OncoLink

Vandetanib (Caprelsa®)

OncoLink
Last Modified: September 13, 2012

Pronounced: van-DET-a-nib
Classification: Tyrosine Kinase Inhibitor

About Vandetanib

Vandetanib is a type of targeted therapy called a tyrosine kinase inhibitor. This means it works by targeting receptors present on the cancer cells. Vandetanib targets several different receptors, which in turn blocks tumor growth and angiogenesis (the development of a blood supply to the tumor).

How to Take Vandetanib

The typical dose of Vandetanib is 300mg taken once a day, but this may be reduced for some patients with impaired kidney function. This medication should be taken with water and should not be crushed or broken. It can be taken with or without food.

If you cannot swallow the tablet whole, you can place it is 2 ounces of non-carbonated water, stir and allow it to break down for about 10 minutes or until the tablets have become very small pieces (they will not dissolve completely). Drink the mixture right away. If residue remains in the glass, add additional water and drink.

Possible Side Effects of Vandetanib

There are a number of things you can do to manage the side effects of Vandetanib. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

High Blood Pressure

High blood pressure (hypertension) was seen in clinical trials of this medication. Patients should have their blood pressure checked regularly during therapy. If you experience any symptoms of high blood pressure, including headache, dizziness or lightheadedness, nose bleed or ringing in the ears, report this to your healthcare provider immediately.

Nausea and/or Vomiting

Take anti-nausea medications as prescribed. If you continue to have nausea or vomiting, notify your doctor or nurse so they can help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea & Vomiting Tip Sheet for more suggestions.

Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Fatigue

While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team and see OncoLink’s section on fatigue for helpful tips on dealing with this side effect.

Diarrhea

Your oncology team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods that absorbs fluid and can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange and grapefruit sections, boiled potatoes, white rice and products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses on non-alcoholic, un-caffeinated fluid a day to prevent dehydration. Read Low Fiber Diet for Diarrhea for more tips.

Decrease in Appetite

Visit OncoLink's section on Nutrition for tips on dealing with this side effect. Ask your nurse about nutritional counseling services.

  • Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals.
  • If you are not eating enough, nutritional supplements may help.
  • You may experience a metallic taste or dislike foods or beverages that you liked before receiving chemotherapy. These symptoms can last up to several months.
  • Avoid any food that you think smells or tastes bad. If red meat is a problem, eat chicken, turkey, eggs, dairy products and fish without a strong smell.
  • Flavor meat or fish by marinating it in sweet juices, sweet and sour sauce or dressings. Use seasonings like basil, oregano or rosemary. Bacon, ham and onion can also add flavor to vegetables.

Skin Reactions & Sun Safety

Severe (and rarely, life-threatening) skin reactions, which can range from mild to very severe, can develop while taking this medication. These include rash, acne, blisters, dry, peeling and itchy skin or redness and swelling of hands and/or feet. Notify your healthcare provider if you develop any skin reactions so they can determine the seriousness of the reaction.

Vandetanib can make your skin more sensitive to the sun. Be sure to practice sun safety - avoid sun during peak hours (10am-2pm), use a broad spectrum sunblock with a SPF of at least 15, wear a hat and sunglasses. This medication remains in your system for several weeks and this sensitivity can last for up to 4 months after stopping therapy.

Thyroid Hormone Levels

You can have changes in your thyroid hormone levels while taking vandetanib. Your healthcare provider will check your TSH (thyroid stimulating hormone) level prior to starting the medication, at 2 to 4 and 8 to 12 weeks after starting and every 3 months thereafter.

Reproductive Concerns

Do not become pregnant while taking vandetanib, as this medication can affect the fetus. You should use effective birth control while taking this medication and for at least 4 months after your last dose, even if your menstrual cycle stops or you believe your sperm is affected.

Serious Side Effects

There are a few rare, but serious, side effects. There is nothing you can do to prevent these side effects, but it is important you are aware of their symptoms. If you experience any of these symptoms, report them to your healthcare team or call 911 right away.

  • Heart Problems (a change in the electrical activity of the heart called QT prolongation).
    • Symptoms include: irregular or abnormal heart beat, feeling faint or lightheaded.
    • Your oncology team will regularly monitor blood levels of potassium, magnesium, calcium and TSH, as well as the electrical activity of your heart with regular electrocardiograms (ECG).
  • Lung problems (interstitial lung disease).
    • Symptoms include: new cough, shortness of breath and difficulty breathing.
  • Stroke
    • Symptoms include: numbness or weakness of the face, arm or leg, sudden confusion, trouble speaking or understanding, vision changes, trouble walking or with balance or coordination or severe headache.
  • Bleeding
    • Unexplained bleeding has occurred in clinical trials of this medication. Notify your healthcare provider if you have any bleeding.
  • Heart Failure
    • Symptoms include: shortness of breath, swollen ankles or legs, weight gain or pain in the chest.
  • RPLS (Reversible Posterior Leukoencephalopathy Syndrome)
    • This is a syndrome that causes swelling in the brain; it can be reversed by stopping the cause - in this case, the medication.
    • Symptoms include: headaches, seizure, confusion, changes in vision, difficulty thinking.