Vandetanib

What is Vandetanib

Vandetanib is a kinase inhibitor that is indicated for the treatment of symptomatic or progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.

In vitro, vandetanib inhibits new blood vessel formation and epidermal growth factor receptor-dependent cell survival.

The drug exhibits a long elimination half-life (19 days) and can prolong the QT interval. Vandetanib is only available through a restricted distribution program, the Caprelsa REMS program; only prescribers and pharmacies registered with the restricted distribution program are allowed to prescribe and dispense this drug. Vandetanib was approved by the FDA in 2011.

Brand Name

Caprelsa

Indications

  • thyroid cancer

For the treatment of symptomatic or progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease

Side Effects

  1. abdominal pain
  2. acneiform rash
  3. alopecia
  4. anorexia
  5. arrhythmia exacerbation
  6. asthenia
  7. bleeding
  8. blurred vision
  9. cardiac arrest
  10. colitis
  11. corneal deposits
  12. corneal edema
  13. corneal opacification
  14. cough
  15. depression
  16. diarrhea
  17. dysgeusia
  18. dyspepsia
  19. dyspnea
  20. elevated hepatic enzymes
  21. exfoliative dermatitis
  22. fatigue
  23. fever
  24. GI bleeding
  25. GI perforation
  26. headache
  27. heart failure
  28. hematemesis
  29. hemoptysis
  30. hypertension
  31. hypertensive crisis
  32. hypocalcemia
  33. hypoglycemia
  34. hypomagnesemia
  35. hypothyroidism
  36. hypoxia
  37. infection
  38. keratopathy
  39. laryngitis
  40. leukoencephalopathy
  41. maculopapular rash
  42. nausea
  43. neutropenia
  44. onycholysis
  45. pancreatitis
  46. pharyngitis
  47. photosensitivity
  48. pleural effusion
  49. pneumonitis
  50. proteinuria
  51. pruritus
  52. QT prolongation
  53. rash
  54. renal failure (unspecified)
  55. rhinitis
  56. sinusitis
  57. Stevens-Johnson syndrome
  58. stroke
  59. thrombocytopenia
  60. torsade de pointes
  61. toxic epidermal necrolysis
  62. tracheitis
  63. ventricular tachycardia
  64. visual impairment
  65. vomiting
  66. xerosis
  67. xerostomia

Monitoring Parameters

  • ECG
  • LFTs
  • serum creatinine/BUN
  • serum electrolytes
  • thyroid function tests (TFTs)

Contraindications

  • alcoholism
  • bleeding
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • contraception requirements
  • coronary artery disease
  • diabetes mellitus
  • diarrhea
  • driving or operating machinery
  • encephalopathy
  • females
  • geriatric
  • GI bleeding
  • heart failure
  • hepatic disease
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothyroidism
  • impaired wound healing
  • infertility
  • long QT syndrome
  • malnutrition
  • myocardial infarction
  • pneumonitis
  • pregnancy
  • pregnancy testing
  • pulmonary disease
  • QT prolongation
  • renal disease
  • renal failure
  • renal impairment
  • reproductive risk
  • requires an experienced clinician
  • serious rash
  • stroke
  • sunlight (UV) exposure
  • surgery
  • torsade de pointes

Interactions

  • Alfuzosin
  • Alogliptin; Metformin
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
  • Apalutamide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Asenapine
  • Atomoxetine
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azithromycin
  • Bedaquiline
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Canagliflozin; Metformin
  • Carbamazepine
  • Ceritinib
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clofazimine
  • Clomipramine
  • Clozapine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Crizotinib
  • Dapagliflozin; Metformin
  • Dasatinib
  • Degarelix
  • Desflurane
  • Desipramine
  • Deutetrabenazine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Digoxin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Doxepin
  • Dronedarone
  • Droperidol
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Eliglustat
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Enflurane
  • Entrectinib
  • Enzalutamide
  • Eribulin
  • Ertugliflozin; Metformin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Ezogabine
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluvoxamine
  • Foscarnet
  • Fosphenytoin
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Glipizide; Metformin
  • Glyburide; Metformin
  • Goserelin
  • Granisetron
  • Halogenated Anesthetics
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Inotuzumab Ozogamicin
  • Isoflurane
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ivosidenib
  • Ketoconazole
  • Lapatinib
  • Lefamulin
  • Lenvatinib
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levofloxacin
  • Linagliptin; Metformin
  • Lithium
  • Lofexidine
  • Long-acting beta-agonists
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Macimorelin
  • Maprotiline
  • Mefloquine
  • Meperidine; Promethazine
  • Mephobarbital
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methadone
  • Metronidazole
  • Midostaurin
  • Mifepristone
  • Mirtazapine
  • Mitotane
  • Moxifloxacin
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Ondansetron
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Ozanimod
  • Paliperidone
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenobarbital
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pitolisant
  • Porfimer
  • Posaconazole
  • Pramipexole
  • Primaquine
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifampin
  • Rilpivirine
  • Risperidone
  • Romidepsin
  • Saquinavir
  • Selpercatinib
  • Sertraline
  • Sevoflurane
  • Short-acting beta-agonists
  • Siponimod
  • Solifenacin
  • Sorafenib
  • Sotalol
  • St. John’s Wort, Hypericum perforatum
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Thioridazine
  • Tolterodine
  • Toremifene
  • Trazodone
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Verteporfin
  • Voriconazole
  • Vorinostat
  • Ziprasidone
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