Vizimpro
Vizimpro (dacomitinib) is one of the first-choice medications used to treat non-small cell lung cancer (NSCLC) that has spread. Specifically, it’s for people with certain genetic changes in the epithelial growth factor receptor (EGFR) gene. Vizimpro (dacomitinib) is conveniently taken by mouth once a day. It commonly causes diarrhea and skin reaction, which can be bothersome.
What is Vizimpro (dacomitinib)?
What is Vizimpro (dacomitinib) used for?
- Metastatic non-small cell lung cancer (NSCLC) with changes in the EGFR gene
How Vizimpro (dacomitinib) works
EGFR is a protein that’s involved in cell growth. It’s found in both normal and cancer cells. But cancer cells usually have more EGFR proteins than normal cells. Some people with NSCLC have changes in the EGFR gene (specifically, an exon 19 deletion mutation or the L858R exon 21 substitution).
Vizimpro (dacomitinib) is a kinase inhibitor. It targets EGFR proteins made by these mutated EGFR genes. When EGFR is blocked by Vizimpro (dacomitinib), the cancer cells can’t grow and spread as well.
Drug facts
Side effects of Vizimpro (dacomitinib)
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
- Diarrhea (87%)
- Rash (69%)
- Nail infection (64%)
- Painful sores inside the mouth and throat (45%)
- Low red and white blood cell counts (up to 44%)
- Low albumin levels (44%)
- Higher liver enzyme levels (up to 40%)
- High blood sugar (36%)
- Low electrolyte levels (up to 33%)
- Loss of appetite (31%)
- Dry skin (30%)
- Weight loss (26%)
- Hair loss (23%)
- Itchy skin (21%)
- Cough (21%)
Less Common Side Effects
- Pain in arms and legs
- Constipation
- Trouble breathing
- Lack of energy
- Infection of your sinuses or throat
- Muscle, joint, and bone pain
- Trouble sleeping
- Chest pain
- Pink eye
- Nausea
- Nose bleeds or inflammation and sores inside the nose
- Swelling or blisters on the hands and feet
Vizimpro (dacomitinib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious lung problems: dry cough, fever, trouble breathing, fast or shallow breathing, chest pain
- Severe diarrhea
The following Vizimpro (dacomitinib) 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
- Dry cough, shortness of breath or trouble breathing
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Severe or prolonged diarrhea
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Change in nail shape, thickness, or color
- Dry skin
- Hair loss
- Loss of appetite with weight loss
- Nausea
- Pain, redness, or swelling with sores inside the mouth or throat
Pros and cons of Vizimpro (dacomitinib)
Pros
- Taken by mouth once a day
- Can be taken with or without food
- One of the recommended treatment option for NSCLC with changes in the EGFR gene
Cons
- Only available as a brand medication, so it might be expensive
- Commonly causes diarrhea and rash
- Raises risk of serious lung problems
Pharmacist tips for Vizimpro (dacomitinib)
- Take Vizimpro (dacomitinib) with or without food at the same time every day. Swallow the tablet whole so that the medication works properly. Don’t cut, chew, or crush the tablet.
- If you miss a dose of Vizimpro (dacomitinib), or vomit after taking a dose, don’t take another dose. Take your next dose at the normally scheduled time.
- If you need a medication to lower stomach acid, talk with your healthcare provider. You can't take proton pump inhibitors (PPIs), such as omeprazole (Prilosec) and pantoprazole (Protonix), with Vizimpro (dacomitinib) because they interact with each other. You might be able to take other medications, such as famotidine (Pepcid), instead. If you do, you'll need to take Vizimpro (dacomitinib) at least 6 hours before or 10 hours after taking famotidine (Pepcid).
- Vizimpro (dacomitinib) commonly causes diarrhea. Let your provider know right away if you experience diarrhea. It’s important to stay hydrated if you experience diarrhea so you don’t lose too much fluids and electrolytes.
- People taking Vizimpro (dacomitinib) who spend time in the sun can be at higher risk of developing skin reactions. If possible, limit the amount of time you spend in the sunlight. To protect your skin when outside, use sunscreen or clothes that cover your skin.
- Because skin reactions are common in people taking Vizimpro (dacomitinib), start using a skin moisturizer when you begin your treatment. This can help lessen some of the skin irritations Vizimpro (dacomitinib) might cause.
- Store Vizimpro (dacomitinib) out of the way from children or pets so that they don't accidentally touch or eat it. Ask your provider or pharmacist about the best way to handle and throw away Vizimpro (dacomitinib) safely. Anticancer medications can be very harmful to people who handle or come into contact with them.
