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vandetanib (Caprelsa)
Indications:
- symptomatic or progressive medullary thyroid cancer in patients with unresectable, locally advanced, or metastatic disease
Dosage:
- 300 mg PO QD
Pharmacokinetics:
- 1/2 life of 19 days
Dosage adjustment in renal failure:
- start 200 mg PO QD if creatinine clearance < 50 ml/min
Monitor:
- electrocardiogram
- serum potassium
- serum calcium
- serum magnesium
- serum TSH
- obtained at baseline, at 2-4 weeks & 8-12 weeks after starting treatment & subsequently every 3 months
Adverse effects:
- QT prolongation (boxed warning)
- torsades de pointes
- sudden death
Drug interactions:
- conconcurrent use of strong CYP3A4 inhibitors may diminish levels of vandetanib; however no clinically significant interaction was found with vandetanib & itraconazole
- avoid concurrent use of other agents that may cause QT prolongation
Mechanism of action:
- kinase inhibitor
Notes:
- only prescribers & pharmacies certified through the Vandetanib Risk Evaluation Mitigation Strategy Program, a restricted distribution program, are able to prescribe & dispense vandetanib
General
small inhibitory antineoplastic agent (ib drug)
References
- FDA: Vandetanib
http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm250347.htm
- Caprelsa (vandetanib) Tablets
http://www1.astrazeneca-us.com/pi/vandetanib.pdf