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
- abdominal pain
- acneiform rash
- alopecia
- anorexia
- arrhythmia exacerbation
- asthenia
- bleeding
- blurred vision
- cardiac arrest
- colitis
- corneal deposits
- corneal edema
- corneal opacification
- cough
- depression
- diarrhea
- dysgeusia
- dyspepsia
- dyspnea
- elevated hepatic enzymes
- exfoliative dermatitis
- fatigue
- fever
- GI bleeding
- GI perforation
- headache
- heart failure
- hematemesis
- hemoptysis
- hypertension
- hypertensive crisis
- hypocalcemia
- hypoglycemia
- hypomagnesemia
- hypothyroidism
- hypoxia
- infection
- keratopathy
- laryngitis
- leukoencephalopathy
- maculopapular rash
- nausea
- neutropenia
- onycholysis
- pancreatitis
- pharyngitis
- photosensitivity
- pleural effusion
- pneumonitis
- proteinuria
- pruritus
- QT prolongation
- rash
- renal failure (unspecified)
- rhinitis
- sinusitis
- Stevens-Johnson syndrome
- stroke
- thrombocytopenia
- torsade de pointes
- toxic epidermal necrolysis
- tracheitis
- ventricular tachycardia
- visual impairment
- vomiting
- xerosis
- 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
