vismodegib at a glance
Medicine class
Hedgehog pathway inhibitor
Main role
Treatment of selected adults with advanced basal cell carcinoma
Administration
Swallow the capsule whole with water; it may be taken with or without food
Major safety issue
Can cause embryo-fetal death or severe birth defects; a formal Pregnancy Prevention Programme applies
What is vismodegib used for?
UK-licensed uses in adults are:
Symptomatic metastatic basal cell carcinoma.
Locally advanced basal cell carcinoma when surgery or radiotherapy is inappropriate.
How does vismodegib work?
Vismodegib binds to and inhibits Smoothened, a signalling protein in the Hedgehog pathway. This reduces activation of genes involved in cancer-cell growth, survival and differentiation.
vismodegib preparations and strengths
Capsule
Route: Oral
Strengths: 150 mg
How to take vismodegib
Follow the specialist team's instructions. Practical administration points include:
Swallow capsules whole with water.
Do not open, crush or chew capsules because this could expose the patient or handler to their contents.
Capsules may be taken with or without food.
Do not stop treatment without discussing it with the treating specialist.
Return unused capsules to the pharmacist or clinical team; do not give them to anyone else.
vismodegib side effects
Common or expected effects
- Muscle spasms or cramps
- Hair loss
- Changed or lost sense of taste
- Reduced appetite and weight loss
- Tiredness
- Nausea, vomiting, diarrhoea, constipation or indigestion
- Joint, limb or other musculoskeletal pain
- Rash or itching
- Menstrual periods stopping
Get urgent medical advice
- Blistering, peeling or widespread rash, especially with fever, flu-like symptoms, swollen glands or ulcers affecting the mouth, eyes or genitals
- Possible liver injury, including clinically significant abnormalities in liver tests
vismodegib in pregnancy
Vismodegib is contraindicated during pregnancy because it can cause embryo-fetal death or severe birth defects. People who could become pregnant must follow the formal Pregnancy Prevention Programme, including supervised pregnancy testing and specified contraception during treatment and for 24 months afterwards. Men must use a condom with a female partner during treatment and for 2 months afterwards because vismodegib is present in semen. Suspected pregnancy or a missed period requires immediate contact with the treating team.
vismodegib while breastfeeding
Breastfeeding is contraindicated during vismodegib treatment and for 24 months afterwards. It is unknown whether vismodegib enters breast milk, but serious effects on development are possible.
vismodegib interactions
Check prescribed, non-prescription and herbal products before treatment. Important examples include:
St John’s wort
Must not be used with vismodegib because it may reduce vismodegib exposure and effectiveness.
Rifampicin, carbamazepine and phenytoin
These strong enzyme inducers should generally be avoided because they may lower vismodegib exposure and effectiveness.
Hormonal contraceptives
Reduced contraceptive effectiveness cannot be excluded during longer treatment, so the Pregnancy Prevention Programme’s specified methods must be followed.
Common questions about vismodegib
Answers are fully visible for fast scanning and source review.
What type of cancer is vismodegib used for?
It is licensed for selected adults with symptomatic metastatic basal cell carcinoma or locally advanced basal cell carcinoma that is unsuitable for surgery or radiotherapy.
Is vismodegib chemotherapy?
It is an anticancer treatment, but more specifically it is a targeted Hedgehog pathway inhibitor rather than conventional cytotoxic chemotherapy.
Can vismodegib be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.