Care During Chemotherapy and Beyond
(vis moe DEG ib)
Vismodegib is the generic for the trade chemotherapy drug Erivedge. In some cases,
health care professionals may use the trade name Erivedge when referring to the
generic drug name Vismodegib.
Drug type: Vismodegib is a targeted therapy. It is a hedgehog pathway
inhibitor- (For more detail, see "How this drug works," below.)
What Vismodegib Is Used For:
- For the treatment of metastatic basal cell carcinoma, or locally-advanced basal
cell carcinoma that has recurred following surgery or in patients who are not candidates
for surgery, and not candidates for radiation therapy.
Note: If a drug has been approved for one use, physicians may elect to use this
same drug for other problems if they believe it may be helpful.
How Vismodegib Is Given:
- Vismodegib is a capsule, taken by mouth, once daily. It can be taken with or without
- Take Vismodegib exactly as prescribed.
- Swallow Vismodegib whole. Do not crush, dissolve or open capsules.
- Do not change your dose or stop Vismodegib unless your health care provider tells
- If you miss a dose, do not make up; resume dosing with the next scheduled dose.
- Do not take more than 1 dose of Vismodegib at one time. Call your health care provider
right away if you take too much.
- The amount of Vismodegib that you will receive depends on many factors, your general
health or other health problems, and the type of cancer or condition being treated.
Current recommendation is for one tablet twice daily, higher doses do not give a
better response and may cause increased toxicity. Your doctor will determine your
dose and schedule.
Important things to remember about the side effects of Vismodegib:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for patients
taking Vismodegib :
These side effects are less common side effects (occurring in about 10-29%) of patients
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your health
care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Fever of 100.4° F (38° or higher, chills)
- Signs of a reaction: Wheezing; chest tightness; fever; itching; bad cough; seizures;
or swelling of the face, lips, tongue or throat.
Always inform your health care provider if you experience any unusual symptoms.
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
- Diarrhea (4-6 episodes in a 24-hour period).
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst,
dry mouth, dark and decrease amount of urine, or dizziness.
Always inform your health care provider if you experience any unusual symptoms.
- Before starting Vismodegib treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.). Do not take aspirin, or products containing aspirin unless
your doctor specifically permits this.
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking Vismodegib.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (Vismodegib during pregnancy may
cause birth defects). Birth control is required during treatment and for 7 months
after completion of treatment for both men and women. Contact your health care provider
right away if you feel you might be pregnant. Women who are pregnant or become pregnant
must be advised of the potential hazard to the fetus. Barrier methods of contraception,
such as condoms, are recommended. Discuss with your doctor when you may safely become
pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- You should not drink grapefruit juice or eat grapefruit during your treatment with
Vismodegib. It may make the amount of Vismodegib in your blood increase to a harmful
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- If you should experience nausea, take anti-nausea medications as prescribed by your
doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that are
effective in managing such problems.
Monitoring and Testing:
If you are female, you will be checked for pregnancy while you are taking Vismodegib.
You will be checked regularly by your health care professional while you are taking
Vismodegib, to monitor side effects and check your response to therapy
How Vismodegib Works:
Targeted therapy is the result of about 100 years of research dedicated to understanding
the differences between cancer cells and normal cells. To date, cancer treatment
has focused primarily on killing rapidly dividing cells because one feature of cancer
cells is that they divide rapidly. Unfortunately, some of our normal cells divide
rapidly too, causing multiple side effects.
Targeted therapy is about identifying other features of cancer cells. Scientists
look for specific differences in the cancer cells and the normal cells. This information
is used to create a targeted therapy to attack the cancer cells without damaging
the normal cells, thus leading to fewer side effects. Each type of targeted therapy
works a little bit differently but all interfere with the ability of the cancer
cell to grow, divide, repair and/or communicate with other cells.
There are different types of targeted therapies, defined in three broad categories.
Some targeted therapies focus on the internal components and function of the cancer
cell. The targeted therapies use small molecules that can get into the cell and
disrupt the function of the cells, causing them to die. There are several types
of targeted therapy that focus on the inner parts of the cells. Other targeted therapies
target receptors that are on the outside of the cell. Therapies that target receptors
are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the
blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.
Basal cell cancer is associated with mutations in the “Hedgehog” pathway. Hedgehog
controls cell growth in embryos, while generally it is not active in adult tissue
cells. Hedgehog mutations associated with basal cell cancer can activate the pathway
resulting in uncontrolled growth of skin basal cells. Vismodegib works by interfering
with the proteins involved in activating the Hedgehog signal.
Research continues to identify which cancers may be best treated with targeted therapies
and to identify additional targets for more types of cancer.
We strongly encourage you to talk with your health care professional about your
specific medical condition and treatments. The information contained in this website
is meant to be helpful and educational, but is not a substitute for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org