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Odomzo

sonidegib
Used for Skin Cancer
Used for Skin Cancer

Odomzo (sonidegib) 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. Odomzo (sonidegib) is very harmful to an unborn baby and can cause pregnancy loss (miscarriage). People who take Odomzo (sonidegib) who are able to have children must use effective birth control.

Reviewed by:
reviewer
Allison Baxley, PharmD, BCOP
reviewer
Connie Zheng, PharmD
Last reviewed on June 8, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageAlternativesReferencesPricesMedicare
basics-icon

What is Odomzo (sonidegib)?

What is Odomzo (sonidegib) used for?

  • Advanced basal cell carcinoma (BCC) that can’t be removed by surgery or radiation

How Odomzo (sonidegib) 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.

Odomzo (sonidegib) is a Hedgehog pathway inhibitor. It treats skin cancer by turning this pathway off so that the cancer cells can’t grow or spread as well.

Drug Facts

Common BrandsOdomzo
Drug ClassHedgehog pathway inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Odomzo (sonidegib)?

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

  • Higher serum creatinine levels (92%)
  • Higher creatinine kinase, suggesting muscle injury (61%)
  • Muscle spasms (54%)
  • Hair loss (53%)
  • Higher blood sugar levels (51%)
  • Taste changes (46%)
  • Higher digestive enzyme levels (43%)
  • Tiredness (41%)
  • Nausea (39%)
  • Muscle pain (32%)
  • Lower blood cell count (up to 32%)
  • Weight loss (30%)
  • Lower appetite (23%)

Other Side Effects

  • Stomach pain
  • Headache
  • Pain
  • Vomiting
  • Itching

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Muscle injury—unusual weakness or fatigue, muscle pain, dark yellow or brown urine, decrease in amount of urine

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Odomzo (sonidegib)

thumbs-up

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

thumbs-down

Cons

Causes hair loss in most people

Can cause muscle spasms and taste changes

Very unsafe for pregnant females

pharmacist-tips

Pharmacist tips for Odomzo (sonidegib)

pharmacist

  • Take Odomzo (sonidegib) on an empty stomach, one hour before or two hours after you eat.

    • Because Odomzo (sonidegib) 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 Odomzo (sonidegib) or for 20 months after the last dose. Males taking Odomzo (sonidegib) shouldn’t donate semen until at least 8 months after the last dose.

      • Some pre-menopausal females taking Odomzo (sonidegib) stopped menstruating while taking Odomzo (sonidegib). Menstruation usually starts up again after the drug is stopped.

        • You might experience diarrhea while taking Odomzo (sonidegib). 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.

          • If you miss a dose of Odomzo (sonidegib), 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.

            • Store Odomzo (sonidegib) out of reach of children. This medication can cause serious harm and growth problems if taken by children.

              • Ask your provider about the best way to handle and throw away Odomzo (sonidegib) 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 are taking Odomzo (sonidegib) shouldn’t breastfeed. Odomzo (sonidegib) 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 Odomzo (sonidegib) and for 20 months after the last dose.

                  faqs

                  Frequently asked questions about Odomzo (sonidegib)

                  Will I lose my hair if I take Odomzo (sonidegib)?
                  Most people who take Odomzo (sonidegib) will lose hair. This is because the pathway that Odomzo (sonidegib) 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 Odomzo (sonidegib) for a while. Hair loss can happen all over the body. Research of Erivedge (vismodegib), a similar medication, suggest that hair typically grows back after Odomzo (sonidegib) treatment but it can take many 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.
                  Is Odomzo (sonidegib) safe to take during pregnancy?
                  Odomzo (sonidegib) isn’t safe to take during pregnancy. Based on how this medication works, Odomzo (sonidegib) 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 Odomzo (sonidegib). In addition, you must use effective birth control while taking Odomzo (sonidegib) and for about 2 years after the last dose. Let your provider know right away if you become pregnant while taking Odomzo (sonidegib). If you’re male and have a partner who can get pregnant, you must use condoms while taking Odomzo (sonidegib) and for 8 months after the last dose.
                  What’s the most common side effect of Odomzo (sonidegib)?
                  Muscle spasm is the most common side effect. The reason Odomzo (sonidegib) might cause muscle spasms 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 Odomzo (sonidegib) because of this side effect. Regular stretching might help lower muscle spasms. Let your provider know if you are taking Odomzo (sonidegib) and have muscle spasms that bother you.
                  Why might my taste and appetite change if I take Odomzo (sonidegib)?
                  Odomzo (sonidegib) can cause taste changes because it affects your taste buds. Your body is constantly replacing old taste buds with new ones. And how Odomzo (sonidegib) works to block skin cancer from growing also 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 Odomzo (sonidegib) 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 Odomzo (sonidegib). Meeting with a dietician experienced in helping people with cancer might be helpful to find ideas for what you can eat.
                  How long should I take Odomzo (sonidegib) for?
                  You should take Odomzo (sonidegib) as instructed by your provider. How long you take Odomzo (sonidegib) 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 Odomzo (sonidegib) 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 Odomzo (sonidegib) if you experience side effects that affect your daily life. Don’t stop taking Odomzo (sonidegib) without first discussing it with your provider.
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                  What are the risks and warnings for Odomzo (sonidegib)?

