vandetanib (Caprelsa)

Indications

• symptomatic or progressive medullary thyroid cancer in patients with unresectable, locally advanced, or metastatic disease

Dosage

• 300 mg PO QD

Dosage adjustment in renal failure

• start 200 mg PO QD if creatinine clearance < 50 ml/min

Pharmacokinetics

• 1/2 life of 19 days

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

More general terms

• small inhibitory antineoplastic agent (ib drug)