Vandetanib (Caprelsa®)

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About This Drug

Vandetanib is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Nausea
  • Diarrhea (loose bowel movements)
  • Colitis, which is swelling (inflammation) in the colon - symptoms are loose bowel movements (diarrhea) stomach cramping, and sometimes blood in the bowel movements
  • Pain in your abdomen
  • Decreased appetite (decreased hunger)
  • Headache
  • Upper respiratory infection
  • Rash
  • Pimple-like rash
  • High blood pressure

Note: Each of the side effects above was reported in 20% or greater of patients treated with vandetanib. Not all possible side effects are included above.

Warnings and Precautions

  • Stroke, which can rarely be life-threatening. Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), have trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • Changes in heart function such as serious and life-threatening abnormal heartbeat and congestive heart failure (your heart has less ability to pump blood properly)
  • Scarring of the lungs that causes stiffness in the lungs and/or inflammation (swelling) of the lungs which makes breathing difficult and can be life-threatening 
  • Severe diarrhea
  • Serious abnormal bleeding, which can rarely be life-threatening – symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding
  • Severe allergic skin reaction, which can be life-threatening. You may develop blisters on your skin that are filled with fluid or a severe red rash all over your body that may be painful. You may be sensitive to the sun for up to 4 months after discontinuing this medication.
  • Severe high blood pressure
  • Changes in your thyroid function. Thyroid replacement medication may need to be increased.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • This medication is only available through a special program called Caprelsa® REMS. You must use a specialized pharmacy and cannot fill a prescription at your regular pharmacy. Your nurse will help you get started. 

How to Take Your Medication

  • Swallow the medicine whole with water, with or without food. Do not crush or chew tablets.
  • If you have difficulty swallowing, dissolve tablet in 2 ounces of noncarbonated water (no other  liquid should be used) while stirring for 10 minutes. The tablet will not completely dissolve. Swallow immediately, mix any leftover medicine with 4 ounces of noncarbonated water and swallow.
  • Missed dose: If you miss a dose and your next dose is due in more than 12 hours, then take the missed dose, and take your next dose at the regular time. If you miss a dose, and your next dose is due in less than 12 hours, then skip the missed dose, take your next dose at the regular time, and contact your doctor. 
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • If you get any of the content of a crushed tablet on your skin, you should wash the area of the skin well with soap and water right away. Call your doctor if you get a skin reaction 
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • To help with decreased appetite, eat small, frequent meals. Eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements. Consider using sauces and spices to increase taste. Daily exercise, with your doctor’s approval, may increase your appetite.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended). 
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Limit sun exposure and cover up when you are out in the sun during your treatment and for at least 4 months after treatment. Apply sunscreen routinely when outdoors and wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.

Food and Drug Interactions

  • There are no known interactions of vandetanib with food.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with vandetanib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort while taking vandetanib as this may lower the levels of the drug in your body, which can make it less effective.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • A headache that does not go away
  • Blurry vision or other changes in eyesight
  • Confusion and/or agitation
  • Seizures
  • Hallucinations
  • Trouble understanding or speaking
  • Numbness or lack of strength to your arms, legs, face, or body
  • Blurry vision or changes in your eyesight
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Pain in your chest
  • Wheezing or trouble breathing
  • Dry cough
  • Coughing up yellow, green, bloody mucus and/or blood
  • Feeling that your heart is beating fast or in a not normal way (palpitations) 
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Tiredness that interferes with your daily activities
  • Unexplained weight gain
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Pain in your abdomen that does not go away
  • Easy bleeding or bruising
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • A new rash or a rash that is not relieved by prescribed medicines
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 4 months after treatment. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: Women should not breastfeed during treatment and for 4 months after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised November 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.