                  Odomzo (sonidegib) 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.

                  risk-warning

                  Serious harm to unborn baby

                  • Risk factors: Pregnant females | Males with a partner who can have children

                    Results from animal studies suggest Odomzo (sonidegib) can cause serious harm or death to an unborn baby. Pregnant females shouldn’t take Odomzo (sonidegib). If you’re a female able to have children, you must have a negative pregnancy test before starting Odomzo (sonidegib). In addition, you need to use effective birth control while taking Odomzo (sonidegib) and for about 2 years after the last dose. Males who have a partner who can have children must use condoms while taking Odomzo (sonidegib) and for at least 8 months after the last dose.

                    risk-warning

                    Muscle problems

                    Most people who take Odomzo (sonidegib) 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 Odomzo (sonidegib) 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 Odomzo (sonidegib) depending on how severe your symptoms are.

                    risk-warning

                    Abnormal bone changes in children

                    Make sure to store Odomzo (sonidegib) out of reach of children. Aside from the possible serious side effects, Odomzo (sonidegib) can cause serious bone problems in growing children.

                    dosage

                    Odomzo (sonidegib) dosage forms

                    Typical dosing for Odomzo (sonidegib)

                    The usual dose of Odomzo (sonidegib) is 200 mg by mouth once a day on an empty stomach.

                    alternatives

                    What are alternatives to Odomzo (sonidegib)?

                    There are a number of medications that your doctor can prescribe in place of Odomzo (sonidegib). Compare a few possible alternatives below.
                    Odomzo (sonidegib)
                    Used for:

                    • Advanced basal cell carcinoma (BCC) that can’t be removed by surgery or radiation

                    View Prices
                    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

                    View Prices

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                    References

                    Best studies we found

                    American Cancer Society. (2019). Chemotherapy safety.

                    American Cancer Society. (2020). Nutrition for people with cancer.

                    Cantelli, M., et al. (2020). Vismodegib-induced alopecia: Trichoscopic and confocal microscopy evaluation. Skin Appendage Disorders.

                    View All References (11)

                    Gutzmer, R., et al. (2021). Key clinical adverse events in patients with advanced basal cell carcinoma treated with sonidegib or vismodegib: A post hoc analysis. Dermatology and Therapy.

                    Hamamichi, R., et al. (2006). Taste bud contains both short-lived and long-lived cell populations. Neuroscience.

                    Migden, M., et al. (2021). A review of hedgehog inhibitors sonidegib and vismodegib for treatment of advanced basal cell carcinoma. Journal of Drugs in Dermatology.

                    Mohan, S. V., et al. (2015). Management of cutaneous and extracutaneous side effects of smoothened inhibitor therapy for advanced basal cell carcinoma. Clinical Cancer Research.

                    National Comprehensive Cancer Network. (2022). Basal cell skin cancer.

                    Nguyen, N. M., et al. (2022). Hedgehog pathway inhibitors as targeted cancer therapy and strategies to overcome drug resistance. International Journal of Molecular Sciences.

                    Skin Cancer Foundation. (2022). Basal cell carcinoma overview.

                    Sun Pharmaceutical Industries, Inc. (2023). Odomzo- sonidegib capsule [package insert]. DailyMed.

                    Sun Pharmaceuticals Industries Ltd. (n.d.). What you might expect when taking Odomzo® capsules.

                    Villani, A., et al. (2022). Sonidegib-induced muscle spasms in the treatment of basal cell carcinoma: Strategies to adopt. Dermatologic Therapy.

                    Yang, Z., et al. (2017). Practical tips for managing hedgehog pathway inhibitor side effects. Practical Dermatology

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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