Common questions about Vizimpro (dacomitinib)
No. There are two types of lung cancer: non-small cell and small cell. Vizimpro (dacomitinib) is approved to treat non-small cell lung cancer (NSCLC) that has spread. Specifically, it’s used to treat NSCLC with gene changes in the EGFR gene. Your provider will perform different tests to help figure out what type of lung cancer you have. Knowing what type of lung cancer you have will help your provider decide what treatment is best for you.
You should take Vizimpro (dacomitinib) as instructed by your provider. How long you continue Vizimpro (dacomitinib) treatment depends on several factors, including how well the medication is working to treat your cancer, and how well you tolerate the side effects. Don’t stop receiving Vizimpro (dacomitinib) without first discussing it with your provider.
Diarrhea is a common side effect of Vizimpro (dacomitinib). Having diarrhea can be dangerous because it can cause you to lose too much body fluid and electrolytes. If you experience diarrhea, let your provider know right away. They can tell you whether or not you need more medical attention based on your symptoms. If your provider says you can manage your symptoms at home, they might prescribe you antidiarrheal medications, such as loperamide (Imodium A-D), to help control the bowel movements. You should also drink 8 to 10 glasses of clear liquids daily to stay hydrated. Try to avoid foods that can make the diarrhea worse, such as caffeine, spicy foods, or foods that are high in fat.
You’re likely to develop nail problems, such as nail infections, when you take Vizimpro (dacomitinib). In fact, 64% of people taking Vizimpro (dacomitinib) in clinical trials experienced this as a side effect. Let your provider know if you develop any changes in your nails. There are also a few things you can do to help keep your nails healthy. It’s important to avoid any damage to the nail, so you should wear gloves when doing chores, like gardening or cleaning. If you regularly get manicures and pedicures, you might want to stop or get them less often. Be sure to also keep the nail areas dry and clean, especially when your hands might be exposed to liquids.
Vizimpro (dacomitinib) isn’t recommended for use in pregnancy, because it might cause harm to your unborn baby. If you’re able to become pregnant, you should use birth control while taking Vizimpro (dacomitinib) and for 17 days after the last dose. Let your provider know right away if you become pregnant while taking this medication.
It isn’t known if Vizimpro (dacomitinib) can pass into breast milk and what effects the medication has on nursing infants if it does. Discuss with your provider about the risks and benefits of breastfeeding while taking Vizimpro (dacomitinib). To be safe, they might recommend that you avoid breastfeeding during treatment and for 17 days after your last dose. Your provider can help answer any questions you have about breastfeeding or recommend other ways to feed your baby while receiving Vizimpro (dacomitinib) or after treatment.
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Risks and warnings for Vizimpro (dacomitinib)
Vizimpro (dacomitinib) 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.
Lung problems
Although rare, Vizimpro (dacomitinib) can cause serious lung problems, like inflammation of your lungs or interstitial lung disease (ILD). Sometimes, this can be life-threatening. If you develop lung problems, your provider will tell you to stop Vizimpro (dacomitinib) treatment. Let your provider know if you have any new or worsening breathing problems, such as dry cough, trouble breathing, taking fast or shallow breaths.
Diarrhea
Vizimpro (dacomitinib) causes diarrhea in most people. In some cases, this can be life-threatening. If you develop any diarrhea, let your provider know right away. They might have you stop taking Vizimpro (dacomitinib) for a little while or lower your dose, until you no longer have loose bowel movements. In the meantime, your provider will tell you to drink more fluids to stay hydrated. They might also prescribe you an anti-diarrhea medication, such as loperamide (Imodium A-D) to help stop your diarrhea.
Skin problems
- Risk factors: Sun exposure
People taking Vizimpro (dacomitinib) commonly experienced skin reactions, such as dry skin, redness, rash, and peeling or blistering skin. Your risk for these reactions is higher if you spend more time under the sun. Before you start Vizimpro (dacomitinib) treatment, your provider will recommend for you to add a moisturizer to your skin routine and to limit the amount of time you spend in the sun. If you develop any skin reactions, your provider might ask you stop taking Vizimpro (dacomitinib) for a little while until your skin heals, then restart treatment at a lower dose. They can also give you antibiotics or steroids that you can apply to the skin to help alleviate symptoms. Tell your provider if you have any symptoms of skin reactions.
Harm to unborn baby
Vizimpro (dacomitinib) hasn’t been studied in human pregnancies, but animal studies show that it can cause harm to unborn babies if taken by mothers during pregnancy. If you're able to become pregnant, you should use birth control while you’re receiving Vizimpro (dacomitinib) and for at least 17 days after your last dose. Let your provider know right away if you become pregnant during this time.
Vizimpro (dacomitinib) dosage
Typical dosage for Vizimpro (dacomitinib)
The typical dose is to take 45 mg by mouth once daily.
What are alternatives to Vizimpro (dacomitinib)?
