Vemurafenib

Other Names: Zelboraf®

About This Drug

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

Possible Side Effects

  • Tiredness
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.
  • Nausea
  • Joint, bone and muscle pain
  • Rash
  • Sensitivity to sunlight/light. You may get a skin rash/reaction while being out in the sun, sun lamps and tanning beds. 
  • Itching 
  • Skin growths

Note: Each of the side effects above was reported in 30% or greater of patients treated with vemurafenib. Not all possible side effects are included above. 

Warnings and Precautions

  • Blurred vision or other changes in eyesight, and/or sensitivity to light (photosensitivity); photosensitivity means that you may become more sensitive to the sun and/or light. Your eyes may water more, mostly in bright light.
  • Rare, but serious reaction causing swelling in the eye
  • Abnormal heartbeat
  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
  • Changes in your liver function
  • Changes in your kidney function, which can very rarely cause kidney failure
  • Severe allergic skin reaction. 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.
  • Sensitivity to sunlight/light. You may get a skin rash/reaction if you are in the sun, or are exposed to sun lamps and tanning beds.
  • Thickening of the tissue in your hands, which may cause one or more fingers to stay permanently bent towards the palm of your hand. You also may develop lumps (nodules) at the bottom of your feet. These may be painful and may make it difficult to walk.
  • This drug may raise your risk of getting a second cancer and/or the development of skin lesions that may or may not be cancer.
  • If you have received radiation treatments, your skin may become red after vemurafenib. This reaction is called "radiation recall." your body is recalling, or remembering, that it had radiation therapy. 

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

How to Take Your Medication

  • Swallow the medicine whole with or without food every 12 hrs daily. Do not chew or crush tablet. 
  • Missed dose: If you miss a dose, take it as soon as you think about it. If it is within 4 hours of your next dose, then skip the missed dose. Do not take 2 doses at the same time, instead, continue with your regular dosing schedule and contact your physician. 
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • 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. Discuss with your nurse or your doctor how to dispose of unused medicine. 

Treating Side Effects

 

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To help with hair loss, wash with a mild shampoo and avoid washing your hair every day.
  • Avoid rubbing your scalp, pat your hair or scalp dry.
  • Avoid coloring your hair.
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • 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 water in the body from losing too much fluid).
  • To help with nausea, 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.
  • Use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
  • Wear dark sun glasses when in the sun or bright lights.
  • If you do 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. 
  • If you received radiation, and your skin becomes red or irritated again, follow the same care instructions you did during radiation treatment. Be sure to tell the nurse or doctor administering your chemotherapy about your skin changes.

 

Food and Drug Interactions

  • Ask your doctor whether to avoid grapefruit or drink grapefruit juice while taking this medicine.  Grapefruit and grapefruit juice may raise the levels of vemurafenib in your body. This could make side effects worse.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with vemurafenib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort while taking vemurafenib 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
  • Fatigue that interferes with your daily activities
  • Blurred vision or other changes in eyesight, or to your eyes
  • Sensitivity to light
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Nausea that stops you from eating or drinking  and/or is not relieved by prescribed medicines
  • Pain that does not go away, or is not relieved by prescribed medicines
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Decreased urine
  • Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way
  • New skin lesions
  • New lumps (nodules) on your feet
  • Thickening of the tissue in your hand, difficulty moving one or more fingers
  • A new rash or a rash that is not relieved by prescribed
  • If you think you may be pregnant

Reproduction Concerns

  • 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 2 weeks after treatment. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: Women should not breast feed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.

Revised November 2017