivedge (vismodegib) might affect your menstrual cycle.
- You might experience diarrhea while taking Erivedge (vismodegib). If you have this side effect, your provider might recommend you take over-the-counter medications like loperamide (Imodium A-D) to help treat it. Make sure you drink plenty of fluids, but avoid sugary sports drinks because these can make diarrhea worse.
- Store Erivedge (vismodegib) out of reach of children. This medication can cause serious harm and growth problems if taken accidentally by children.
- Ask your provider about the best way to handle and throw away Erivedge (vismodegib) safely. Anticancer medications can be harmful to people who handle or come in contact with them. You should store the medication up and away, so children and pets won’t be able to reach it.
- Females who're taking Erivedge (vismodegib) shouldn’t breastfeed. Erivedge (vismodegib) hasn’t been studied in human milk, but because of the possible risks to a baby, it’s best to avoid nursing if you’re taking Erivedge (vismodegib).
Common questions about Erivedge (vismodegib)
Most people who take Erivedge (vismodegib) will lose hair. This is because the pathway that Erivedge (vismodegib) blocks to stop the growth of skin cancer is also the same pathway that’s involved in hair growth. Usually your hair will thin gradually, and hair loss might not be noticeable until after you’ve been taking Erivedge (vismodegib) for two months or more. Hair loss can happen all over the body. Typically, your hair grows back after stopping Erivedge (vismodegib) treatment, but it can take several months. If you do notice hair loss, consider wearing a hat or using sunscreen on your scalp and using mild shampoos to protect your skin.
Erivedge (vismodegib) isn’t safe to take during pregnancy. Based on how this medication works, Erivedge (vismodegib) could harm an unborn baby and cause pregnancy loss (miscarriage). If you’re able to have children, you must have a negative pregnancy test before starting Erivedge (vismodegib). In addition, you must use effective birth control while taking Erivedge (vismodegib) and for 2 years after the last dose. Let your provider know right away if you become pregnant while taking Erivedge (vismodegib). If you’re male and have a partner who can get pregnant, you must use condoms while taking Erivedge (vismodegib) and for 3 months after the last dose. Also, don’t donate semen while taking Erivedge (vismodegib) or for 3 months after the last dose.
Muscle spasm is the most common side effect of Erivedge (vismodegib). The reason for this isn't well understood. For most people, the spasms are mild, tend to occur in the arms and legs, and happen mostly at night. The spasms aren’t usually painful, but they can be bothersome and some people have stopped taking Erivedge (vismodegib) because of this side effect. Regular stretching might help lower muscle spasms. Let your provider know if you are taking Erivedge (vismodegib) and have muscle spasms that bother you.
Erivedge (vismodegib) can cause taste changes because it affects your taste buds. Your body is constantly replacing old taste buds with new ones. The way that Erivedge (vismodegib) works to stop skin cancer from growing is also the same way it blocks the process of how your body replaces old taste buds. As a result, this medication can change the way things taste. If things don’t taste the way you expect them to, your appetite for those foods might also change. Sometimes changing the amount of salt or spices in your food can help. Because some people who take Erivedge (vismodegib) have a metallic taste in their mouth, it might help to avoid metal utensils. The way things taste usually goes back to normal after you stop Erivedge (vismodegib). Meeting with a dietician experienced in helping people with cancer might be helpful to find ideas for what you can eat.
You should take Erivedge (vismodegib) as instructed by your provider. How long you take Erivedge (vismodegib) depends on several factors, such as how well the medication is working to treat your cancer and how well you tolerate side effects. Your provider will determine how well Erivedge (vismodegib) works by regularly checking your skin lesions by measuring their size and through scan results. Most of the common side effects like muscle spasm, taste changes, and hair loss aren’t serious but they can be bothersome. Your provider might consider stopping or pausing Erivedge (vismodegib) if you experience side effects that affect your daily life. Don’t stop taking Erivedge (vismodegib) without first discussing it with your provider.
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Risks and warnings for Erivedge (vismodegib)
Erivedge (vismodegib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious harm to unborn baby
- Risk factors: Pregnant females | Males with a partner who can have children
Results from animal studies suggest Erivedge (vismodegib) can cause serious harm or death to an unborn baby. Pregnant females shouldn’t take Erivedge (vismodegib). If you’re a female able to have children, you must have a negative pregnancy test within 7 days of starting Erivedge (vismodegib). In addition, you need to use effective birth control while taking Erivedge (vismodegib) and for 2 years after the last dose. Males who have a partner who can have children must use condoms while taking Erivedge (vismodegib) and for 3 months after the last dose.
Serious skin problems
Rarely, Erivedge (vismodegib) can cause serious skin problems, including severe skin reactions or infections that can be life-threatening, such as Stevens-Johnson syndrome (SJS) or Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Tell your provider right away if you develop painful blisters, skin wounds, peeling skin, or fever as these are signs of a serious skin reaction that need immediate medical attention.
Muscle problems
Most people who take Erivedge (vismodegib) experience muscle spasms, but they are usually mild. Rarely, the spasms can be severe, painful, and cause a high level of creatine phosphokinase (CPK) in your blood that suggests tissue damage. Your provider will measure your CPK level through labs before you start Erivedge (vismodegib) and any time you have muscle pain. If you have painful muscle spasms or aching joints or higher CPK levels, your provider might pause or stop Erivedge (vismodegib) depending on how severe your symptoms are.
Abnormal bone changes in children
Risk factors: Exposure to Erivedge (vismodegib) Make sure to store Erivedge (vismodegib) out of reach of children. Aside from the possible serious side effects, Erivedge (vismodegib) can cause serious bone problems in growing children.
Erivedge (vismodegib) dosage
Typical dosage for Erivedge (vismodegib)
- The usual dose is 150 mg by mouth once a day.
Interactions between Erivedge (vismodegib) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aluminum Carbonate, Basic
- Aluminum Hydroxide
- Aluminum Phosphate
- Calcium Carbonate
- Cimetidine
- Dexlansoprazole
- Dihydroxyaluminum Aminoacetate
- Dihydroxyaluminum Sodium Carbonate
- Esomeprazole
- Famotidine
- Lansoprazole
- Magaldrate
- Magnesium Carbonate
- Magnesium Hydroxide
- Magnesium Oxide
- Magnesium Trisilicate
- Nizatidine
- Omeprazole
- Pantoprazole
- Rabeprazole
- Ranitidine
