vandetanib at a glance
Medicine class
Protein kinase inhibitor targeting RET, VEGF and EGF receptor signalling.
Licensed use
Aggressive, symptomatic RET-mutant medullary thyroid cancer that is unresectable, locally advanced or metastatic.
Food
Tablets may be taken with or without food.
Key safety issue
Vandetanib can prolong the heart's QT interval, so ECG and blood-test monitoring are essential.
What is vandetanib used for?
UK licensing represented by the selected product covers:
Treatment of aggressive and symptomatic RET-mutant medullary thyroid cancer when disease is unresectable and locally advanced or metastatic.
Use in adults, children and adolescents aged 5 years and older. A RET mutation should be confirmed using a validated test before treatment starts.
How does vandetanib work?
Vandetanib blocks several tyrosine kinases, particularly RET, VEGFR-2 and EGFR. This can reduce growth signals within medullary thyroid cancer cells and restrict the formation of blood vessels that support the tumour; its precise overall action in advanced disease is not fully defined.
vandetanib preparations and strengths
Tablet
Route: Oral
Strengths: 100 mg, 300 mg
How to take vandetanib
Take vandetanib exactly as directed by the specialist team. It may be taken with or without food.
Swallow the tablet with water.
If swallowing is difficult, place the tablet—without crushing it—in half a glass of still water, stir until dispersed, drink immediately, then rinse the glass with more water and drink the rinse.
The dispersion may also be given through a nasogastric or gastrostomy tube when directed by the clinical team.
Do not change or stop treatment without discussing it with the prescriber.
vandetanib side effects
Common or expected effects
- Diarrhoea, abdominal discomfort, nausea or vomiting
- Rash, acne-like changes, dry skin, nail changes or sensitivity to sunlight
- Tiredness, weakness, headache or dizziness
- High blood pressure
- Reduced appetite
- Blurred vision or corneal changes
Get urgent medical advice
- QT prolongation or dangerous heart rhythm changes, which may cause fainting or palpitations
- Severe diarrhoea, dehydration or electrolyte disturbance
- Severe high blood pressure
- Interstitial lung disease, causing breathlessness, cough or fever
- Severe blistering or peeling skin reactions
- Seizures, confusion, headache or visual symptoms associated with posterior reversible encephalopathy syndrome
- Kidney failure, gastrointestinal bleeding or bowel perforation
vandetanib in pregnancy
Human pregnancy information is limited, and vandetanib may harm an unborn baby or increase the risk of pregnancy loss. Specialist review is essential if pregnancy is planned or occurs; effective contraception is required for people who could conceive or father a child during treatment and for at least four months after the last dose.
vandetanib while breastfeeding
Breastfeeding is contraindicated during vandetanib treatment. Because vandetanib remains in the body for a long time, ask the oncology team when breastfeeding may safely restart after treatment ends.
vandetanib interactions
Vandetanib has important interactions, especially with medicines that affect heart rhythm or drug transport. Check prescribed, non-prescription and herbal products with the specialist team.
QT-prolonging medicines
Medicines including moxifloxacin, intravenous erythromycin, toremifene and class IA or III antiarrhythmics are contraindicated because the combination can provoke dangerous heart rhythms.
Ondansetron
It can add to QT prolongation and is not recommended with vandetanib unless specialist monitoring and management are arranged.
Rifampicin, carbamazepine, phenobarbital and St John's wort
These strong CYP3A4 inducers can reduce vandetanib exposure and should generally be avoided.
Common questions about vandetanib
Answers are fully visible for fast scanning and source review.
Is vandetanib a chemotherapy medicine?
It is a targeted anti-cancer treatment rather than conventional cytotoxic chemotherapy. It inhibits several protein kinases involved in tumour-cell signalling and blood-vessel growth.
Does vandetanib require a positive RET mutation test?
Yes. For the licensed indication, a RET mutation should be confirmed with a validated test before treatment because activity is considered insufficient when no RET mutation is identified.
Can vandetanib be taken with food?
Yes. Food does not materially alter vandetanib exposure, so the tablet may be taken with or without food.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.