Vemurafenib

What is Vemurafenib

Vemurafenib is a serine/threonine-protein kinase BRAF inhibitor. Vemurafenib is indicated for the treatment of melanoma in patients with V600E mutations of the BRAF gene; it is not indicated for use in patients with wild-type BRAF.

Vemurafenib is also indicated for the treatment of Erdheim-Chester disease in patients with BRAF V600E mutations.

Secondary malignancies including new primary cutaneous malignancies and noncutaneous squamous cell carcinoma have been reported; monitor patients closely for signs or symptoms of new malignancies.

Brand Name

Zelboraf

Indications

• colorectal cancer
• Erdheim-Chester disease
• hairy-cell leukemia
• malignant melanoma

Side Effects

1. alopecia
2. alopecia
3. anaphylactoid reactions
4. anorexia
5. arthralgia
6. arthralgia
7. asthenia
8. asthenia
9. atrial fibrillation
10. back pain
11. back pain
12. blurred vision
13. coagulopathy
14. constipation
15. constipation
16. cough
17. cranial nerve palsies
18. diarrhea
19. diarrhea
20. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
21. Dupuytren’s contracture
22. dysgeusia
23. elevated hepatic enzymes
24. elevated hepatic enzymes
25. eosinophilia
26. erythema
27. erythema nodosum
28. fatigue
29. fatigue
30. fever
31. fever
32. folliculitis
33. headache
34. headache
35. hyperbilirubinemia
36. hyperkeratosis
37. hyperkeratosis
38. hypertension
39. hypertension
40. hypotension
41. interstitial nephritis
42. iritis
43. lymphadenopathy
44. maculopapular rash
45. maculopapular rash
46. musculoskeletal pain
47. myalgia
48. myalgia
49. myocarditis
50. nausea
51. nausea
52. nephrotoxicity
53. neutropenia
54. new primary malignancy
55. palmar-plantar erythrodysesthesia (hand and foot syndrome)
56. pancreatitis
57. panniculitis
58. peripheral edema
59. peripheral edema
60. peripheral neuropathy
61. photophobia
62. photosensitivity
63. photosensitivity
64. plantar fibromatosis
65. pleural effusion
66. pruritus
67. pruritus
68. QT prolongation
69. QT prolongation
70. radiation recall reaction
71. rash
72. rash
73. renal failure (unspecified)
74. renal tubular necrosis
75. retinal thrombosis
76. skin cancer
77. Stevens-Johnson syndrome
78. toxic epidermal necrolysis
79. uveitis
80. vasculitis
81. vomiting
82. vomiting
83. xerosis

Monitoring Parameters

• ECG
• LFTs
• serum bilirubin
• serum creatinine
• serum electrolytes
• skin cancer screening exam

Contraindications

• alcoholism
• bradycardia
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• coagulopathy
• contraception requirements
• coronary artery disease
• diabetes mellitus
• Dupuytren’s contracture
• females
• fever
• geriatric
• heart failure
• hepatic disease
• hypertension
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypotension
• iritis
• long QT syndrome
• malnutrition
• myocardial infarction
• new primary malignancy
• plantar fibromatosis
• pregnancy
• QT prolongation
• radiation therapy
• renal failure
• reproductive risk
• serious rash
• sunburn
• sunlight (UV) exposure
• thyroid disease

Interactions

• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
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